|
~'a~aerwork Deduction Act 1\~otice
<br />'Public reporting burden for this collection of infomtation is estimated to vary from a range of 10 hears as an
<br />average per response for some minor facilities, to 110 hours as an average per res?onse 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 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 Manz.gement and
<br />Budget, Washington, DC 20503.
<br />~-eneral 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 "Permittee Name%No%/%ng Address (and facility name/location, if different)," " Parmit Number," and "Dir~harga
<br />Numbar' µ here indicated. (A separate form is required for each discharge.)
<br />3. Enter dares beginning and editing "M.nitoring Peric ~"covered by form where indicated.
<br />4. Enter cacti "Paramer~r" as specified in monitoring requirements of permit.
<br />5. Enter "Srnpte ,LLasurerta:rt" datz fcr each pa,-arneter under "(;,ta+rtiry" and ~nrslih~" as specified io permit Arr, eras" is
<br />rorrally atit'tme[ic zvcrage (gcomeric average for bacterial parameters) of all sample measurements for each patamcta;
<br />obtained dw:cg '^~:,.;irorioo f'rri;l"; ",'~l_s%,aun," and P.i%ninuu~" arc normally e,;~r~me i igh and lots mcasu-cmcnts
<br />obu!incG during "iii .,,il-.,-ine f- r J". (1~nte ,n mwt~cipals ~:i+h sacnnd,ry trcatmcn. r:::;u rcme~t: '~n~er 30-dal• avc~rpe
<br />of sample mcastc~emcnts a*der ":: c:, log, and enter -taxim um 7-diy average e. sam;•lc roast rcn cots obtained c'irirg
<br />monitoring period under "h/azimwa.")
<br />6. Cos,r'T1.Tii!IRl./:.'LY,i,.1.1!"inrcarhparametcrund~'"nl„/ih"end"Ch•o/%i~,";y:,t„ciicd',perrrit
<br />7. Jndcr "fir, F.:;" enter numbs- of ;a-plc -casuremcr.t ~i r.ae mnr..IOr.nr r;~n? t-:m _~.cecd rn a`.irrum (t nd/or min~T.um
<br />or 7-dry averz ~„ ; , rppropriatc) permit requ^.mcnt for tact, parameter ` tf none, rntcr "0".
<br />8. =;m-r "Pry. -; ~ `,';ulYC+c" ;;nth as "5~.,,,~t ` L: ~ ~~r~ :.,,rnr" (,;,curl ;reyuccc^ c'' s:.npliug a~ d an:cl; sis Lscd dcrht;;
<br />monit~r.nL ner;~d) ~ .d as "P ~,.,.i: R..• ,,-ird,:L•„I" specified in nen~,a. !,: ~ iota- °'.,n1 " tits u,nt aaous rronitorino, "1/7"
<br />ter on. dry per ~,,;c::, "1/30" For oue day per man±h, "1'90" for one day per quart , ch:.)
<br />S. '-a•c- "S~•„~, ' • T ;-e" hof~: r. "5.,,,~1.: ;~.,:oa,+:-~,,.dn1" (actual sample r)•pe u•.rd t{.urir~ n~o titcrin~ per edl and as "~ ,,;nil
<br />R ~:t,r%r; n7s.r"' (~.~ ~nlur ":;r~l " for ir.div~doal srmnlc, "74/1 ~" fcr 24 ,~ r comp; site. ",\%: " for continue-~.
<br />monitoring, e`c.)
<br />10. L'11t,n: t~olcticns of oarmit renuiremzn±s ,,ro rte; ortc{ a*tach a hri.f :z~lr.natio~ t~ d_scribe caw= and ccr~~7vc actions
<br />to be taken, and reference each violation by dart.
<br />11. ?f ", o discharge" occurs doing monitoring period, cnt:;r "No Discharge" acruss fo,m in place ofdata entry.
<br />12. Enter '71'om.JTitl~ .f !'rhtcir ~/ /~,t,:ulir.r GJi.a~" with "Si;,-n~turs of fS-%n. if.~! Precu'iv: G~_er cf An!!,•,r'x1
<br />lgen+, ""TelzpG~,r ~ NumF~r, "and "Gat_•" a t bottom of form.
<br />13. tiiaii signed 2eport to Ofliee(s) by date(s) specified in permit. Retain copy for your rte-cords.
<br />14. 1•lo-e detailed instructions for use of this G%s=h~rge d4on%tainb R~ro:7 (L ~IRJ fom may be ob~:tincd from Office(s)
<br />specified in permit.
<br />Legal Notice
<br />Tbis report is required by law (33 U.S.C. 1318; 40 C.F.R. 125.27). Failure to report or faihue to sport 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)
<br />
|