|
r I"aperworlk Reduction Act Notice -~
<br />?ublic retorting burJcr for [}~s colL:clion cf information is estimat:d •:. csry from a range of !0 hours as as
<br />rve~agc per -e.~tuns~ ''rr so+ ~.e ninon facilities, to I10 hours a. mt rvc ub, :r-r response `or some major fazilib ~•, '
<br />wiiF~ e w; g-te,l av_~;t,e fc :nor a~ai minor facilities of 18 hots per szo,-sc, including time for tYviewing
<br />~nsti~~c+ior c, sc~+,:hi~ia e::is ~~~, r'ala sources, gathering and main ai tin ''e err neerc?, t.nd Gt>;,pieliog .toil
<br />-evizw~el :' ~ c,~'e_. ~c~ n' t`r -~v^.t~on. Send commends regardi~~g the :.irden esti mac or any ath er aspect t( ~
<br />this coilerti-r c` irtc-ma: -•: ~?cl.uding suggestions for re.ducv~g :hi utnlen, to Chief, Infurrna[i.tn Pu~.cy
<br />3rnnct, P`.`-7.2?, U.f.. env t! ~-ar.trl ?ratection Agency, 401 M Sh xt, `. `h' x1'aehingtno, DC 20cJi0; and to ~.te
<br />C~ fice of n oc-: ~.[~c , _'d R.,. s.o ' F •'fairs, Office of AAaragemvtt wd t udgu[, Washington, DC 20503.
<br />._. -- - - ~ -- -- - -.-. .. - ---~ -- ---- - --.J
<br />General Instructio~zs
<br />J. It- forr gas ;;ee^ pafiaC" completed by preprinting, disregard instntctions directed e' coin}' of that infocvati~n
<br />already ; rep'~nted.
<br />2. Em:er '?ernitrec '~ann~.lailing Address (aril Cacili[}• namc/loca ion, it diffe.*cn[)," "Permit r\nmbcr." a'd
<br />"D+sc,~'varge ~und,rr" wbe.-c izc:icatcd. (A separate form is regdred fe .ach rlischargc.)
<br />3. Enter da:cs ocgin • i tg aril ending "hlnnitnring Period" covered by for n xherc indicated.
<br />4. Enter cash "Pnra'nrrer" .a specified in monitoring requirements of pcmtii
<br />5. Enlcr "Sam,.•,e !Jro.cure,nc •.i" data or rich pa a!netc" ender "Q Penh
<br />".-1~~errg~'" i•~ nonmil!y ~. _.~e ~-•etr•,z (gcor-:eiric a~~cr;tge for'tac~
<br />for cFCh pa r2mc+;r c'~ti c: c'.!-i n;, "b,'e~iorrinK Period'. '7-c~ir nn;,
<br />and low mctst:~.r~c-~.i~ c'•lined d~~in~- ".~4;nricnnX Prnnu." C~
<br />rcquiremcni Ei.ic l~-`° .. z~agc o'S<~.nn+c mcasurcmcros ur.r'_r"
<br />oC sarnp!c nr_asu rent o :.' ncd daring moni'oring pcnod unr'cr ",vi
<br />and "QuaGrv" in units specified i : xraa
<br />'rl p~^mcuis) of all ~arnplc mezs_r:mztls
<br />a,d ";.finimu+n" arc no~nzlly csircrrc hio'
<br />. to rrun:cifn!:, uah secondary trea:mr~'.
<br />e,rge." aad en'.r maarm m 7-da" aer.~:
<br />irnur. t. I
<br />6. Enter '!'err N .R~rv irerr. n'~~ "cr each pcr..meier under "Quamit,•' ~std'Q•rnlir~" as stec~ficd in permit.
<br />7. Under '^:e i.'x" er . ~ :r or :2moJc men ucnen!s i wring r'or :o^rg pcnod ha' w:ceod max'mum :andrer
<br />minirrmu ci i-d i,r roc--r s ap:ropr.,.'c) prrmit-cquircme.-t ran ear: pzramder. I`nonc, crier '0°.
<br />8. Evlet "i•re~,+~-rr;• ojA:a'^s!s" ! c'1, as "Sonrple ,ileerrrmrn+" (act 1 crcucnry of s.9rnpliy; and an;dls~s until
<br />durinf, rr~or ori+.; cer+r~~)~c.^.d s "Pern;ir Regvircnrenr" spedfic; ~crr;t. (e. g., Enl.r "=;r.;," for con imrrns
<br />mc,ti ar ag "1/T fr o,.: Ccy ncr v;evt;, "1/30" for ore day per monta ' !/90" for o..^.e day per quarter, etc.)
<br />9. Ente+ "Sarr,tte ~••-~" t~'1' cs "San, pie .Veasvremenr" (actual sa an1, 'y 1c used dung raoni[oring perio~) zed ns
<br />"Permit Rrywrrr(o•n!,' (c.;;., °_nier "Grab" for 4tdi•r+dua! rairple, '?•!11C" For 7.~ hewn compos te, '.VII" fur
<br />canGuuous moni.oring, r„r.)
<br />l0. When: iol a~iors tf pc'^ ::equi remenL are reported, ai'.ach r aiu- :e~l2 na_ion t~ dscribc cause and co'reclivc
<br />acuoos aJcrr, and -cfen:ncr. crch t^olation by dale.
<br />11. -f "no d sd arge" e~curs during monitoring pericd, enter ".Vo Disc4ar r~~" across forr in pace of data entq.
<br />12. Enlc' ".Van-r//i:/r ojF-i.+cipal Executive O,rcer" with "Sigrorare rj Pri~tripal h_'xecmive Officer ojAerthwhed
<br />Agenr," "Tctaphnne I<'ur'b ~;~,'' and "Dote" ai ba[lom of form.
<br />13. Mail signed Repon to C+" ce(s) by date(sl specified i n permit Retain copy for your records.
<br />14. Vlore de~i ~d instr~+cGc s rer tae of this Drsc:rarge,t fonirorin~Repc-: fD;~.R) form map be ob~aincd from O~x(-:)
<br />specified ir, permit.
<br />Legal Notice
<br />iris report s required tt late 73 U.S.C. 1316; n0 C.r.R. 125.27). Fail: ~.: to report or failure [t. report truth fi l~y ran
<br />;.au![ in civ,l Sena;ties tot to excu~ 510,000 per day of violation; or it cr: -:~: al penalties not [o exc;zC `25,000 per dry
<br />of violatioc, or 6~ imprisonment for not More than cne year, or by both.
<br />EFA Fmna 3120-I (1•trv. OS ;~)
<br />
|