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-- ------Pairwor~~c ~i:,rlucti(tnl Act.-N•ioe --- ---
<br />' I'u b.u rcnortrag hurdrn t:~: :his ~~oileA:hun ~~f ;nlomtal~on is asUrnated ~.c ~. ~~ ~rom ~ range of 10 hours as an
<br />aeeragr t.,r restanse for s.:me miner facilities, to 110 hours as an average rrr rcpum.,. for some major factlitie;;,
<br />with a t;e~ghted average for major and minor facilifies of 18 hours per r.:,pon:.,, including time for reviewing
<br />instructions, saarcbing ezrsting da;~ sources, gathering and maintaining :ha ~L,ta oe..ded, and completing and
<br />roviewirg the cone. ton of tnti:rtnation. Send comm.:. ~•.....,c:g We burdem estimtite or any other: aspect of
<br />thi :olirrion ..f mf,:rm:! •~ l.r.~;uding ,uggestions `.. c.i~.:u:g this h~urdcn, to Chief, Information Policy
<br />i3raoch, PN--[23, U.S. Env;ronmeotal Protection Ag_.:__ ;0. `.1 Street, S'JV Washington, DC 20460; and to the
<br />~ Office of [nformation and feeguiatory Affairs, Off+.c: of ;.tanag;ernznt and Budget, Washington, DC 20503.
<br />General Instructions
<br />1. If form has been parlial'y completed by preprinting, disn:gard instructions directed at entry of that information
<br />already preprinted.
<br />2. Enter 'Permittee NamrAlailing Address, (and faciiirv muneJloplion, if differenQ," "Permit Number," and
<br />"Discharge Number" r:h..re indicated. (A separate Conn is raluired for each discharge.)
<br />3. Enter dates beginning and ending ".t!oniroring Period" covered by Corm nhere indicated.
<br />4. Enter each "Parameter" as specified in monitoring requirements of permit.
<br />5. Enter "Smnp!e :4fensu; croon[" data for each parameter under "Quantity" :md "Qualirv" in units specified in permit.
<br />"Average" is aormail} anthme:~,: average (geometric average for bacterial parameters) of all sample,measurements
<br />for each parameter obta~.'ted du*irg ";tlonitoring Period'; "Afarmrum" and ''A!inirnum" are normally extreme high
<br />and low mcasurcmeets .~btain~ .j during ":1lomtoring Period." (Note [o municipals with secondary treatment
<br />requirement: Enter 30-dac accra~e of sample measurements. under "Average," and enter maximum 7~ay average
<br />of sample meas:remeWS eb4uncd dttring monitoring period under "Maximum.
<br />b. Enter "Penn;! Fenrrire~r.,-nt" for etch parameter under "Quanrrty" and "Quality" as specified in pemtit.
<br />'. Under ",No Es" toter c~:nbcr of sample measurntents during monitoring period that exceed maximum (and/or
<br />minimum or 7-day aver,~gc as appropriate) permit requiremend for each parameter. If none, enter "0",
<br />8. Enter "Frequrrcv r,j.ar.,;!vsrs" twth as "Sample A/eosunnenP (actual frequency of sampling and analysis used
<br />during monaoring pe:ied) and as "Fermi! Requirement" sptcified in permit. (e.g., Enter "Coot," k'or continuous
<br />monitoring, "1~7" for ~r.c day per week, "lr~0" for one day per month, "/,'90" for one day per quarter; etc.)
<br />9. Enter "Snurpte Tvpe" boot as ".Sample A!earuremenr" (actual sample qpe used during monitoring period) and as
<br />"Perrntr Requuerncrr." ,c.g., G~~.tter "Grab" for individttal sample, "2JH(:" Cor 7.4-hour composite, 'N/A" for
<br />wnuruous mamlorina, z~c.)
<br />10. tVhere violalicns of j;ci ~ pit rcq.rirements are reported. attach a brief explanation to describe pose and corrective
<br />actions taken, and ref:ret`ce each ~iola[ion by date.
<br />11. !f "no discharge" 0~\'urs _'uring monitoring period, enter ",Vn .Discharge" across form in place of data entry.
<br />12. Enter "A'ame?, de oj-Yr.ncipa! Executive Officer" with "Signature ojFrincipal Ea~ecutive Opcer ojAu/horized
<br />.agrrt," "Telephone Number," and "Date" at bottom of (orm.
<br />13. Mail signed Report to Office(s) by date(s) specified in pemrit. Retain copy for your records.
<br />14. Afore detailed inslmcuons for us. of this Discharge Alnnitoring Report (I?A!R) Conn may be obtained from Office(s)
<br />specified in permit.
<br />Legal Notice
<br />7?eis report is required by !.w (33 U.Q.C. 1318; 40 C.F.R. 125.27). Failure to report or failure to report truthfully can
<br />rasa![ i^ ~ i~il iw-n3lt.as act a c>.~r,~d S%0,000 per day o(violatioo; or in criatinal penalties not to exceed;2$,000 per day
<br />.:f vinlaticn, or by imCrisorm: ".t nor no[ afore than one year, or by Lath.
<br />EPA Form 3320.1 (Itev. 0 t-vs)
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