|
Paperwork Reduction Act Notice
<br />b~c reporting burden for this collection of information is estimated to vary from a range of 10 hours as en
<br />' ge per response for some minor facilities, to 110 hours as an average per response for some major PaCi~ities,
<br />' weighted average for major and mirror facilities of 1g hours per response, including time for reviewing
<br />lr}tctions, searching existing data sources, gathering and maintaining the data needed, and completing end
<br />rr,png the collection of information. Send comments regarding the burden estimate or any other aspect of
<br />~ Il~s collection of information, including suggestions (or reducing this burden, to Chief, Information Policy
<br />Bramch, PM-223, U.S. Environrcental.Protection Agency, 401 M Street, SW Washington, DC 20460; and to the
<br />rl~~e of Information and Regulatory Affairs, Office of Management and Budget, Washington, DC 20503. .
<br />~i~-:._
<br />General Instructions
<br />~~ form has been partially completed oy preprinting, dismgaid instructions directed at entry of that information
<br />;steady preprinted.
<br />~2.
<br />moister "Permittee A'ama~;Llailixg Address (and Cacility namellocation, if different)," "Permit A'umber," and
<br />i~Discftarge Number" where indicated. (A separate form is required for each.discharge.)
<br />r _-;.
<br />ter dates beginning and erdmg "tloniturinq Period" covered by form where indicated.
<br />h'Egter each "Parameter" zs spectfied in mo~titoring requirements of permit.
<br />~. Enter "S~mple Measurer,., et" dos Cor each paramMc- under "Quantity" and "Quality" in units specified in permit.
<br />"Average" is normally arithmetic aver?ge'(gromeVic a~crage for bacterial parameters) of all sample measurements
<br />~'' for each parameter obtaine i dunnk 'Yvlnniroring Per md'; ':ifaximum" and "Afinimum" are normally extreme high
<br />• and low measurements obtained ~~uring ".tlonirorins Period." (Note to municipals with secondary treatment
<br />!- requirement: Enter 30~av r.verage of sample meaauentents under "Average," and enter maximum 7~day average
<br />of sample measurements obtained dunng monitonng pcnod under "hlarirnum.
<br />t5: Enter "Permit Requirement" for each paranrcter under "Quantity" and "Quaiity" as specified in permit.
<br />7. Under "Ara Es" enter number of ample measurmems during monitoring period that exceed maximum (and/or
<br />{ minimum or 7~ay average as appropriate) permit requirement far each parameter. If none, enter "0".
<br />Enter "frequency ojAnatysis" both as ".Sample tii~asurment" (actual frequency of sampling and analysis used
<br />' Quring monitoring period) and as "Fermi! Regwrer.dnr" specified in permit. (e.g., Enter "Cons," for continuous
<br />monitoring. "1.'T' for one day per week. "; •3U" fm' one day per month, "/'90" for one day per quarter, etc.)
<br />teeter'".Sm;rple Tjpe" bosh ac "San,vle dfennrrement" (actual sample type used during monitoring period) and as
<br />"Permit Requrrement," (e.g., Enter 'vrub" for in2rvidual sample, "?JNC" for 24-hour composite, "N/A" for
<br />continuous monitoring, etc.)
<br />b: 'Where violations of permit requirements are reoor~ed, attach a brief explanation to describe cause and corrective
<br />:o actiorrs taken, and reference each violation by date.
<br />~..U "no discharge" occurs during mo;~itorirg period, eater ",No Discharge" across form in place of data entry.
<br />t. '
<br />~~ Enter "Name/Tide ojPrincipaf r:recvhve Officer" wtth "Signature ofPrincipnl Executive Officer ojAuthorized
<br />-. Agent," "Telephone Number," ana "Gate" at bottom of form.
<br />~. Mail signed Report to OtTice(s) by date(s) specked in permit. Retain copy for your rernrds
<br />'d. More detailed instructions f~.v use of this Dischn ~e.lfonitoringReporr (DA1R) form may be obtained from O13ice(s)
<br />~, specsed in permit.
<br />~~~ Lego; Notice
<br />Tl~m~ort is required by law f33 U.S.C. 1318; 40 C.l~.k 125.'17). Failure to report or failure to report truthfully can
<br />1 ~~ civil penalties not to exceed SI0,000 per day of vi ~'s[ion; or in criminal penalties not to exceed 525,000 per day
<br />of plstion, or by imprisorunert fur n.,t rrmw than one year, nr by lath.
<br />~.:., ,
<br />n-
<br />EP~ Form 3320.1 (Rev. US-95)
<br />~:. , ,
<br />ko~~ -
<br />6~
<br />
|