|
Paperwor~ Redaction Act Notice
<br />Public reporting burden for Ihis collection of information is estimated to vary from a range of 10 hours as ao
<br />average per response for soma minor facilities, to I10 hours as an average per response far some major, facilities,
<br />with a weighted average for major and minor facilities of IS hours per response, including time for'tevfewing
<br />instructions, searching ezistutg ua~a sources, gathering nerd roeintaiaing the data needed, and completing and
<br />reviewing the collection of information. Send co®rttettts regeroi.rg the burden estimate or any other aspect of
<br />this collection of information, uicluding suggestions for :edLCing this burden, to Chief, information Policy
<br />Breach, PM-223, U.S. Eovimnmental Protection Agency, 401 iv[ Street, SW Washington, DC 20460; and to the
<br />Office of Information and Regulatory Affairs, Office of Management and Budget, Washington, DC 20503.
<br />general Instructions
<br />1. If form has been partially completed by preprinting, disregard instructions directed at entry of that information
<br />already preprinted.
<br />2: Enter 'Permittee Name/Alailing p..(and facility nameJlocatioq ff different)," "PenJtit Number," and
<br />"Discharge Number" where indicalCd: (A separate form is required for each discharge.)
<br />3. Enter dates beginning and ending 'iLlonitoring Period" covered by form where indip[ed.
<br />4. Enter each "Parameter". gs specified in monitoring requirements of permit.
<br />5. Enter "Sample Measurement" data for each parameter order "Quantity" and "Quality" in units specified in permit.
<br />"Average" is normally aritlunetic average (geometric average for bacterial parameters) of all sample measurements
<br />for each parameter obtained during "Itlonitoring Period"; ",'vlarimune" and "Minimum" are normally extreme high
<br />and low meastucrncnts ot~tained during "Monitoring Period." (Note to mutuc,pals with secondary treatment
<br />requirement: Enter 30-day average of Semple metsuremeais under "Average," and enter maximum 7-day average
<br />of sample measurements obtained daring monitoring period under "tilaximum.'J
<br />6. Enter "Permit Requireutenr' for each parameter under "Quonnry" and "Qualify' as specified in permit.
<br />7. Under "No Ex" etaer number oC sample r,.easurr.~ents during mmtitmdng period that exceed maximum (and/or
<br />minimum or 7-day average as appropriate) permit requirement for each parameter. ff none, enter "0".
<br />S. Enter "Frequency ojAnalysis" both as "Sample klensunnenP' (actual frequency oI sampling and analysis used
<br />during tonitoring period) and as "Perrot Requirement" specified in pcrmt[. (e.g., Enter "Cone," for continuous
<br />monitoring, "//7" for one d:ty per week, "1130" for one dap per month, "1/90" for one day per quarter, etc.)
<br />9. Enter "Sample Type" both as "S'oraple Measurement" (actual sample type used during monitoring period) and as
<br />"Permit Requirement," (c.,., Enter "Grab" for individual sample, "2JHC" for 24-hour composite, "N/A" for
<br />continuous monitoring, etc.l
<br />10. Where violations of permit requirements are reported, attach a brief explanation to describe cause and corrective
<br />actions taken, and reference each violatiom by date.
<br />11. if "no discharge" occurs during monitoring period, toter "No Discharge" across Conn in place of data entry.
<br />12. Enter "Name/!'itle ojPrincipal Executive Officer" with "Signature ojPrincipn! Executive OJ~cer ojAuthorized
<br />Agent," 'Te:ephone Number," and "Date" al bottom of fornt.
<br />13. Mail signed Report to Office(s) by date(s) specified in permit. Retain rnpy for your records.
<br />14. More detailed instructions for use of etas Discharge Alonitoring Report (D.tilRJ form may be obtained from O(Tice(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 truthfully cam
<br />result in civil penalties mot to exceed 510,000 per day of violation; or in crittirtal penalties not to exceed x25,(100 per day
<br />of violation, or by imprisonment for mot more than one year, or by both.
<br />EPA Form 9320-1 (Rev. GB-95)
<br />
|