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~~.~erwork Redaction Act Notice
<br />Public reporting burden for this collection of information is estimated to vary from a range of ] 0 hours as an
<br />average per response for some minor facilities, to 110 hours as an average per 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 instructions, searching existing data sources, gathering and maintaining the data needed, and
<br />completing and reviewing the collection of infotvtation, including suggestion for reducing this burden, to
<br />Cbief, Information Policy Branch, PM-223, U.S. Environmental Protectio^ Agency, 401 M Street, S.W.
<br />Wasi~ington, 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 [hat information already
<br />Preprinted.
<br />2. Enter "Permittee Namz/Mailing Address (and facility name location, iF different)," " Pzrntit Nunrher," and "Discharge
<br />Numbe>" where indicated. (A separate farm is required for each dischazgc.)
<br />3. Enter dates beginning and editing "Ivlonitorinb P.~riod"covered by form where indicated.
<br />4. Enter each "Faramtl~r" as specified is monitoring requirements of permit.
<br />5. Enter 'S~mplz hL•.rrur~•ur.nt" daft fo.- each parameter under "Qzuntiq'"and Qu1Gt}'" as specified is permit. "Av~:~_r~s" is
<br />normally arit:vnetic average (gccmctric average for bacterzl parameters) of all sample measurrncnts for each parameter
<br />ob*aincd during ",tG ni~srin Fdri~,~"; ",t4r.iunn,r" and llininrurn" are nc•anally cstrcme high and low •neasurtments
<br />nbtainec', during ",tl,n;l,ria~ F.•,-i .!". (A!at:: to municipals ~~'uh seconuary lreatmcnl rcyuiremeet: L-nter 30-doy ave-egc
<br />o`'samplc mcasurcm~-'.~. a^dc- "~io_,-~o_," a!-d enter nrexia,um 7-da, average u. sample mcssuremcnts obtained during
<br />monitoring period under "rLlzrirnzw;.")
<br />5. '_?n'.r ':~ •~ r,,it R ~; air _•urcnt" for each oar omelet and.- "~e~.,~!irr"nn~ "rr!_dily" as s,:cciiied in perm i.
<br />7. U~,rdn~ "iti~. F..-:" enter munhcr of sam;lc n-~~,.asurencr: ar~n-~g mrni'~i ing net god t'~:,:..:,ecea maximum (and/cr minimum
<br />e- 7-d; y avenge rs sppirnriate! snit r,:yaircncnt .or each parameter. If none, enle; "0".
<br />P. Fn,er "Pr_;e:,r5• rj .frv ~/vs+:" hntil c. "S.i.;;• 1. '.,. _ ,.. _,,. •,rr" (:;oturl frrnuerc; r,r samn'ing u:;d analysis ~tscd during
<br />mon~tari-~g ner.odl .and a . "/': nr%r R:.nnr, n.-r~" s;ceificd in ~cnnit. (c.g t t,ter "'~,,u,' for canliauous monitorrg, "//7"
<br />fer one day p.:r v. ce!:, "!/30" For one day per mon!h, "1,'90" fur one day p.:r quarter, clc.)
<br />9. Fn'er ':P~r{~t_ T• y •" hnt'i . "~ur,rSL M~•~SU: Irrr,rr" (ach-ral sample I~ k,: ,!sad during monitoring period) acd as ''n~rvri!
<br />2guin•m ,lr," (e.g. ;inter ":,ral " for individual sample, "1dH;' for 24-hour composite, "•\%A" far co•rtimtous
<br />monitoring, err;.)
<br />10. V,'her,: vielatians of permit rnquimmcns arc reported, attach a brief explanation to describe cause and corrective actions
<br />to be taken, and reference each violation by date.
<br />11. if "no discharge" occars during monitoring period, cntcr'TIo Discharge" across form in place ufdata entry.
<br />12. I?nccr "Nama/Titlr nj Frincirl! Fs~~urira (;%/%;•r" witit "Siyrrature rf l'rirr_i/v! Fx~,.uriv.• G~_-~r of Aud;o,izzd
<br />Ar;art. ""Tzlephwt; Numi~ar,"and "flora" at bottom of form.
<br />13. Mail signed Report to OtTice(s) by date(s) specified in permit. Rctai^ copy for your records.
<br />14. More detailed instructions for use of this Gis~hlrga IVfouitoring Re~r,,v (Lti71~ funs may be obtained from Office(s)
<br />specified in permit.
<br />Legal Notice
<br />This report is required by law (33 U.S.C. ] 318; 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 violation,
<br />or by imprisonment for not more than one year, or both.
<br />EPA Form 3320-1 (Rev. 03/99)
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