HYDRO25023 - Laserfiche WebLink

Home Browse Search

Paperwork Reduction Act Notice Public reporting burden for this collection of information is estimated to vary from a range of 10 hours as ea average per response for some minor facilities, to 110 hours as an average per response for some major facilities, with a weighted average for major and minor facilities of 18 hours per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data Herded, and completing and reviewing [he collection of information. Send comments regarding the burden estimate or any other aspect of this collection of information, including suggestions for reducing :his burden, to Chief, Information Policy Braoch, PM-223, U.S. Environmental Protection Agency, 40l M Street, SW Washington, DC 20460; aHd to the Office of information and Regulatory Affairs, Oftce of Management and Budget, Washington, DC 20503. General Instructions t. If form has been partially completed by preprinting, disregard instructions directed at entry of that information already preprinted. 2. Enter 'Permitlee Name%4lai(ing Address (and facility namellocadon, if different)," "Permit Number," and "Discharge Number" where indicated. (A separate form is required for each discharge.) 3. Enter dates beginning and ending 'itfonitoring Period" covered by form where indicated. 4. Enter each "Parameter" as specified in monitoring requirements of permit. 5. Enter "Sample hfeasuremenr" data far each parameter under "Quantity" and "Quality" in units specified in permit. ".4rcrage" is normally arithmaic average (guomctric average for bacterial parameters) of all sample measwements for each parameter obiaincd during ";L;nnitaring Pcrrcd', ".1loxuau•n" and ",tfinimunl' arc normally extreme high and low mcasurcmcnis obtained during ".t/oarronng 1'errod." (1Votc to municipals with secondary u-eatment requirement. Enter 30-da}' average nF sample mcasuremcros under ".overage," and curer maximum 7-day average of sample measurements obtained during moniuring period under ",tfaximu,n. 6. Enter "Permmt Requirement" for each paramder under "Quarrtiry" and "Quality" as specified m permit. 7. Under "T'o Ez" enter number of sample measurments during monitoring period drat exceed maximum (and/or minimum or 7-da}• at•erage az appropriate) pcrniit rcquircment for each parameter. If none, enter "0". 8. Enter "Frequency oJAnalvsis' both ss "Ranp!e ;~.9easurmeni" (adual frequenry of sampling and analysis used during monitoring period) and as "Pernrir Rcgvir•errtenr" specified in permit. (e.g., Enter "C'onr," for continuous monitoring, "1/7" for one day per week, "1130" for one day per month, "1/90" for one day per quarter, etc.) 9. Enter "Sample Type" both as "Sample Measurement" (actual sample type used during monitoring period) a-id as "Permit Requirement," (e.g., Enter "Genie" for individual sample. "14f/L" for 2~-hour composite. "T%A" for continuous monitoring, etc.) 10. Where ~ioladons of permit requirements are reposed, attach a brief explanation to describe cause and corrective actions taken, and reference each violation by date. 11. If "no discharge" occurs during monitoring period, enter "T'o Discharge" across form in place of data entry. 12. Enter "Name/I'itle ajPrincipa! Executive Officer" with "Signature oJPrincipal Executive Officer oJAuthorized Agent," "Telephone T'umber," and "Dale" at bo[b~m of Corm. 13. Mail signed Report to Ogce(s) by date(s) specified in pemrit. Retain cop}• for your rceords. 14. More detailed instructions Cor use of this Discharge Monitoring Report (DMRJ form may be obtained from Office(s) specked in permit. Legal Notice 'T'his report is required by law (33 U.S.C. 1318; 40 C.F.R. 125.27). Failure to report or failure to report truthfully can result in civil penalties not to exceed S10,000 per day of violation; or in criminal penalties not to exceed 525,000 per day of violation, or by imprisonment for not more than one year, or by both. EPA Fatvt 3320-1 (Rev. 08-95)