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?~~~e~-vaork 12Q~a~ction Act Notice
<br />a
<br />Public reporting burden 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 ] 10 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 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 Regu]atory Affairs, Office of Management and
<br />Budget, Washington, DC 20503.
<br />General 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 "Pernriltee Name/Mailing Addrzss (and facility name location, if different)," " Pem~it NumFer," and "Discharges
<br />Nunrt'er" where indicated. (A separate form is required for each discharge.)
<br />3. Enter dates beginning and editing "Mouitorino P~ric1"covered by forth where indicated.
<br />4. Enter each "Paromarrr" as specified in monitoring requirements of permit.
<br />5. Enter "Susl-fe M~asra~~.n_ttt" data for each parameter under "~:euntity"and ~tralir)~" as specified iv pcrrr ii. "Arrr ryz" is
<br />nor,nally arrth:netic a•: erage (geometric avaagc for bacte~al pai~mcters) of all sample measurements for each paramc~.;r
<br />obtained during ",11~r:lt;,-bro Ttr%~~'; ";InLwrn," and irTnin::rur" arc normally e:,rcmc high and low measurement
<br />obtciner during "r!.'~,n;r~,r%n~ Pari•,.1". (1Jotz to ntcr,icirals tci`h sccondcry treatment ~. u^cmer.t: Later 30-gay avc-20o
<br />of tiamnt.e neLL+u;cr-cn•s tinder ".I v:,~.;s,"and enter :ximurr 7-day svcregc of scn-ple mesuremen's o6ti~ine' d~uriry
<br />monitorutg period under "iviarin:urn.")
<br />G. I:n`u 'T.•,wt%t R: airy;:"r!" `or each paramcicr under "LO~rlin•"and "iii%~lity" as s^..ci lied +n p=rm`t.
<br />7. Jnder "iJ•, T~-" enter nwnl..r of sample measw~mr~l d. ring n-mi:o-ing ntrod t''.ct ~_eceed m~LL.i~num (r,-cLbr m~n;nurn
<br />ar 7-day a~~eragc t ~ cnpropri2tc) pamtit reo~rrc:r,. nt f n' each .rarmder. if naee, e:,ier "0".
<br />P. Lrt:r "Fr.., t:,~.~ -,f ,Lulyr.'~" -oth :s "S ~,;y h Yvcn. _,;;a:r" (eema' fie?ucn ry c ,cntfl:ng a-ri ar a!_~sis used d~-ine
<br />moat+nr:ngr•crioo) r~td as "!'.•n.~ir k :;rr;r.~ur_n!" sncnfitd in fcnnit (e.g. L-cicr "..c,rl,"ic-cort:nuou>: ironitu~cg, "1 /7"
<br />for nnc day p_: r: cc!:, "1/30" far an^ day ra month, "1/90" for nn: day per gnartn', Gc.)
<br />,. =.nts "5~,.7 !_ T;; :"LnPt cs "S,r;;~!_ L; e~.,rr r,:,n^ (actual s:umpic t~-nc sued du L g m~niRiiing rc~i rn'' asc as "1 zr,q:,
<br />k~yrur.~m~a!," (c.g. `inicr "G;-.:!-" fur indivir!•~al ~•~np:a, "ldil::" fc,- 24-!o~.~r cun•pccitc, '~~V/r" for cont~nuaus
<br />monitoring, etc.)
<br />10. `; "t_rc violations of pcmR requirements arc ren0'te ~, zYach a l; icf c:p'~ anion in describe cause and cw~J~livc actions
<br />to b: raked, ,.nd reference each violation by date.
<br />1 i. L`"no discharge" eccus daring ^ronitoring pcr.o•1, eat. "Tdo Diecha;gc" across foist in p!acc ufdata a;tr.•.
<br />t2. En,c,- "R'amJT%tle of fn%fl_iral F..r_arliv= rJr_•_r" wi[1t "Si,~rur~:a of !'rir: ii _! Crz_urlvr Ojfi_~,- rf hut,'r•„-v.~J
<br />rigent, ""Telapk~,n ~ Numh,•r, "and 'T,al~ " at bottom o f form.
<br />13. Ma l signed '.report to Qilice(s) by date(s) spcci tied .n permit. Retain copy for your recoras.
<br />14. More detailed instructions for use of this Lis:;urgs M,uiroring R~p•,r-t (L';,972J form may be oblaincd from Qf ice(s)
<br />specified in permit.
<br />Legal Notice
<br />This report is requited by law (33 U.S.C. 1318; 40 C.P.R. 125.27). Failure to report or failure [o 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 coy of violation,
<br />or by imprisonment for not more than one year, or both.
<br />EPA Form 3320-t (Rev. 03/99)
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