HYDRO26163 - Laserfiche WebLink

Home Browse Search

aperwork Reduction Act Notice Public reporting bur en For this collection of information is estimated to vary from a rangy of 10 hours as an average per respons for some minor facilities, to l1C how-:; as an average per respon e for some major facilities, with a weir hted average for major and minor facilities ei~ 18 hours per response., including time foe ret iewing instructio s, searching existing data sources, gathering and maintaining the data needed, a-td completing and revi wi~tg the collection of information, incb~ding suggestion fur reducing this burden, to Chief, Information i oli.y ['.::etch. PM-223, U.S. f~nvirottmen[aI Protection Agency, 40111 M Street, S.W. Washington, DC 204~i0; and to the C11-fice of lnformation and Regulator}' Affairs, Office o~' Management a td Budget. Washington, DC 20503. J ~eneralInstructions I. If tbrm has been Martially completed by preprinting, disreeard instruction directed at entry of [fat information aheady preprinted. 2. Enter "Pennit[ee ~ amei!lerhrrg Address (and Facilih~ name/location, if different);' 'Per»ut ,ti'tr bee;' and "Discbage ,Vurnber" where in icaied. 1 A ,ept rate form is required for each discharge.) 3. Enter dates beginni tg and editi tg ":llunitoring Period"covered b form there indicated. 4. Enlereach"Parom~•ter"assperified inmoni[oringrequirementscl'permit. 5. L'ntzr "Sample Mer~s:n•r;nen'" ~a[a for each parameter tinder "Quavuin'' ar~d Quulin "as specified i permit. 'areruge" is normally arithmeti l! average {t,_o+r,etric average for bacterial parameters) of all sample measurem nts for each parameter obtained during ":1~1rn~:;oring Pc'rr rd'; ",44usim:rm" and Minimrenr" are normally extreme high nd low measurements oht:.iined during "N onirn-ing Period". (Note [o municipals with ;.ecor.dary treatment requirement Enter 30-day average of sample measure cots under "A~~eroge,"and enter maximum i-dac average of samplz measurements obtained during monitoring period under ",4~srrarrrr,r.") 6. Enter "Permit Regrr'rement" for each parameter wider "Qtrmuih•" and "Quality" as specified in pen it. 7. Under "No Ex" ent r number o`sa nple measurement during monitoring period that exceed maxir~ium (and/or minimum or 7-day average as appropriate permit requirement for each parameter. If none, enter "0". 8. Enter "Frequency Ana/ysis" boNt as "Sample Measurenreru" (actual frequency of sampling an~l analysis used during monitoring period) d as "Permit Requirement" specified in permit. (e.g. Enter "Cons,"d~or contin ous monitoring, "1/7" for ~ me day per wee , '7/30" for one day per month, "1/90" for one day per quarter, etc.) 9.' Enter 'Samp/e Typ~" both as "Sample Meosurernent" (actual sample type used during moniWring ~eriod) and as "Permit Requirement," (e.g Enter "Grob" for individual sample, "24HC" for 24-hour composite, N/A" for continuous monitoring, etc.) 10. Where violations o permit requirements are reported, attach a brief explanation to describe cause ~artd corrective actions to be taken, and reference each violation by date. 11. if "no dischazge" oc urs during monitoring period, enter.."No Discharge" across form in place of des entry. 12. Enter "Name/Title f Principal Executive Officer" with "Signature of Principal trxecu[ive ~j~cer of Aulhori=ed Agent, ""Telephone urnirer, "and 'Dare" at bottom of farm. i 13. Mail signed Report (O 01'fice(s) by date(s) specified in permit. Retain copy for your recoads. ]4. Mon; detailed inst~ctio:ns for use of [his Discharge Monitoring Report /DMR) form may be ob)ained from Office(s) specified in permit. Legal Notice ~I This report is required b. law (33 U.S.C. 1318; 40 C.F.R. l25 ~7). Failure to report or failure to report truthfully can result in civil penalties not to exc ed $]0,(100 per day of violation; or in criminal penalties not [o exceed $25,00¢ per day of violation, or by tint?risonment for t more than one year, or both. EPA Form 3320-1 (Rev4 08/95)