|
- - Pa~ ork Ire~ucifarn Act ^i~t~
<br />i
<br />Public reposing burden for this collection of information is ,~tirnated It ~.,.1 ..,,n . runge of LO boon as an
<br />averagz per response for some minor facilities, to 110 hours as an .: erago per n~~,; ~onse ,Far some Major facilities,
<br />with a weighted average for major and minor facilitieB of IS h...r~ per resf~onx., iucJti~lpg tithe for rgv~ewing '
<br />i mstructions, searching existing data sources, ga~aring am i,.: ~N,ia:og the da4t needed, and wmplet.~g and ',
<br />reviewing the collection of information. Send cagfttrent> ~.~ir~iog tee i`,.tJet .stimate cr any other asxct.of
<br />1 this collection of information, including suggestions fui reducing this t~uNe t to ~ itief, Information Policy I
<br />Branch, PM-223, U.S. Environmental Protection Agency, 401 114 Street, SW' Wa,~hiaglon, DC 20460; ao~ to Wz i
<br />L (Nfice of Infonration and Regulatory Affairs, Office of Managetaoent and Budget, 'tYashmgtoo, DC 20503. -
<br />General Instructions
<br />1, L' form has been partially completed by prepnoting, disregtud instructions drrecled at entry of thtu information
<br />already preprinted.
<br />-.
<br />2. Enter "Permiltee Name/Mailing Address (and facility tutme/logtion, if c'iffererrt)," "Permit Dumber," and
<br />"Discharge Number" where indicated. (~tseparate form is requuad toreach discharge.)
<br />3. Enter dates beginning and ending 'Monitoring Period" covered by form v+here :adigrcd.
<br />4. Enter each "Parameter" az specified in monitoring requirements of permit.
<br />5. Enter "Sample Measurement" data for each parameter under "Quantity" and "~'uali(~" iu units specified in permit.
<br />'Average" is normally arithmetic average (geometric average for baMerial pa:z.»eters) of all sample measurements
<br />for each parameter obtained during "Monitoring Period"; ",Narimum` and "bl ninm:+r" are normally e:areme high
<br />and low measurements obtained during "Monitoring Pesa~." (Note to m.micip;Js ttith seconder; treatment
<br />requirement Enter 30-day average of sample measurements under "Average," :.nd _mer maximum 7-day average
<br />of sample measurements obtained during monitoring period wider "Maxitrrurn.'~
<br />6. Enter "Permit Requirement" for each parameter trader "Quantty" and "Quality" az specifed io permit.
<br />7. Under "No Ex" enter number of sample measurements during monitoring period ttat exceed maximum (and/or
<br />minimum or 7~ay average az appropriate) permit requiremeal for each parameter. If ,none, enter "o'.
<br />8. Enter "Frequency ojAnatysis" both az "Semple Measurmen!" (actual O~equenry o' sampling and analysis used
<br />during monitoring period) and az "Permit RequiremenP specJed in penttit (e.g. Enter "('ont," fo conttnuous
<br />monitoring, "1!1" for one day per week, "1/30" for one day per month, "190" for one day per quarter, d:.;
<br />9. Enter 'Sample Type" both az "Sample Measurement" (actual sample type usea dunng monitoring pF:iod) and as
<br />"Permit Requirement," (e.g., Enter "Grab" for individual sample, "7J/!C" for 31-hour mmposilc, "NiA" for
<br />continuous monitoring, etc.)
<br />10. Where violations of permit requirements are reported, attach a brief explanation to describe cause and cerrectivc
<br />actions taken, and reference each violation by dale.
<br />11. if "no dschage" occurs during monitoring period, enter 'No Utscharge" :across form : n place of data et try.
<br />12. Enter "Name/title ojPrincipal Executive Officer" with "Sigaalure of Principal Executive Officer v'ha.~thorizrd
<br />Agent,' 'Telephone Number," and "Date" at bottom of Corm.
<br />13. Mail signed Report to Vice(s) by date(s) specified in permit Retain copy for your records.
<br />14. More detailed instructions for use of this Discharge Monitoring Report /DM,Tj form may be obtained tiom Or7'ice(s)
<br />spocil;ed in permit.
<br />Legal Notice
<br />'Ibis repos is required by law (33 U.S.C. 1318; 40 C.F.R. 125.27). Failure to report or failure to :epurt tn~.thiully can
<br />rt~rlt in civil penalties not to exceed E10,000 per day of violation; or in mminaL penalties not to exceed S25,OOJ per day
<br />of violation, or by imprisonment for not more than one year, or by both.
<br />F8A Form 3320-1 (Rev. 08-95)
<br />
|