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~aperworlk ~educf:ion Act Notice
<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 110 hours as an average per response for some major facilities,
<br />with a weighted average for major and minor facilities of L8 hours per response, including time for reviewing
<br />instructions, searching existing data sources, gathering and maintaining the data needed, and completing and
<br />reviewing the collection of information. Send comments regarding the burden estimate or any other aspect of
<br />this collection of information, including suggestions for -educing this burden, to Chief, Information Policy
<br />Branch, PM-223, U.S. Environmental Protection Agency, 401 Ivl Street, SW, Washington, DC 20460: and to the
<br />Office of Information apd Regulatory Affairs, Office of hLamgement and Budget, Washington, DC 20503.
<br />General instructions
<br />1. If form bas been partially completed by preprinting, disregard instnctions directed at entry of that information _
<br />already'preprin[ed. - ... , '
<br />2. Enter "Permittee Name/,lrlailing Address (and facility ramelloeation, if different);' "Permit Number," and
<br />"Discharge Numbei' inhere indicated. (A separate form s required for each discharge.)
<br />3. Eoter dates beginning and ending "bfonitoring Period" coT;ered b}~ form where indicated.
<br />4. Entry each "Parameter' as specified in monitoring requireenerts of permit
<br />5. Enter "Sample ,bteasurernen!" data for each parameter urd ~r "Quantity" and "Quality" in units specified in permit.
<br />"Average" is normally arithmetic average (geometric al~etage for bacterial parameters) of all sample measure-
<br />ments for each paratnetcr obtained during "P.:ortitnrin;; ['-rind"; "rilaxim.~m" and "A4inimum" are normally ee-
<br />treme itigit ana low mc:tsurcmcn[s oht;r~ncd during',,,%i it-.ri-'r PeliraC" (~oic to rnunicipr.ls with secondary
<br />trearmen' requiremen*.: Enter 30-dig ae..ra~r c` ser'..tp e ~..n~~asu._mcnts under "riverage," and enter rnaxi;num
<br />7-dad, ~wer.,ge of sample mcas~.!re:-lens r,F[: ln. d d~n1n^ Ir,ir ito; :-g periud under"1)ecimurc."1
<br />v. Inter ! en~nrf egelrer;ten~ er each p:.ra.-peter unoet "{7.:~r~,tlry .n^.d !)rlnrl!~' as tipcc~ ec in permit.
<br />~. L'nd.r "~'.:11~" en'~~ numSer o" airl-.~ ,ca,ure-r.cnt, : ~. -~ rro^itnring poricd n_.. cu:cd ma:.n:um (anci.'or
<br />mtri r.um u~ "I-d.;; a.crage ~:: appropriate) permit rcquile'.lenr n~ cash puan~.acl ,F none, emer "0."
<br />~. ±+-ate- "Irregtre;:~,l of ilr:a:j~sis" 1-ot'~ a; "Can+-r!Y dleasle,'.~ -~r.t" (,~-ru,il frog°.ICr~i of .amplin~ ar.J snalyss usod
<br />,. ,~
<br />du-log rnont~crrg penod) ands ",'e~~ni! I:er~dren+enY s;~eclued in perm[[. (~.~.,r:nt~~ C~Imt, far cun[muou,
<br />~.TLni[QCin P„ ~~1; T' for Ono C~a~ O.I '.` 2K, ":': 3~" fOC 0112'.; 'j ik'r n"Cn'h,, "!/9~" pt'.- Jilt ~ _~ pzr ~l7rICCI', ~::.)
<br />9. Enter ",San!p/r'tlp~'" h_~t~: as "Sa~»ple d'Irru rlntrnent" (z_.
<br />"Pemt_t Reduireme: a," (e:g., Fnrer "^.~b" i~r ndi/idurl
<br />tinuous mr,nitoGng, etc.)
<br />10. ~7~terc-7o(ations ofnermit renutremente ere t?ported, t t
<br />a~iiens [;t2: r, ar,d re ": r; nrr each G,ni~-~en e; pate.
<br />:a! salr.°.ple'}ne uses
<br />~nplr, "J~=NC' for 3
<br />Bch a hr . t eeplanatic
<br />-u:~,r~ ~~ .~nltorn~ prod) and a,
<br />h,n.r composite, ".V/,:" for con-
<br />. .:-}.-~ _ • '- , - ....
<br />in [n descrhe cruse and rurrectice
<br />1 i. i; "na ;iis=.h.li;~" UCC;Iis duar~ roar:i'erny. l,crii.d, ern _ ~,%, ~ Jisll:n-~~~" across ion.' m place ,~: ddt-~ entry.
<br />17 Later ~.~ cc. 'Ttlr ~J 'r;,ei.: z! ia:c ~' . -, ~~_ o .,_ ;° yrr rr,Ndl F:~rCl~rire Ulric,[ ~j A-!rhori,:ed
<br />,[gory," '~ I'rlcTa~une `.lwirbrr," '.,.d "Crrt -.' liaGnu, nr .,i_ ,- ~ -
<br />i3. y,tail siencd K:pcr,'o gffe:(tip ht vale! pt 5,ed r , ,~ i... ~e~e;n c.;p, I'u~}our r_m~ds.
<br />1 'riarc Lcran~_~ instr ~:irlnc'a, use ni ;,as llarrlr.>~;e :,1 n-ror~I~„ .`; -nu~-r !U~,I".l fort Hwy ;:v e,tar.._J .?nm O(
<br />`;ce(sj cpea,ied in e mit.
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<br />1'I:is rector[ ie ~~ ;a~ic.` 5, ,.tr IJJ .,.a.C ' ?1~~. ' ( :._ . ._ ~ ' .. F ,~
<br />•~ -: r., : ~r:.,r i::i' _:~ ',: ~:hui. ', ut..,, .....:
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<br />~ .. -,i, U: 1 ~ .. IP I erta t ~ - G~ ~ ~ .~., a~J,~ ~ <~; ~- ,
<br />;13r1<~r.. (.: '~~ 1mf; Lr] .h il` .Ji ~. _.~ ..c ,i~:_i ~ one ~.. ,, , ~I,-,
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