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<br />'~uirL,, rrLnling F•ur,f: ~• i^a~ , ... .,. r r.: r:. 'i _ U ,. m:> .. .~
<br />ev~.ret•r Ftir ;. spcm,r ; ,. •i:u~ •u ~ 6 .ur a` ar: ::.,.,. ~.I~.,: G•r som, major facili tir::,
<br />•.'Ith c wrrghtzd a~;_:;~- ~~ ..,~:~ ;.+ ~ :r• pr; ;~:;u~,~. inJuuing time fo; ra,•ie~.rog
<br />imtructums, sear~hm; r:i~~.m~ ,.:.~~. ._ ;:,n.,r.. n tl;: dat: nred.', an colnt:elinf ane
<br />tc~rru mt the collr<une „. mfon~~~ati~.~c tie^I'i,,: bu, dec e: tonal ,_- roi,r aspc_ of
<br />the cnllrxri~.lr ul inL~il::.ln~r.. u'~.no-lnit~ .u__"c,.:h ~ _ .. ~. '. ". '~`rrmat:oo P+di~}.
<br />Rrut.h, P~!-223, ;..5. L:. rr,n ~ •Y,..t:nr A~ __ :b( :' _. 'J . I t,~to.., DC ?0460' aoci to the
<br />Olfire ul lnfr:rmutior .vn: f ciu; ~:~. ~ ~i;. Office ,:' Atanagan:rrr :•~• la ; •c. ':+:uhin~ton, DC 20503.
<br />~enerai ~nstructiar~~.
<br />I. II form has beer. partially conrpletec: by preprintin;. E'eregar~ m~tr u:u.~n: ~_i+e.a ur rt enLp r(t rat in tonrndion
<br /> alread~~ preprinted.
<br />2. C-nle: 'Pennitlee Vnmr~Tfailing ,4ddree• ,-~ .-_'ii:+. n:rmeAocali•r•. C-etcm~ ..n+r.r A'unrl~e•.' °r:.
<br /> '1?ischorgeNumbrr'v~herc indirrtcd !:~ stpa~aL fort ,: requiredfc rli..'Itnec.~
<br />3. Enter dates beginning .trd endi i<. .,ior,:ror, nl: Per:nd'~ covered t~:. ~t :,cr r•d:c.tte~
<br />t. Enter each `Pnranrcler'~ n~ sf~c:~f :c it moniton.ng reawrcme:ns c' p. n•~I
<br />`. Enter ' Rornple :Lfrn.vrc ,a•rn !o- c:;d parameter nn; e: ' !!.;r., . _ G
<br />,..,r' i IGr c:r:
<br /> .; crrage' is nornrally a~~tluu. ~ ncrngc (eeomelric averag< (e" i7,~:~ p; ~ ~ ,rl~ ~~~. .. ~ i>ni.. ne: ~ ,remr~-~,~
<br />..
<br /> furcact: parameter obiaine: G .al ':'(urr~lorirFPe~ir,r(.'~.tfar•,;r.~a .; „ ~r,an:'
<br />... - r:~.ail~ ~~xl+em~ ;I~t!
<br /> and lov: measure n:cw: oC c.~ !. c!unnf ' tfarilorrr>,c~ i, r,, d' uc:oal ~, " :nd~a~ re: (;-,la
<br /> rcyuirernenf Enic 31 -.Lq :r. of couple nrcasurenr:nL urd^.~ : u' enc.. , ,^:•n^ `~d:. .•rcr~ f:
<br /> eCs:uuple mrasurcmcn'.~ ob.ain.~: curing moniWringpcno:; under ".if..r: .•n. '
<br />C. Enter'1'rnnr( Regv•rrrn•nr' i;;~ c.c. parameter under "Qu~nhn' : r~~a .I r oc, ~rr ~: tic ,~ri~
<br />i. Under ' ~"a Fr' cnC7' : imbcr r ~::a ck mensurnn:nt during :.,:"r> .~od th eo:.. a;:(xunm, .,tr,~~ir
<br />~
<br /> minimum or i-da, ,:~~ ;.gc ~_ 2~,p-opria6_' pcrn:i' rnmremcr.' tc-e~,: , i(t.~~n.; , . '•)`.
<br />:r
<br />E. Enter '!•iequencl •:f 'r; ai s ~ ~ ~s '~~an:/':. •x«rrrrer, r' ;:tat r ='' .r•t^ '•nr nna~~_: ' _.
<br />~
<br /> dunng monitoring fh od; ,~rrnr Fc~y:. r:,, >pccilicC ,
<br />~ ,:.. ' ,.: .r : ,.
<br />i:.
<br />"
<br /> monitorink.'!~?' for on, d::_ r .rsk.'.~ip'... ..~. c:~ pcrmonl^ .. - rn, d.~ ~ •re.^.er.r-1,7,~
<br />S. Enter'Samp/r Ttrr' both 2` ' - .. cct,r•nn'rr" ~,~:~,;,r ~, n c' ~I ~ n,~:~l :~•u:€ p•:rio_~ .u:._
<br /> ' Prrnu/ 11Pl1nrr2/nr,iL' (C. f, ._" 4' fiF md:~.~ldt~" .,.. r:! ~ ~,~ . ~.'to:~- ,Irl:ositc .. .;
<br /> continuous monitcriny. I:~c.;
<br />'0. R'hcre. violations o: pc nri rco u.icnlcn L~ rrc n.pcr,e~..m^:h . , .. .:~L : In„ ,.r b- ,1,=,. n''. ^..:~sc enr' ~.i;ti ::
<br /> actions taken ane r.Fcleua c::ri cda ier b+ d;u;
<br />' Ii'nodischargc' occur :.tint; r•,.I~IC:i~:_ p?:~,~;: cn' '_ ":r'"• -c, _ ~ I ~,,... Ilr cmr
<br />:. Ertle: '.`,cmc•7ula nr ,'.,ncyr ~. .', ~. ~~ rJfj.~:: er" rt .'I :~ r. l
<br />.' .n~~~ ~~ar d•:v .~, rr „1. ";;,r; ~,...:,
<br /> ~enr , "7e(ephonc .1 u•r bet ' .- . ' . la'," :•' bo'!on c. ~ fc rm
<br />~. Sai; signet Repot; (c OTIc_• ~br~ spzci':~_ , ,ern i Rc;„ zn".,_
<br /> ~.ivi~ d_tallzd I::S(nlu,'.. r. it r.,r•.* _,, .r. " "1 Ilr .:le( r_,.I,..
<br /> spccdtcd rrt pcrnli~
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<br />T I ;a^ I
<br />r i~r :!il:. ~ :'E ~'. ..
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