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I~~:~~;~-work ~~~~ ~`:ion Act Notice
<br />Public reporting burden for this collection of information is estimated to vary from a range of 10 beers ~s an
<br />average per response for some minor facilities, to 110 hours as an average per resi~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, Itrformation Policy Branch, PM-223, U.S. Environmental Protection Agency, 40i M Street, S.W.
<br />Washington, DC 20460; and to the Cffice of Information and Regulatory Affairs, Office cf Management and
<br />Budget, Washington, DC 20503.
<br />General Instructions
<br />1. ]f form has been partially completed by preprinting, disregard instruction duected at entry of that information already
<br />preprinted.
<br />2. Enter "Permittee Nome/Mai/ing Address (and facility name location, if different)," " Tarnrit Number," and "Discharge
<br />NumG•zr" where indicated. (A separate form is required for each discharge.)
<br />3. Enter dates beginning and cdidng "M~nitnring Faricj" covered by farm where indicated.
<br />4. Enter each "Faramztar" as specified in monitoring requirements of permit.
<br />5. Enter 'S:nnplz lvf~~rw.~me~rt"data for each parameter under "~u~nrin`" and ~:u~lil}`" as specified ir, permit "Ava,~age" is
<br />normally arithmetic average (geometric average for bacterial parameter;) of sll sample measurements for each parameter
<br />obtained durir~ ".bl nir.rino Pri-,1"; "ii6_aiu+uur" znd i~dini~,~;uu" arc nornrally c~~:cme high and'.ow mcasmemenh
<br />obtained dit~r,g ",t;.nil-.rr.re 1 a:-i:.f". (iVutc to municipals v; i;lt scendary rcatmcn' r. ,uireme ~l: Lnicr ,0-day 2vercge
<br />of samnlc rneasurcmcats unr'cr "Acarl~~,"and cnlcr+-t~cmuut 7-d:y average, cf sn t p'.; m.sr.rcmcrts ohla~ncd CurntL
<br />monitoring period under ",L1lximm~..")
<br />G. '-:r."c•'T,`n,.~;Rr;;•irz„u:~t"in cachpammcterund: 'L~,.,,rii;p"any ";v/ih,"asspcci~icdinp~: nit.
<br />7. 'Jad.r "1'.L Er" cuter numhzr nfsai~nlc mea~x:men, dung mo ''r i~ `_~od t~:•; _;c.ed mani.rLm (snd'cr rrunir^ur,+
<br />er 7-d<y nvert~a as a. propriate) permit rcq`rr_mcnl ftv each n:r^rneter. If no^:;, enter ",
<br />- ~,
<br />$. cmcr Fr~_~•`~n.; .. : ,r ~/;•x`r" Loth ¢s "S ~.r.; r_ h'.• ~.r,•,....~;:r" (.:cmrl L,. u; nc~ of ,:..:~piir,o, e ~.d anal. "-~ sod c'^!i`t~
<br />monixr;;~greriod) r .c as'Ts;;,ritR~;a`irc;r?;t"spe~:Gcti in pu,n~:- (c.6.' 's "- +, "'ra cu.rt-.aos rnnniWrirg, "//7"
<br />for ouc day nor+.:oc'~ "//30" foe cue day per ro.nmb, "!.'90" for ors day per yuar.~r, a.:.l
<br />9. °n:cr ",S1rr;• '_ TY .•' I+c r` zs "S~;IIrI_ ~'.; =~sn~_~,:.:,~~' ("ucl s.~rpl, iv.. ,i. d d:.; ;~ :rtonil~rin~ ccrind) and as "P.-.rig'
<br />R~.lnira;~~nl," (e.g. Cplcr "Groh" fur individur,l r.ara,;l.. "7-,;/~ fa' 7,:_nt.^ wmpc-etc, "?.%." for conGnuou::
<br />monitoring, etc.)
<br />10. 1',"]c-r, viclaliens of penrt$ recuircmcn*s ~re re^orterl, attach a I;rief c,:plr^ation to dscribe caLL~;e and eeraive actions
<br />to be taken, and reference each violation by date.
<br />l1. 1; "no discharge" occurs dtuing maniter;ng per+nd, crtar "~lo liischxr"e" across Run in plr-co nfdats cn,r}.
<br />12. FnICr "Ar~mz/TNL rf,^rin;:ir~! F_c_srtiva Gfj'.•,~" with "Si.;nwoe of i•;~ur~i/._r F;e_viiv_ D~~zr of Auth~.rize_t
<br />Abznt, ""Talaplr~na Nrunbar, "and 'Data" at bottom o f form.
<br />13. l~fail signed Report to Office(s) by date(s) specified .n pcm~it. Retain copy for your records.
<br />l4. Ntore d:aailed instructions for use o` this Us_~17a;ga i:4arira-Lm Rri,o,± (D,L7iJ form may be obtained from Cffic:,(s)
<br />specified in permit.
<br />Legal Notice
<br />This report is required by law (33 U.S.C. 1318; 40 C.P.R. 125.27). Failure to report or failure to report truthfu'ly 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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