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Paperwork Reduc,.iolr~ Act ]Vnric.
<br />Public rrrxr:mg hurden fur this collection u( infurmahun ,• asaanated to - ... ronrr rat I~! tour as an
<br />average per rrs-p:mse fcr some wnur (ac?lities, to 110 hours as an averag; ; ~.~ .. _ , ,r ..;rn~ m,,.~r fa il~tizs, j
<br />with a weighted average for mainr and minor facilities of 18 hour per ~.r pon . ~acl !dmg time S.r re~izwmg
<br />instruction., searching ex!cnn ~ ;ia;:, eourees, gathering and nlai -_ t: a d.a uer~:zd, and completing and
<br />m mwmr the cvllrctie: of mfu.,ia;b.ro. Send Gt~r?bts rr ar._ , d_: n rdrn rstitturtz or any other 2spect of
<br />t}ri, cnllr,tiun cf information, !n:icdcr_ suggestitYOS fu! n~J.n r~ thu b irdeu, to Ctuef, Information Policy
<br />Branch, PM1f-223, U.S. Environmental Prulectior P rrncy, 4U; ht Street, ~i'.V 1V.~chingWO, DC 20460; and to the
<br />Office of Information and Regulatory Affairs, ~: rice u! !~Sanagrmznt and Bt Jigzt, ~Nashitigton, DC 20503. ~
<br />General Instructio;u:;
<br />1. If form has been partially completed by preprinting, ~L---~ yard mstrvctinns .i rrrt, .~. zt entry of that in(ormatioo
<br />already preprinted.
<br />2. Enter 'Permirree Nnnr. Afnrirn~ addreus (and (, ~ ~ tarnz.'locateor 'f _. ~~. "I'rrnu. A{una4c-." and
<br />"Di.crhnrge A'vmber'~ ~.? here indicated (A separate L _ ~.~ytured for ra :h d ~ '
<br />9. Enter dates bcginnin£ and cndinp '."•larirorirrg P~ ~ Frei by form t Li ~ ,i.
<br />-0.EI?I:?~,:c;."Purnmerer"asspecifedinmOttitorir -~ ~:•nlsofpmm~
<br /> Eut<:. ~an,pM dlea~,:. ;::,•.,r' ':n: for each . _a' "nu,.a:i( ,;n, ..' i : r. ,r~rmn
<br /> ru.~' !s nonuall. ..: !u~ti~ :average : ,ge for bacG. .. ..: do a.:a~...en;c,..
<br /> 1. ,: ra:i; paramclr ubi::.ac~ dunng "rt/rv ,':Nm-i•vr:. ~ ~ .nor 11: ! •.,•- ~,i •'
<br /> gunk lo•,v rmav:re;ncros nMamrd due! n.:~.:-... Yerioa " ,.~. o!r 7. ~
<br />,. ,~.
<br />... _.. .~~c::: nn u'
<br /> rl'(111Ih nt, n~' F1112r iU-dal ;i\C' ~Y• ~ - ~:. it U:''•:i M1'!nCm$ Ildl:r; ~..~:~,:. .~ ... ,. "'....', : i ~: ~. L.qr,'.'.',:
<br /> of x+nipi: musurcnrms obtainer - ~,:nr,!or nl pr!!. ; ur .r. .,::n:. ,
<br />. Fntc: "!'r~: ;., Yeyurrrr.n .:' ...:: parr. ,rc!er und:r' . r~••nrrn" , nc ' ~ :~ . ,. ~ ... r.-. r.:;
<br />~. 1'rd~ e .,'~ . : ,' cnn~r nun:' -.,.nplc me,tsunncc.: Burin, ~.:~uiG! ~
<br />~ .. .....,. ,..:u,:r'~ tandn:
<br /> tn!a~r;,:m v. '-day avera~... - ~ra!r: psnnil reyr~remenl for ea.• ~
<br />i • .. ,...,_ zed: "r'
<br />~. Fnicr "l rryurncr ni Inul: ~.,:~ ~ :c ' `, nnp/e :llc. ", near, l" t::c•~. ~ i :: ~ipl: n:.~ : ^ . ,.,,~:i.: ~,.:.:~
<br /> durint munura ing pcnod) ~ :~' . ':"'arnur hequirernr,~r ~pn i~ C g u.'r ' a..' •;.i ~ x' is
<br /> n?oni!onng, ' i 7" (or one dm c ,:4. ', ~U' fc: one Bar p:r ::... ~ otn •;} ~r ~ .,.t^•: r.
<br />.r Enter "Sanrplr 7i/~e" both as ' .. .. .~ ~ r. at,rrn:en!" .?,_tu:rl sa:~:r;- ;
<br />•
<br />~
<br />~
<br />,- ~,. >>r,i!orug pc ~i,, ~.;1 ;wc ...
<br /> "Yrrrnir Requirement," (c.g, F.:
<br />"~ '(:r:~t" for tnds
<br />?d;:ai 5an'^i~
<br />`: ~ ~::r -.~~^-c~:b ~•.: ! ~~
<br /> continuous monitoring, clc ;
<br />1(1. Where viola(ions of perms; rcquiramcnu arc reported anarh ..:-m. ~.~ I,. d..n 'cs:r~nr .,:r.~. :: S .... ..-
<br /> actions taken, and reference eacl: violation by chic.
<br />1 I. 1("no discharge" occurs durigr; monitoring period, Cnl2i 'Yu 1%rse har;t:•a" ~ : ~r ~ hrn~ :ce :~i .. ~r: c: tr.
<br />12. Enter "Name Title of Prinnpr.! F_eeculivr (iJficer" arth "Srgrrnhvr o/~1'rr; i a; /:: ~ ~ -rr ~ %Il`rrr ! ~.t vrira ,
<br /> Aganr," "Telephone Number," vtd "Dare" at bottom of form.
<br />13. Mail stgncd Report to CHTse(s~, by dale(sj specified in pernut Re~wn ccp~. fcr y ;ur rc.,;eds.
<br />(4. More detailed instructions for ;ur of this Discharge Afonin,rlrta krpor; (/,qI t. firm rtav oe oi~la+.:ed iion, Oi"''c.':;,
<br />specified in permit.
<br />Legal Notice
<br />This report is requireG by law (33 C.S.C. :318; 40 C.F.R. ;?j.27). Fxilurr E ..o: ~. or r ii:c.e a, ;el"rr• nuth(uG. r. ~•
<br />result ir. civil penalties not to exceec SI0,000 per day of violation; o* in cri mia '~ (_rr ties r,rl :~~, uacee.., ~"!5 tK)a n~
<br />of violation, or by imprisonment for not more than one year, or by both.
<br />.~
<br />EPA Form 3326-I (Rev. OS-95)
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