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~'a,~erwork Rey' ~4 r~:n~~. Act l~Totice
<br />Public reporting burden for this collection of information is estimated to vary from a range of 1 C ho~~rs 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 ] 8 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 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. Lf form has been partially completed by preprinting, disregard instmction directed at entry of that information already
<br />preprinted.
<br />2. Enter "Permittea NameGNailing A~Jress (and facility name/Iecation, if different)," " Parmit 1Namber," and "Du_harge
<br />Nrrntb~r" where indicated. (A separate form is required for each dischazge.)
<br />3. Enter dates beginning and editing "Monitoring Perini"covered by form where indicated.
<br />4. EnG:r each "Paramet_r" as specified in monitoring requirements of permit.
<br />5. Enter "SJmfla A1•aenre,n=nt" dak for each parameter under "~uautilp" a!-~d ~ualin'" as specified in permit. `Ar:•rJg_"is
<br />normally arithmetic average (gcomeG-ic average for bnctnsial paramctere) of all sample mean u'e nenls (or each parameter
<br />obtained drrmg "~ I-nirori,!o f'v'i.1": "A9irinnun" air'. f./ini,runn" a-c nu~nally c.;t~~me .,i~, and low measun~nents
<br />obtrinul dwin,'>, "/d.~,irnring Peri•,l". (Note In mw`cipals r; i:h scccudv;- treatrr.ist r... ua,.;ncr1: 'ia[cr 30-day ave age
<br />of'a n'Ic :neasnremerts r.~r'er "dva;vye,"ard enter rara~-un: 7 day r.se ~~gc o"s. r,~ta mcasurenc,~ts obi<ined uiricg
<br />monitoring petyod undcr'SLfaxirtunt.")
<br />5. '?n:.r "1'~,~;tit R ;~•irerr_at";or each parameter und. - "~h,:r,;;,,."ar9 "ti.r, air,"zs s~cci°~ed in p~ra t.
<br />7. Undo' "/t`. F..ti' enter number ufs: m'.c mensurmoit rlaricg „~,ml . im~ r._r:u: .' .,, ~ r,._d :^~::i,~iun (; ;.d'er min ~-~w.~
<br />or 7-day average as rppronriclc) p~rmi[ rx:q•~:~cnnrt fnr sect, nn~:uneterJlf none, entci "0".
<br />R. °.nl: ";"r•: :,r;':.f;,vv/ysis"both c, "S: ,1, P•:'1•0. ~.,r_ . ,~ctusl f:cc;u^r.c; "~-~, ng ~r;analys~s used rr a,
<br />moni'~r;ng per:ud) e. ~u „s ""_r;.;i! R.tgui; ~:x: ~:,"sl:rc~fcd .n rcn;; '. (t.g.:i SIC ". . r! " ~'or cool .•oo;.s u,cnila,'irg, "//7"
<br />fee one day ~: =- v. ce?:, "//30"for e.;c day per iron'I-., "1/90" for one day per quote:', et :.)
<br />7. ~nt~ r "5 •,nf!. T;;r ' heft ~_ ,,.5,,,,rf'I • ;.,~~~ ~„ _,,._„ ' ("~ aual v.:'p h';.. ~,d r_'....r„ --~.~ .it.: my pcri o:i; aux. as ",^r,-,...•
<br />,`i=aurt.~m>,:!." (e-~. Inter "G;v/" far iadivir'u:a s~.~;pL "7J,':'~ fr~:~2» o ~r. cn~puai:z '~':r/A" for continuous
<br />monitoring, etc.)
<br />10. !'Jh.r,, ,ial:lions of permit requirements arc rc~oZCJ, aaa,;h a brief ezntrns'io t M d~,c.-iuc cruse and corrective ac:inns
<br />to be takce, and reference cash violation by da~c.
<br />l t. t"'na disc?rcrge" eocurs dw;rg monitoring pc*iol enter "Ne C~schargc" across for,-~ in p:ac: af.9a'3 entry.
<br />1'?. Enter 'S`.!~na/!itla cf Pr[;tair~l tr~_utivz (iji_±;" ~yiilt "Si_~a1;,,,v cj (b•iv y.~' lis-,:e"ivc ':~~_•r -.f futh;rize.t
<br />A; znt, ""TekFho., ~ lYmnPdr, "a od "Date" at bottom o f form.
<br />13. Nail signed Report to Circe(s) by date(s) SfacciGed in permit. Retain copy fnryow records.
<br />14. Mere detailed instructions for use of this Cis:h~rga 1~larit.ri;rg Rat: ,;-t (CA1ft7 font may be ob'uiocd from OfPce(s)
<br />specified in permit.
<br />Legal N otice
<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 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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