|
- - - --- - -a - -- ---- - - -- --~- -- - -- - - -----~ ~ -
<br />Paperwork Ireducti~on Acs ',`~'~.:'.:' ,
<br />Public rrgrrting burden for this colluCOn of information is esum,.tet. 1,. ~ .. 'xu:_r •;; ~.:; L;,ur; da an '
<br />~ average per response for some mino- facilities, to ; 10 he,m; as an averag: ; :r c.s~ 'or ~nu~~ -:; ~~: fa ilrt;es,
<br />~ ~s~ith a weighted average fnr major and minor facilities of CS huun per ~• IK~.: ~ ire :Jing :i:r._ ' r re k~:.ng ~~
<br />~' inslnlelir,ns, searching existing daL•, sources, gathering .i n~ maintaining ,... ::e,. ul, ~;.~ ..c mplet ag anc,
<br />~~ reviewing the collection of mforma[ioo. Send comment_• rrganjing [he r, r~.r =;im...c ~,: aay other a;pxt of
<br />This collection of information, including suggestions fol redur~,ng [his h -u:,., 4, ',,,,;, I~funration Policy ;
<br />Branch, PM-223, U.S. Environmental Protection Agemcy, 40. ht Street, S'. ".': r airg ~n~ JC 20460, end to the ~
<br />Office of Information and Regulatory Affairs, Office of Management end 131.: get, ',Nash ^gtuo, DC 20503 -~
<br />General Instructions
<br />1. If forth has been partially completed by preprinting, disregard urstructlons directe.i at entry of that information
<br />already preprinted.
<br />2. Enter 'Permittee Nnrne/Maiting Address (and facility name location.. if di6erertt)," "Permi! Number," and
<br />"Discharge Number" where indicated. (A separate form is required for ear-h discharge.)
<br />3. Enter dates beginning and ending 'Monitoring Period" covered by form where indicated.
<br />4. Enter each "Parameter" as specified in monitoring requirements of permit.
<br />5. Enter "Sample MeasuremenP' data for each parameter under "Quantity" :md "~'uality" in uniLS specitie,i in permit.
<br />"Average" is normally arithmetic average (geometric average for bacterial parameters) of all sample n;c;asurements
<br />for each parameter obtained during "Monitoring Pertud"; "Martmum" and 'Y~limmu,n" are normally eetreme high
<br />and low measurements obtained during "Monitoring Period." (Note to r~u.nicipals wish secondary treatment
<br />requirement: Enter 30-day average of sample measurements under 'Average," and ulster maximum 7-.gay average
<br />of sample measurements obtained during monitoring period ur;der "blazimum. ~
<br />6. Enter "Permit Requirement" for each parameter under "Quantity" and "Quality" as specified in permit.
<br />7. Under "No Fx" enter number of sample meastuments during monitoring period teat exceed maximum (and/or
<br />minimum or 7~ay average as appropriate) permit requirement for each parameter. if none, enter "0".
<br />8. Enter "Frequency ojAnalysis" both as "Sample beasurment" (actual freyuenty or sampling andmialysis used
<br />during monitoring period) and as "Permit Reguirernent" specified in permit (e.g.. Enter "('ont," fo. continuous
<br />monitoring, "f/7" for one day per week, "1/30" for one day per month, "1.,90" for one day per quarter, ei:.;
<br />9. Enter "Sample Type" both as "Sample Measurement" (actual sample typt: uses during monitoring peiod} attd as
<br />'Permit Reguirernent," (e.g., Enter "Grab" for individual sample, "1JHC' far .•l-hour composite, "A::i" for
<br />continuous monitoring, etc.)
<br />10. Where violations of permit requirements are reported, attach a brief explanation to describe cause at d cor;ect,~
<br />actions taken, and reference each violation by dale.
<br />11. If "no discharge" occurs during monitoring period, enter "No Discharge" across form ~ n place of data et try.
<br />12. Enter "NameiTitfe ojPrincipal Executive O,~cer" with "Signature ojPrircipat Executive O-(Dicer o"f.urho"iz~~d
<br />Agent," "Telephone Number," and "Date` al bottom o(forn.
<br />13. Mail signed Report to Olfce(s) by date(s) specified in permit. Retain copy for your records.
<br />14. More detailed instructions for use of this Discharge Monitoring Report (Dh/.'2J form may be obtained fo om ;6ice(s)
<br />specified in permit.
<br />Legal Notice
<br />Tbis report is required by law (33 U.S.C. 1318; 40 C.F.R. 125.27). Failure to report or failure to report truthfully can
<br />result in civil penalties not to exceed SIQ,000 per day of violation; or in criminal penalties r~l>t to exceed $25,000 per d._;
<br />of violation, or by imprisonment for not more than one year, or by both.
<br />EPA Form 3320-1 (Rev. OH-95)
<br />
|