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I'~.Y.~~y~dv~rix ~ .~~~:~;:~t~ion Act Notice
<br />Public reporting burden for this collection o; information is estimated to vary from a range of 10 hour as an
<br />average per response for some minor facilities, to 110 hours as an average per response for some major
<br />facilities, with a weighted average for major and minor facilities of 18 hours per response, including time for
<br />reviewing instrtrctions, searching existing data sources, gathering attd maintaining the data needed, and
<br />completing and reviewing the collection of imformation, including suggestion for reducing this burden, to
<br />Chief, Information Policy Branch, PM-223, U.S. Environmental Protection Agency, 401 M Street, S.W.
<br />Washington, DC 20460; and to the Cffice of Information and Regulatory Affairs, Office of Management and
<br />Budget, Washington, DC 20503.
<br />~~neral Instructions
<br />I. If form has been partially completed by preprinting, disregazd instmction directed at entry of that information already
<br />preprinted.
<br />2. Enter "Pat•mittee Nome/ivlailing Aldress (and facility name location, if different)," "Permit NumEsr," and "Disch.rrga
<br />Numhz/' where indicated. (A sepazate form is required for each dschage.)
<br />3. Enter dales beginning and editing "zLlati[w-ingPzrio.~"covered by form where indicated.
<br />h. linter each "Parameter" as specified in monitoring requirements of permit.
<br />5. F,n_er "S,rmpl~ i~L•~strrartznt" dat<~ for each parameter under "~u1N!i1~ "and ~:v~iiry" as stecified in permit. 'Ava,•aoz"is
<br />nornally arithmetic ava*age (gcoraatrc average for bacb_rial aaram_ters) of all samp;e mea~uremcris for each parameter
<br />obtaint~1 during ";viorrit;rizt,; l ~~ i .l'; "dfirirrrm" and ,'~lini.nznn" ar,: net.nally extreme high and love maasuremrnt,
<br />obtained dt_iug ".:ir.n:i:, ing !':r%- +". (Mote In municipals ~~~'.h secondary tre:Jr~cN rcquircmert: Enter 30-dcy eve-age
<br />of sample msa;t~_cmcnts under "~(.~ ~,voe, a-d eate maximums 7-day avargc of szmplc mezsur:rnenis obtained d rirg
<br />monitoring period under "iviaxin, vt,r.")
<br />6. ;rn : "r'en;~i! l~eTttirerr_n["for eac1: parameter undo: ",r,.rr.!i;,"end "[iualily" as specified in pcmi'.
<br />7. Under "h4r ir" enter number of sample mc~sw c~r.ent cv~~.ing ~,onitor ng peri ~:;i th:.: _>.cr~d mnzimcm (t nd/or mire rr:wn
<br />or 7-day a~~arege 25 appropri_~:c) pcrmi: rcc;eiremc:.' fur cacir par..tnatc. rf none, er.[ar "0".
<br />8. Ln'c "r•r„quar_y of~i,,aly.r-," froth cs "S_.,; L ;-;.•.~tz~,~.,~,a~t" (.c.cJ frr;~icncy n'sn~nFting and ancl~•sis ~seil duiin;;
<br />nooiforing period) a rd as ";'~, ,n t<_'.ir%,~tn.;•,"a:~cifiCd i~ pun ~!. {c.g. rrl.r "~ srt,"for conC'ruo~s monitorirg, "i ~?"
<br />;or one day per rrce':, "1/30" fo~ one day per month, "1/90" for one day par qur_Yicr, etc.)
<br />S. =ai_r "So„~F!d TjT~"bu.h as "S~,r~?le i::__ ~.•,~am_ :!'• (ectua! .^m~i_ type t!~ ~d c:u~ing monitoring pc,iod; and a_s "T~:-n,~r
<br />k,:fnir,:,a.~tt.' (e.,;. 1.zter "Graf" Cor :ndividu~i sswp'_, "?s11.:" fn; 24-~eur co,rposite "A'/~:" for con~:nuous
<br />monitoring, etc.)
<br />10. 1'lhere violci'uns of r..rnit requiremens are r,ported, eTtsdi a bri_(e!:plana ion iA ce: tribe cause and cen'ective actioaa
<br />to be la:[en, and reference each violation by date.
<br />11. ".ro disehazga"occurs during monitoring period, e.,*.er "iQo Discharge" across fon.r iu place of data enlrt.
<br />12. Emcr "T.ramt/Titlt '~J PrinciTJ.rsurtied Gi)'z_=:'' with "Si;;n~ttn-,r rf £rin.i; a Ez~,zrlnz G~~~; rf Aur;ro.-ize~/
<br />fig,rnt, ""Telaplrone N~mhar, "and "Carr" at bottom of Corm.
<br />13. ?:.a it signed Report to Office(s) by aatc(s) specified in permit. Retain copy for your records.
<br />'<i. for detailed instructions for use of this Discharge frl~nitnring R.pwt (G.t•~ form may be obtained from Office(s)
<br />specified in permit.
<br />Legal Notice
<br />This report is required by law (33 U.S.C. 1318; 40 C.F.R. 125.27). Failure to report or failure to report ttuthfiilly can result i^
<br />civil penalties not to exceed $10,000 per day of violation; or in criminal penalties not [o exceed $25,000 per day of violation,
<br />or by imprisonment for not more than one yeaz, or both.
<br />EPA Form 3320-1 (Rev. 03/99)
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