|
<br />Public reporting burden for this collection cf information is estimated to vay uom a range o'' ] 0 ho :rs aS an
<br />average per response for some minor faci]ities, to 110 hours as an average :er response ;o. ec~-~ r:ajo-
<br />facilities, with a weighted average for major and minor facilities of ! B Lours per uspoase, i~~::~uding fire fc-
<br />reviewing instructions, searching existing data sources, ga.hering and nain'aiLing the data aee::e3; nat.
<br />completing and reviewing the collection ~_` information, including suggristion for reduci,-tg :his brdcn, to
<br />Chief, Information Policy Branch, PM-223, U.S. Environmental I=,otection Agency, 4~Oi ::I ~trect, ~.vd.
<br />bvashington, DC 20'660; and to the .^,f!zce :, i information and Regulatory .Sfi£±-s, Cr~ice of G: tango.--.ea_ and
<br />Budget, ~Jashington, DC 20503.
<br />
<br />1. if form has been partially completed by p~,.p;'nting, disregard instruc:ior~ directed at retry of th~i info_-maCor already
<br />preprinted.
<br />2. Enter "Permittee iJome/Mailing Ad+ress (..od f2cility nameAocation, iC diffe,ant)," " ,'errnit Nu,; :. -," an_ "D,s~he,•,;:
<br />Number" where indicated. (A separate `ore is requird for cacti discharge)
<br />3. "serer dates beginning and editing "Ivl...ritor; ~~ Period"covered by form where tnriicrted.
<br />4. Enter each "Parameter" as specified in mod .oring reeuirements of permit.
<br />5. Enter 'Sa,ap?e ivle urerren!" data for each ~aramet~r under "~ua~+trty" ant. Qacf ~' as ;~ecificd ice.: =ro _ t. `tiveroge" s
<br />normally ru-ithmetic aversge (geometre ave,-rge fe - b: ctera! naram~•ters) cf all saff ~Ic ~ ~asnrem~iG, C~ • esc ~ ~. ~rmetcr
<br />obtained during "monitoring Period"; "iii..:ir+ur:r" and iur;:i.,no-.r" an ~.o;?nr'.ly c..tr~ne bi;h r*iJ o:': ncesu~emcr~'s
<br />obtained during "Monitoring Period". (Note to-..•,micipals :vith seconder; L-catmcn' rc.lusem~:. ~.: e. 3C-nay ;.vesoe
<br />of sample measurements under 'Average,"rid catz maximum 7-day rveage o; sap:e measu-c.-_rts oba.:ner: du-'c,
<br />montoring period under "Marimum.")
<br />5. Eater "Pen:,a Rgcirer;rent"for each parameter under "Quentiry"and "Quality" as sp eci. icd in pst -~::.
<br />7. Under "Aro Ez" enter n•retber of sample mra_ure~r. _nt during monitoring period tbr' ~;cccd ma::ir-n m (.udr.: - m ~~^.+ .~
<br />or 7-day average as appropriate) permit req_~irement for each parameter. it"none, entr.r "0".
<br />8. Enter "Frenuency ofAnolysis" both as "Sm;;o!e I/eas:•rzneit" (ac.ual fregecncy o` sanpling and a-a~ysi: sec durn~
<br />monitoring period) and as "Permit Requtrea.ent"specified in permit. (e.g. 3r_*.r' "Cott," `o: contiruou~ mon'~orir~, "1,7"
<br />for one day per wee!c, "1/30" for one day per month, "1/90" for one day per quarter, e:c.)
<br />9. Ente= 'Sample Type" both as "Sample Meas^remert" (anon'. sample type used durinh monitoring ;a :ad) err as "Per;r.;t
<br />Requirement," (e.g. Enter "Grab" for inuvidual sample, "14HC" fo.- 24-hour composite, "~.,',:"' fo- car.tinuc~
<br />monitoring, etc.)
<br />1C. S/here violations of permit requirements are reported, attach a brief explanation to desc~ue cause a;c. co~rrx ive =cticas
<br />to be taken, and reference each violation by isle.
<br />11. If "no discharge" occurs during monitoring period, enter "Ido Discharge" across form `n place of data c ory.
<br />12. Enter "Namelfille of Principal Executive Officer" vrth "Signature g` Principal Executive O„rcAr o,` A~t.~orize~l
<br />Agent,""TelephorreNumber,"and "Date"at bottom of form.
<br />13. Nail signed Report to Office(s) by date(s) specified in permit. Retain copy for your rceords.
<br />14. Mon: detailed instructions for use of this Discharge Monitoring Report (DMR) fr, ~ may be obta:oed fra. a Office(s)
<br />specified in permit
<br />:s~~~~Il ~T®tice
<br />This report is required by law (33 U.S.C. 1318; 40 C.F.R. 125.27). Failure to report or fai ~rrre to report tn.fr_ully can rsult ir.
<br />civil penalties not to exceed $10,000 per day of violation; or in criminal penalties not to exceed $25,000 }er day c.f violation,
<br />or by imprisonment for not more than one year, or both.
<br />EPA .Forst 3320-1 (L2ev. 03/9)
<br />
|