HYDRO28215

• Permit No: C1981018
• IBM Index Class Name: Hydrology
• Doc Date: 2/26/2001
• Doc Name: January 2001 DMRs
• Permit Index Doc Type: DMR’s
• Media Type: D
• Archive: No

Paperwork Reduction Act Notice
Public reporting bwden for this collection of information is estimated to vary from a range of IO hours as an
average per response for some minor facilities, to 110 bows as an average per response for some major
facilities, with a weighted average for major and minor facilities of 18 howl per response, including time for
reviewing instructions, searching existing data sowces, gathering and maintaining the data needed, and
completing and reviewing the collection of information, including suggestion for reducing this burden, to
Chief, Information Policy Branch, PM-223, U.S. Environmental Protection Agency, 401 M Street, S.W.
Washington, DC 20460; and to the Office of Information and Regulatory Affairs, Office of Management and
Budget, Washington, DC 20503.
General Instructions
]. If form has been partially completed by preprinting, disregazd instruction directed at entry of that information already
preprinted.
2. Enter "Permittee Nome/Mailing Address (and facility name/location, if different)," " Permit Number," and "Discharge
Number" where indicated. (A sepazate form is required for each discharge.)
3. Enter dates beginning and editing "Monitoring Period" covered by form where indicated.
4. Enter each "Parameter" as specified in monitoring requirements of permit.
5. Enter "Sample tLlzasurzment"data for each parameter under "Quantity"and Quality"as specified in permit. ':4vzragz"is
nomally arithmetic average (geometric average for bacterial parameters) of all sample measurements for each parameter
obtained doing "Mcrriroring Period'; "~Llaximnm" and Mininurm" are normally extreme high and low measuremeoCS
obtained during "~Ylonitoring Pzriod". (Note to municipals with secondary treatment requirement: Enter 30-day average
of semp(c measw-emenis under "Average,"and cote; maximum 7-day average of szmple measurements obtained during
monitoring period under '9Llarimum. ")
6. Enter "Permit Rz_Ivinmznt" for each parameter under "Qtr~~mliry"and "Quality"as specified in pet~nit.
7. Cndcr "Na Es" enter ^umber of sample me _surcncnt dwing monitoring period Utat cwcced maximum (and/or tnirmum
or 7-day average as appropriate) permit requirement for each parameter. if none, cuter "0".
S. Era.r "Fretuerry ojAa.t!ysis" both as "SanrpL• tDfeasvrzntzmt" (actual frequency o"synpling and analysis used during
monitoring period) end as "Permit 2 ~u!rtntent"specified in permit. (e.g. Enter "C%tr!, "for continuous monitoring, "1/7"
for one day per week, "//30"for one day per month, "1/90" for one day per quarter, etc.)
9. Enter "Samf !e T}Fz"both as "Sample tlleasu;~ement" (actual sample type used during monitoring p:,riod) and as "Permit
2auirzinznt," (e.g, linter "Grab" For individual sample, "24H~" for 24-hour composite, "N/A" for continuous
monitoring, etc.)
10. 4'here violations of permit requirements are reported, attach a brief explanation [o describe cause and corrective actiuns
to be taken, and reference each violation by date.
11. if "no discharge" occurs during monitoring period, enter "No Discharge" across form in place of data entry.
12. Enter "Namt/Ti!le of Principal Exzcutivz GjjS~er" with "Si~rtature of Principal Execrrtive Geer of Authorized
Agznt, ""Telephone Number,"and "Date" at bottom of form.
13. A4ail signed Report to Office(s) by date(s) specified in permit. Retain copy for your records.
'. <. 1,[ore detailed instructions for use of this Du°horge Monitoring Report (GMIj) form may be obtained from Office(s)
specified in permit.
Legal Notice
This report is required by law (33 U.S.C. 1318; 40 C.F.R. I25.2'n. Failure to report or failure to report truthfully can result in
civil penalties not to exceed $10,000 per day of violation; or in criminal penalties not to exceed $25,000 per day of violation,
or by imprisonment for not more than one year, or both.
EPA Form 3320-1 (Rev. 03199)