|
Paperwork Reduction Act Notice
<br />Public reporting burden for this collection of information is estimated to vary from a range of 10 horns 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 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 Management and
<br />Budget, Washington, DC 20503.
<br />General Instructions
<br />1. If form has been partially completed by preprinting, disregazd instruction directed at entry of that information already
<br />preprinted
<br />2. Enter "Pernrittee Name/Mailing Address (and facility name/location, if different)," "Permit Number," and "Discharge
<br />Number" where indicated. (A separate form is required for each discharge.)
<br />3. Enter dates beginning and editing "/vfonitoring Period" covered by forth where indicated.
<br />4. Enter each "Parameter" as specified in monitoring requirements of permit.
<br />5. Enter "Sample Mzasrrrzment"data for ezch parameter under "Qulntiry"and Quality" as specified in permit. "Aven_ge" is
<br />normally arithmetic average (geometric average for bacterial parameters) of all sample meastrements for each parameter
<br />obtained during "N1,nitoring Period"; "rLLui;;tura" and :Ylinimum" are normally ex[rome high and low measturtncuG
<br />obtained durng ";vionitor ing Peri~_t". (Mote to municipals wish secondary trea~ment requirement: Enter 30-day average
<br />of sample meast~remunts under "riv~rao~,~,"and eater m~umurn 7-day average ofsatmplc measurements obtained durng
<br />monitoring period tinder 'SYlaximum.")
<br />6. Eri::r"Pe:;aitRtatrir,~rn~nt"for each parameter under"Qu_m!in,-"ar,d"Qneoliry"asspccifiedinpennit.
<br />7. Under "T/~ Gi' entry na>sbcr oFsamplc rrcasrr_mcnt during monitoring pericd that crcccd maximum (and/or rti:'mum
<br />or 7-day average as appropriate) pcrrnit rcquiremect for each parameter. tf none, ester "0".
<br />8. Er..er "Fre;re.t_y cf~InuJysis"bolo as "51,,:F1~ .L;arau ~rrta,u" (actual p~qucr.cy o"sampling and antalysis used during
<br />monitoring pcr.od) and as "PCliili! R~yui."nrur"specified in permit. (c.g. 5n:er "Co,r!,"for continuous monitoring, '7/7"
<br />for une clay per v,~eelc, "//30"for one day per montit, "1/90"for one day per quarter, etc.)
<br />9. F.u[et "SamFla Typ."both as "S„nFla ,L1=~r.~;r,a:rr~"(actua ;ampl_ type used dttring monitoring period) and as "Frn;rit
<br />R:.iuirzm~ tt," (c.g. Enter "Graf" for individual sample, "24f,'C" for 24hour composite, "N/A" for continuous
<br />monitoring, etc J
<br />10. Rlhere violations of permit requirements are reported, attach a b. ief explanation to describe cause and corrective actions
<br />to be taken, and reference each violation by date.
<br />11. ]F"no discharge" occurs during monitoring period, enicr "No Dischazge" across form in place of data entry.
<br />]2. Enter "NantJTide of Principal Exscvtiv~ ~_•.r" tvi0r "Sibnatur,: of Prin_ipa! Eseczttive O~cer of Atrthorized
<br />Agent, ""Telephony Number, "and "Date" at bottom of form.
<br />13. Mail signed Report to Office(s) by date(s) specified in permit. Retain copy for your records.
<br />14. More detailed instructions for use of this Discharge Mcnitoring Report (DMf~ form may be obtained 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 tmUtfully 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 />
|