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Paper~t~ ark Reduction Act Not:ice
<br />Public reporting burdee for this collection of information is estimated [o vary from a :-ange of ]0 hours as as
<br />average per re.;ponse for some minor !'acetifies, to 110 hours as an average per res*oore fx some major facilities,
<br />with s weighhxi average for n'mjor nrd ~tinor facilities of IS hours per response,. including time for reviewing
<br />instructions, starching existing data ~:o:~~cns gathering and maintaining the daL-, needrd, and completing and
<br />reviewing the collation of infornaLon. Sc:,d comments regarding the burder. e^li~y1[e or any other aspect of
<br />this collation of information, ~na~.c'.ir, su;gestions for reducing this burden to Chfef, (n formation Policy
<br />Breech, PM-223, J.S. Environmental Protu:.ion Agency, 401 M Street, S\Y `.'/c: ~i gton, DC 7.0460; and to the
<br />Office of Informaton and Regtaatory 4flairs, Office of Manag®eot and Budget, '~/ashirg[on, DC 20503.
<br />G' eneral Instructions
<br />1. if form ha:: bean partially can-pl~.'.ec. by preprinting, disregard instructions 'i-:;c ed at entry of that information
<br />alrardy preprinted.
<br />2. Enter "Permil~ee h'ome%Llailing Aodre.cc (and facility tutmegocatien, ii i:IG:rent)," "Permit .Vurnber," and
<br />"D~scharge Number" where end:cater (A separate farm is requi!ed for eac:'t discharge.)
<br />3. Em.cr dates beginning and erring '9I hue-urg Paned"covered by forte t~ here rdicatcd.
<br />4. F.n;cr each "Pa-amerer" as spec feed ;.. ~,o titoring requirements of pcrn,i[.
<br />5. Ener'ltiaa~~lr M1feasvremenP' data fm ~~:~c r ;cram: er under "Qnnnlihf` 2,d ~'[ t~hN' in use's sp;cif;ed in parse!
<br />,~,rnQe" ~s n rmr:dh dnthr:,_!'C :, re >>„ 'rzremetnc ucerzgC for cac[cr: : _rs~ of all <~!nple me8surem~..•ti
<br />ror ~,ich ra •:~r. ~Ier ob6!inra ~',,tri .i ; "' ; ,~ ronno l'rrro.f,. ".1 •'nxrmwn~' and „ : rr ,,,:;' ;:re ~':vrma111 extren~c '•'g -:
<br />ur,rl low n~...sir~menL ot'e~^~:d ':a~,~ ",MoriTuring Permd." (Note '.. ... grin°i~ .. _' sece':!: ry treat~~~r~
<br />rr •,i,.crnr m. .:~,ICi 7]-dap a~~erag • `, a ~~~Ic measurements urccr "Avereg% - d ~n._r .. _•.'inar~ "-d:y s.. ~2gc
<br />of s ;n~la rice ~ reracnts obta.nrd r:,ri ~~ monitoring p?rind under'^..!axr::wm ~.~
<br />6 En;cr "Perrui„'equirernent" fur esr h ; r'amctcr unr;er "Qunnfirv" and "Q.rlily" ,u ~peci8ed `.r c :rnti'
<br />7. Under "A'n Fs" enter nu~rbcr of :a 'n'c ~neasumrenls during rr~eci'aricy ~ ,•! ttie' .. _ ,.,tuts ;rte[:_'
<br />nuunrim pr 7~;ay' averag^_ as a~.rf ~~:p~i.:~) pcrnit r^quiremen! far c~~ch par, r r..,. .; :ro~.~_, cn:e °.9 ,
<br />B. Enter "Freyue:,cy oJAnol;;n" bath .~ "Smnple ,lieasurmen!" (aelu~l frrl_c. q of saTplirg a,~~ annlysis us_~
<br />during monitoring period) and a; "I',•rr,u: Requirement" specified in pem,it. ;c. g., 3ntcr "Con!," for cont+nuc~s
<br />mcni~:oring, "! T' for one day per •,eeeit, "1 30" for ane day per month, "/+90" fiat one day per grartcr, etc.)
<br />9. Enter ".Smuple Tvpe" both +s "Snrrp:: !IracuremenP' (ac4ua! sample 7T' u.; 5 d Ming moo toeing period) and. as
<br />"Y~•rnri! Rrqun•emrnf." (e.g, ErL•r "tF-r h" for individual sample, "2dJ7("' b• 24-hour ,ompos~~c, ":\%4' -o-
<br />continuous mo~;itoring, etc ;
<br />a0. 1'Jltere ciolatiru of pernut requiem ~ms ire reposed, attach a brief exp;^.n^l` ~. o describe cause tnd m:.te_~cc
<br />actions taken, :end reference each ~~~ol non b}' date.
<br />11. If "no discharg::" occurs during mo utnrinp penod, enter "b'u Discharge" across Icrm in place of data :ntry
<br />12. En(cr "Name7ide oJPrincioa! L:tec wive OjTccr" with "Signature ojPrinr.p:il ixecufive Officer oJ,4ulhorized
<br />Agenf," "Trlep~4one Number," and "Date" :rt bottom of form.
<br />13. M;dl signed Report [o Ofiicc(s) b) rla~~:(s) ~pccificd in permit Retain copy for your records.
<br />14. Mure detailed instructions far use of I tis Discharge Afonitoring Report (D,I1RJ f.~rt.i may be obtained from Office(s)
<br />spxified in permit.
<br />Legal Notice
<br />This repos is requireai by law (33 LI.S.C. 1318; 40 C.F.R. 125.27). Failure to report or failure to report truthfully can
<br />result in civil penalties not to exceed 510,000 per day of violation; or in criminal penalties not to exceed 525,000 per day
<br />of violation, or by impriscxrment for not more th:m one year, or by both.
<br />EPA Form 3320-1 (A;ev. 08-95)
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