|
~'~.~y.t s~T~r~~ ~~~~~~~;~~~ ~~~4 ~T~~~~~
<br />Fubl_c reporting burden for this collection of infor,~ation is estimated to vary from z range of . C hors rs an
<br />average per response for some minor fact ities, to 110 hours as an average rer °esponse for some n-ajor
<br />facilities, with a weighted average for .-,iajo. aizd minor facilities of 1 g hauls per response, inc'LCiisg .irnc for
<br />rEYieWing iIlSirllctions, s°arching existing tats sources, gzthering zn:i mzint~ini'.g the d;..:r. rea~~:l, ant
<br />completing and reviewing the collection o' infoi~ation, including suggestion for reducing tits bu men, to
<br />Chief, Information Policy Branch, Pig!-22. , J.S. Lnvironmentzl Protection i .gency, 40? i~~ S(rec , :.'.?t.
<br />\':'as'nington, BC 20'.60; and to the OfCce c mso-rrtation and Regulatory Ai~'a:a, Croce of i~:znr ~e:r.~nt ~.c
<br />Budget, 4~/ashington, liC 20503.
<br />
<br />1. If form hes aeen partially completed by pn printing, disregard ins?ructio~ directed at enYy of th_t i. fo,:.•a.~oo ,'ready
<br />preprinted.
<br />2. Enter "Pernittee Name/Moiling Adwress (a -1_ ;acility namc~ocadon, if different),` " Permit Plu.-; !•~ ,` anc. "D% cl;arg
<br />Number' where indiczted. (A separate fortr s required for each discharge.)
<br />3. enter dates tegirudnl; and editiug "1:4c,7i!or' ~ Perie.l"covered by form where ;nr•ica,cd.
<br />~, Enter each 'Parome:er" as specified in mos ring requirements of permit.
<br />5. inter "Sample ideasurement"date fo,- ,zcb :.r,~: ter wider "Quantity"and Qualih,,' -s : T~cified ~~ F ..rci:. .._ •.'ge'' s
<br />normally ai[hmetic average (geometrc aver ge far ozcterial aara^leters) o''all sample r :-snremc ~L cr caci~ p2 •ce e
<br />obtained dart lg "ivonitorbrg °eriod"; "al ir,.•;n" aid I/.irimur;" ere neatly e. 're. a high aid 1 nr rersw..me,!u
<br />obtained du.-ing "F.~.c::itori;rg Period". ;I~'ot, to s.Laicipals vrith aecondar~ trca~ent re-;v~sement: ~YTr 30-, ~; ..vorg:
<br />of sample mesurements under 'Avtra~s,"r rd ent~°- maximwn 7-day average of saz•pl~ measu-c-i~ a obtr'n.? dur.',,
<br />,noaibring period under "lrlaximum.";
<br />6. Enter Perait Rgvirement"for each parrm+: er Dndcr "Quonrity" an6 "Quality" as spccifi rd in pear a
<br />7. rJnder "No E.x" enter number of samp'e mer rra.:nt during monitoring period that e;:cccd maxima (ard/o • znim. ! i
<br />or 7-day average as appropriate) perm, requ' -cmcm .or each parameter. I`none, entc- "0".
<br />8. Enter "Fre,7uency ofAnolysis" bc'b s 'Sa ore i.'e2s~rrenrart" (actual frequency of sampling and -lalysis used dr-ilg
<br />monitoring peried) and as "Pe,-.nit Reg::re;, . ri" specifiied in permit. (e.g. Enter "Cora', ° _°Or COntml DnS momin~mg, "1/9"
<br />for one day per week, "1/30" for one dad pe: month, "1/90" for one day per quarter, etc.)
<br />9. Enter "Sample Type" both as "Sa;;rple idea.+~~re.:rer+t" (actual sample type used during monitoring ~cccd) and as'Perr,:i•
<br />Requirement," (e.g. Enter "Grab" for in_ ividua'. sample, "24NC" fu. 24-hou_ co,aposite, "T7~?" far canLnuous
<br />monitoring, etc.)
<br />' 0. dVhere violations of permit rcquir~ments ^s resorted, atta.",h a brief explauation to dcscrbe cause and corrective actions
<br />to he taken, and reference each violation by ?rte.
<br />.1. If "ao discharge" occurs during moni;otingl,,,riod, enter "No Discharge" across form .n place of data eatrj.
<br />.2. Enter "Name/Title of Principal Executive ~cer" with "Signature of Principal Executive Officer of AutSorized
<br />Agent, ""Telephone Number, "and "Date" at ,; oitom of form.
<br />i3. Mail signed Report to Office(s) by date(s) s,rcciGed w permit. Retain copy for your records.
<br />i4. More: detailed instructions for use of this ~?ischarge Moni[~ring Repor! (DMR) form may be ottairad from Office(s)
<br />specified in permit.
<br />.. ~~~~a.Il I~T~~tC~
<br />This report is required by law (33 U.S.C. 1318; 4 J C.F.R. 125.27). Failure to report or fat; are to report tra~ifelly c: n rsult
<br />civil penalties not to exceed $10,000 per day of ~•iolatioe; or in criminal penalties not to ezce:d $25,OOJ tEr day c: viDlatic_,
<br />or by imprisonment for not more than one year, c: both.
<br />RJPA Form 332Q-fl (rev. 03/9)
<br />
|