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~twperwork IZe~' action Act Notice <br />Public reporting bw--den for this collection of information is estimated to vary from a range of 10 hours as an <br />average per response for some minor facilities, to 110 hours as an average per response for sonic major <br />facilities, with a weighted average for major and minor facilities of 18 hours per response, including time for <br />reviewing instructions, seazching existing data sources, gathering and maintaining the data neoded, 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 />General Instructions <br />1. If form has been partially completed by preprinting, disregazd instruction directed at entry of that information already <br />preprinted. <br />2. Enter "Fermittra Nonte/Mailinb Address (and facility name location, if different)," "Permit Numb_r," and "Duchargr <br />Numhzr" where indicated. (A separate form is required for each discharge.) <br />3. Enter dales beginning and editing "Monirorin~ Perio,y"covered by form where indicated. <br />4. Enter each 'Paramzt_=r" as specified in motitoring requirements of permit. <br />5. Enter "SmyL .~rasuranznl"data for each parameter under "~umuiry" and ruali0'" as specified in permit. "Ar~~ra;;." is <br />narn~ally arithmetic a~ crage (geometric av_rage for bacterial parameters) of all sample measwements for each parnmc4r <br />ottained during ":1•k nil;rin^ f~~ri•,d'; "LA~zinuun" and Mi,i%mum" are normally extreme ~~igh any low measur:mcnts <br />obtained during "dl,nit~,riag /`;;..l". (T~'o.c to mur.icij;als with secondary trcahnrnt r; _iui,~cmcrL caLr 30-day avercgc <br />of sample messurcm_-t, ender 'Y.va:lie,"and eater maximum 7-day avera~a of saa~,:!c measworr:nts obtained dcrutg <br />monitoring period under "Maximo+m.") <br />'. Er,t~r ":'c,~+ui: 21t+henr_rt"for each paramciur und: "~v:,;!ity"and "~etality"as s;ceificd in perm. <br />7. i;rder "A'; F,.." en+cr rumba of sample raeasuremem durng r•n^irn-ing ;grind tl- ~. c,~ecd maximum (and/r,r mi ~i: gum <br />er 7~day av.:rt;,c sa appropriate) permit requirement for etch pr ~amretur, if none, enter "0". <br />li. i-ntc* "/rr. /;~•; ,• cf Arr.r!~•si~" both as "5:,.,,-/_~ ~lL .;.v„:,,; •,.;" (zcluc! fr.c,u.:nc; r` ;amp'inS and araly;s used P -~n~ <br />monimri~g nct;ud) end ss ";'z•-„rig R: ~uir~n: •c!" spccificG in j.cmiir. tc.g. L-ntc: '..:at,"for cant:ucus mooitor~t •, "!/7" <br />f:r one dad p ° ±•: ee'.c, "l/30" for ore day Fs man'h, "1 /90" fcr one day per yu:,rter, etc.) <br />S. ~°.~t_r "JJli~i ' • T ,~ -" lm~~ rs "~.+,tr(e ;h.vvr:•+n tar" (acual sample .type used burin;; monirorin~ peiod) and as ",`rnui! <br />T4./ai+r,nen; " (e.g. Inicr "Groh" for individual sample. "3df/_:" fcr 24-hoer composite, ';";//!" far conlineowti <br />monitoring, etc.) <br />1C. 11"-,era violations of permit requirement; are rcpor!ed, atwch a brief e';ptanation to d_seribe cat!cu rind corrective actions <br />to Se taken, and reference each violation by date. <br />". If"no discharge" occurs during monitoring period, enter "No Dischargo" across form in place of data entry. <br />17_. rmer "Nart~/Tit! r_f /7-'n_^1Tal FTeauiv~ <:~:~r•' with "SiS-+ratvr,• aj I'r%r,iTa! £as_ut%v_ O,r~ar oj,4utl•~,,,a~,l <br />Abent, ""TalaTh~ne Mumh~,;"and "Gars" at bottom of form. <br />13. Mail signed Report to Oflice(s) by date(s) specified in permit. Retain copy for your records. <br />14. More detailed instructions for use of this Gisautga iLioniroring /.,~-.rt (L ~fkJ form may be obtained from Ofiicc(s) <br />specified in permit. <br />Legal Notice <br />This report is required by law (33 U.S.C. 1318; 40 C.P.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 violation, <br />or by imprisonment for not more than one yeaz, or both. <br />EPA Form 3320-1 (Rev. 03/99) <br />