|
I_'=.~~~rworl~ ta~~n~tion Act Notice
<br />Public reporting burden for this collection o': 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 some major
<br />~ facilities, with a wcight;,d 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 b~rdea, 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 />~neral Instructions
<br />1. If form has been partially completed by preprinting, disregazd instruction duec[ed at entry of that information already
<br />preprinted.
<br />2. Enter "Permittee Name/Moiling Addr•ss (and facility name location, if different)," " Par-mit Numher," and "Dischorg~
<br />Numher" where indicated. (A s('pazate form is requred for each discharge.)
<br />3. Enter dates beginning and editing "ionitoring Fer-iv~"covered by form where indicated.
<br />4. Enter each "Parameter" as specified in monitoring requirements of permit.
<br />5. Enter "S~'rple ;vit~suu,:r3nt"data for each parameter under "Qtrarrn0~"and ~ha~(ir,'" as specified in permit. 'Aver;age" is
<br />normally a';rl7metic average (gcumc~-ic average for bacterial parameters) of all sample mcacureme+7ts far each parameter
<br />obtained uw'i~g "blonitoriuo Fai•,~("; "i:•;zrirmm~" aryl Sirair;nr:r" are normally ex[rcmc l'ig1 and loet mcasu'umenis
<br />obtainer; du.~ng "J.I ,tit„in,5 f •r-•..r". (T`!o~e in rnuni_!pa's with secondary trcatmc:r rcyulrcmcit: Fnter 3C day average
<br />Of 5. mplC mCHSllre LlenlS VII(.Cr 'ii l'_.VO'2," ar'1 LntC" ma':Im ll` ~ 7-d£)' a\'^_G:oe Of S4mp1C mEeSLreS 67115 Obt<"!1nCd dLrl l'•b
<br />monitoring period under "rVscimeml.")
<br />E. En'.cr "Pe:;ait r2_•~uirt;r,~nr" for each paramcier under "des;rrirp" snc "LUUli.ry" ae specified i ~ purri:.
<br />7. under "i•ro cX' eGCr num`~r of sample aieasw _"~'ni duriu~' +m'ni(ol'ng Fen ud ih~; ~.~a::d ma:.imum (a.ld/ur ra~n'mum
<br />Or 7-coy ;~ : cr,:,c as apj.ropr~aw) permit renuu-emc. t for each parameter. If none, ent_ "0".
<br />8. _:~,'cr "P'rc,'r:,r ^ ~` ... ,(r.+~ ' h;.!h u "S. •,; 1:.,._.nrr, „ ,. ~r_tuc] GCy:._~~c)' ~~~ sampiin~ end anal;sis .~sud dwul~
<br />nnni.orno pcliod) as'Y :,ni; k~;t+i,vn; ,n°rp:_cffau hl fe:r:h. (cg. Sate: ".s:r ° forconLnuo.: n_.m;to:=ng, "]; 7"
<br />fog ore c~ay per is eo':, "1/~ 0" :or u~,e d!, per r:onti~, "1. %0"fur one day per quaztc.-, e.eJ
<br />S. °n.._r "Sr r'G TjF„" oath a, "~ ~..;t,l~ ; :'t.'sr'r_,,;a~~"(acural son pl,: tyj .used dur'n~ , lonitcnn•; nericd) and as "Pu-m;r
<br />R:.]rrh's;,.e:•t" (e.g. ~.l~r ":;r.+i-' Car i..divid,:cl samplu, "]9H~" for 24-hour compe<_ite. 'S'%'" for continuous
<br />monitoring, etc.)
<br />0. !Yhcn' violas;ons of pc: alit ltyu'rcmcnts a:c r(.pe1 fed, e~i~clt a bne( c;p]znaucit to descrd7e cau5c and. ccrrctivc a.!:ure:
<br />tc be t<~4cn, and reference eaci~ violation by date.
<br />11. If"no dischazge" occws d. ~ing monitoring period, em.~r "i~o Dischar~c" across forn is placr ofdah entry.
<br />12. En:cr "Nane/Tida ~f ; tin:%i~1 Est,zNir,; G~~ ~, " with "Sig,r~arre of Prin,iTal Erece:ir_ O~a•r of Avlhn.-i=~1
<br />Agent, ""Tel~F;r ne Nwntsr,"and °r1t5" at bottom of form.
<br />13. :v1ai1 si6med Report to Offce(s) by date(s) specified is pcrnut. Retain copy fur your records.
<br />14. krorc detailed instructions for use of this Gisc/r~,ge i~f~nitorirr;{ ReF~rt (CslffiJ form may be oblmined from Office(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 truthfu~ly can result in
<br />civil penalties no[ 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 />
|