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- -- - - '~g-~~.'r,~~r~rk 1'teduction E1'~~t ,n,ic~e - -- ---
<br />P•~hl!c r~pnrling hoof n ~~~ the. I ,~ i:.:n of mf,nn!!i::n is e;timet,.1 ':~ ~!.~ ~:.~a~ a range of 10 hours as .m
<br />.+~.~_+ ,_e frr r_siu~.nse ' rt :..~,~ ~,:.... . '. +.+iiti~s, !n ! !0 hours as an aver ~. ~.. ,:~y:•m~e for vtnre ma}or facilities,
<br />~.rith a t:uehtcJ as~, :roc kr ta+F,~ .:. ! ;:La,,; +auldics of 13 hums pc: ~~ I~ u: ~~ inauding t me for reviewir~g
<br />' ;n.tnr,n:,nc, ~:rar:hin~ r~: 'mg :~.: i ~~:r.:•.~-,, e;,l rcnng and rtuintamir+,~ ~. ,L~:~, nr;,dtd: and completing and
<br />~c•ri~ ~.~.~:-e :hr wll::c.t„n ,~. itd::u:,.a:~,n. Seed .;,:rmn,nu regazding der Lu ~Jc.t ~;~limate or arty other aspect of
<br />this a•I!.aiun of inthrmr :n, i,~;hdu~g nuggcstions for reducing Ihia harden, to Chief, Ltformation Policy
<br />Brarsh. PM 223, U.S En•~i•us~:+~m::l P+.ttecuun Agzncy, 401 M Street, SR' W.~sbington, DC 20460; and to the
<br />Office of Informatior ,md F:ogul:a~cy ',hairs, Office of Management and Budget 4/ashington, DC 20503.
<br />General Instructions
<br />1. ff form has heeo parl~~ ly aoniplzteJ by przprinting, disregard iostructi~oos directed el entry of that inforrtta[ion
<br />already preprinted.
<br />2. Enter 'Permitree A'a ur/tlarlirg Address (and facility name/location, if different)," "Permit Numher," and
<br />"l7+schorge A'umArr" w hose indicated. (A separate Corm is required Cor each discharge)
<br />3. Eulcr dates beginning and ending '.t;•ntitoring Period" covered by form w,ACrc indicated.
<br />4. Enter each "Parameter' s sp`cSied in monitoring requirements o(permil.
<br />5. Enter ",l'nn!p(e .A(rmu , ~.. ~nr" ^ :ta nx :ash parameter uudcr "Qunnhty" and "QuaLry" in tmtts specified in permit.
<br />".!v~~ra; r" is norn;.uit .: ~~he.~~~. : +~: rage (fcon~ctric average for bacu•nal pannietcrs) of alt sample measurements
<br />fn- each pa::mtta mot.. ~-_d .:~ i,i, "t.'urun,rurl; Prnurl"; ",tlnxi~nu~n" and ",1linimum" are normally extreme high
<br />and low measuren•:cr .:r, ~ dnnog ':. fu»w~.;ne Penud." ('Note to municipals with secondary treatment
<br />rcyiurentcnl: Erna l :. ; of sample mcasurcmcnls under ":I:erage," and enter maximum 7~ay average
<br />of sample mrsurcn:.:.i.. ~:cCr:.~_;i i!unctg monitoring period under ",t/axunum. "1
<br />6. Enter "Pcrroir N^;,u-r ~ . '" :~ •• h r;.~~rd:nelCr under "QuarNrlV" and "Uu~~lily" a.> specsed in permit.
<br />. Und:r ".\'o Rx" cm.cr . r:tc: ~ ~nnplc n~easurmrats during monitoring pericid that exceed maximum (and/or
<br />minimum or 7-da~ .~•.. ,. ,.. ~, q::opr.::e) permit requirement for each parameter. If none, enter "0".
<br />~. enter "J:ra.q;r...rn , f ~." ..:~~~ .~.. ";:;::np!e !Jnacvn>renl" (actual fr:quwcy of sar»pling and analysis used
<br />.: ,, : .
<br />duru+g moauonr,E. ik ~ ~ "I'..urir Ragi,irenrenr" specified in p.nnit. (c:g., Enter "Coat," !or continuous
<br />ur.:,~~iu:~ing, "/ %" iur . rr ._ ~~. ~~ i ,:cck, "h?0" fur one day per month "1'90" fcr ane day per quarter, etc.)
<br />y. Enb~r "Sample ;}; ." ~ ::: ,~s " r rple S;c-acurenu•nP' (actual sample iypc used during monitoring period) and as
<br />"rte/:nu .^nluirrmrm." (::~, i, c!u "r;rob" for indtr idual svnple, "7. J.'IC' for 24-hour composite, ",V/A" for
<br />continuous monrtorng. etc )
<br />i0. '1'hoe tioiauons of rr~n:t .~- ..': nos arc reported, attach a brief uxphtnanon to describe pose and corrective
<br />actions taken, and reLre„r.;: _„-i, , icianon by date.
<br />11. If "no discharge" ix'r rs J:,rin;; monitorng period, enter "Nu Discharge" across form in place of data entry.
<br />12. Enter ".\'ur~a•Tirle aj r'rp;,•ipnl ` rr„cr (:~reer" Stith "S'ignature ofPrmerpal F_xecvrive O~eer rfAutharized
<br />.tgrnl," "Trleplrorec A'u,,,F.rr," ,~::'. "r7a:r" al bottom of form.
<br />13. L!nil signed Report to O!Lce(s) b:. i,tc;~.) specified in permit. Retain cupv lor_:nur records.
<br />14. h:c.c dctai)cd instnic'io~rs for trs. ~' ".r~ l)ie;9rnrge.4lonironng Report InbfR) loon may be obtained from 06ice(s)
<br />specified in pern»I.
<br />Legal Notice
<br />This rcrur; is required h. . • ;" ] U. '.C. ! ~ I8; 40 C.!'.R. 125.27}. Failure tc. report or Failure to report Wthfully can
<br />riuh in cn ~I pcna;ties n ~! . ~ ~.~ ••' '!.'.~ r'!>,1 per .S:ay of violatirn; or in crirni:~rl yk•nal[ics not to exceed 525,000 per day
<br />r~f violation, or by i^rpris,:! ::.,.t or -~.: mnrc Ihi~ ane year, or by both.
<br />f'PA Fur: i .332il-1 ;Rev. at •rj
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