h~..~~~rwork Re~~:~,tion Act Notice
<br />Public reporting burden for this collection of information is estimated to vary from a range of 10 hours as a^
<br />average per response for some minor facilities, to 110 hours as an average pcr response for some major
<br />facilities, with a weighted average for major and minor facilities of 18 hours per response, including time for
<br />reviewing inst7ttctions, searching existing data sources, gathering and maintaining the data needed, and ~
<br />completing and reviewing the collection of information, including suggestion for reducing this burden, to'
<br />Chief, Information Policy Branch, PM-223, U.S. Environmental Protection Agency, 401 M Street, S. W.
<br />Washington, DC 20460; and to the Office of Information and Regulatory Affairs, Office of Management and
<br />Budget, Washington, DC 20503.
<br />C °neral Instructions
<br />1. If form has been partially completed by preprinting, disregard instruction directed at entry of that information already
<br />preprinted.
<br />2. Enter "Per~rtittee Name/hfaifing /+ddress (and facility name/location, if different)," " Fennit Numher," and "Dis„harga
<br />Numher" where indicated. (A separate form is required for each discharge.)
<br />3. Enter dates beginning and editing ",~ionit~~ring Fzric.f"covered by form where indicated.
<br />4. Eater cacti "Furamda=r" as specified in monitoring requirements of permit.
<br />5. Cnter "San+rl=,1-L•isru~an,°nt" data for each parameter under "Loan/ih'"and Lualit) "as specifed in permit. "Avzrvee" is
<br />normally arithmetic avcrEgc (gear-utric average Cor bacterial parameters) of all sample measurements for each Para*nc~:r
<br />obtained dw ing "bfortir~~r;no f ~ri~ !'; ";bl~ziarum" and ,aisi„unu" arc normally extreme high and law measurements
<br />obraincd durinb ".YLnit,rLtF F-risJ". Q+'rte to municip;us with secondary treatment recui-emenl.: Fnter 30-day average
<br />of snmpla mcasurcmcnL: onricr "dr~r~~e," a~~d enter maximum 7-d:.y average of sample measurements obtained derittg
<br />monitoring period under ";vlzrirnu;n.")
<br />C:. Era_ "Pen;u! Fm; r•ir'smm:"for cad? par.-meter under "~r•~n+ih.,' and "~ualiq~" as s iceifcd in porn *.
<br />7. Golfer ",ir ~ .t" en:~_* nonce, o'samplc m~..+urement during n-~uoitoring period iha' :xcud maximum (and/or mi ~i,num
<br />or 7-day ;n u'cae ~s approprir(c) p:rroit requircmcut fur each paratncter. If none, enter "0".
<br />g. _~~!_ "Fr:~r•:,r ; 'i,'r~l ~s" both rs "S_.. r; !_ .1•;_.rcrr, :,r~_..:" 'ual fre ue.ic•• of s'amp ing and analyss .?sad d.ains
<br />. "J J~. t~_. 4
<br />;noniio;in~ peroc) and as "T.,'„ri! R.?erir:u~a~!"spceificu in pcm;it. (z.g. Fntcr "~onl,"fur cor4inuous mooitorino, "//7"
<br />fe* age ~'y p: ~ tvc~::, "1/30" fo: one day ; cr month, 'Zr90"for one dny pcr quarter, etc.)
<br />S. ~nL;r "S~c ,r !a 1}Fa" bunt e_ "S r.oF L• ;.~_ ,?,-~--nr ;r."(ecru. l camp's t~-p_ usrd durn~ r.?anitoring pcnod) end as "/'s~m;i!
<br />Xsinirvn+,:rt." (e.g. Pntu "Grab" for indiviu_!;:I sample, '7-0!/:.'" for 24hour composite, '7r%1" far contiruous
<br />monitoring, etc.)
<br />10. 1'Jitere violations oF;-errnit requ' enenri arc i cponed, attach a Friel explanation to describe cr use and corrective ac:iuas
<br />to be taken, and reference e<~ch violation by date.
<br />I I. ?f"no Discharge" occws dung monitotino period, enter "No discharge" across form in place ofdata entry.
<br />12. r.-;nlci "itram_/Ti/le %f rr;,r:;F~r P,a.rrtic_ !i~~_•r" tvittt "Sisnllur_ ~f Pria, i/~l F_re_zrriu; ~_'er of ~n!fr.rc:/
<br />fig.: ut, ""TeleFlr,nr A'umhn•, "and "Cara" at bottom of form.
<br />13. \4ai1 si;ned Report to O~cc(s) by date(s) specifed in permit. Retain copy for your records.
<br />14. ~1ore detailed insu-uctions for use of this Disrhargr Monitoring R:~rt (CeY1RJ form may be obtained from Otlice(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 can result in
<br />civil penalties not to exceed $10,000 per day of violation; or in criminal penalties not to exceed $25,000 per day of violatio0.
<br />or by imprisonment for no[ more than one year, or both.
<br />EPA Form 3320-1 (Rev. 03/99)
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