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- - 'ap€~:•a~rark P;eduction Pict Notice -------- --~
<br />F';;I Lr r: n:,r::n ~ hur:b ~ this . ' . .:: o of inftrrnc+hon is est,maled n: +ary ~rotn a range of 10 hours as an
<br />avora;a pot response 1 .- ~.;,;+~ non,:;~ t~c;htia~, to 110 hours es an average p:r resprmse for some major facilities,
<br />with .+ wea~hiul avers •, li~; nwpn .ui ^rinor faalities of 1F hours per rcslwns-e, una uding time for reviewing
<br />m.~trc_ti„ns, seerchiut ..,c:ing 1,i.• >:om ces, galliering and maintaining lha date needed, and comple[iog and
<br />r_.ic.:,rb the collecti~~n +~f wformat,un. Sand comrnenh rogarding the burden eslirnale or any other aspect of
<br />:h.; aullxtion of in;%~r,~,:.on, in:lading suggestions for reducing this burden, to Chief, Information Policy
<br />Branch, PM-223, U.S. En:,runmcn;.+l {'nnectioo Agency, 401 M Street, SW Washington, DC 20460; rind to the
<br />Office of Information and rt?gulan,rj Aflairs, Office of Manxoement and Budget, Washington, DC 20503.
<br />General Instructions
<br />L [f form has been ~ar:udly com;,leled by preprinting, disregard iastnrctions dinxted at entry of that information
<br />already preprinted
<br />^_. Enter 'Perrniltee ,'an,, dtailie ,Id,rrecr (and facility nameJlocalion, if ~differenQ," "Permit Number," and
<br />"Chacharge A'umb. • ,rh,sc indicated (A scparde form is required for each di~~chargeJ
<br />3. F.:acr dvcs bcgim ' ~~; an9 ends, a 'a!unituring J errod" covered by form where indicated.
<br />-.. °: ;.r c,ch "1'arur~„~:rr" a spcc.~r,:d 'n monitoring requirements of perms.
<br />-.... 7::,,vplc ', f. .;,~ ; ,•n," d. , ..,.r .ach paranrrer under "Quontiiti" and "~iu,a(rty" in units specified in permit.
<br />','„ r-, •: " ,; nun.. ~ ~, , , ~!Icu.•;~, .:+.: r;, ~e ;J;COfllelfld al ef8'SC for bactenal par:inreters) of all sample measurements
<br />a.! ran:nct;~ ;...,d d.c,... rnu;enrz,r J'crud"; "Slazvmum" and "Afrn,rnum" are normally extreme high
<br />;,;i to.; unions., ..: ,btuu~.l „c;ug "tlor,:,urtn; Pe•rrud." (?Go;c t., nun,cipals with secondary t[ealment
<br />r°;•nircn,euC Eu': ,'~-~'~~. r.c. ~ ;:.;; :a;uplc mcasurerncnts under ".;renrxe "and enter maximum 7~ay average
<br />:~f •.:ur:p:e ntcasur,:;.~ nr: ~~bt:ri~,r.; .L ,+,:~ monilo~~ng period under "Alarunum.';i
<br />6. Eu;cr "Penn.: Re ; .':•», •,i" (or .•,.: I. p.,remcter rwdcr "~luantily" and "Quality" a<, specified in permit.
<br />.. Ilndcr "Nu ?~';;" ,., ~nb.r .cr.~lz rotas:utncuts during monitoring period that exceed maximum (and/or
<br />mi;;imum or 7th;r ; ~ -. as ai,: ~;u;,ralc/ pcnnlt requirement for each parwcler if none, enter "D".
<br />8. Fnter "1•irgarnrr ~ ~~.'~ ,. ., ~i :" ~., :, ,•; ",1';,»rp/:• ,llcaaurment" (actwi Ge:quency of sampling and analysis used
<br />owing uua,itori::y. .:-c.: r anJ . , rnr; l:egtarrrnrm" specked in permit. (eg., Enter "Goof," for continuous
<br />monitoring, "1~'' :::.~o.:_ da} pc ..ck "I ,u" far one day pcr month, "/ 9 J" for ane day per quarter, etcJ
<br />9. Enter "Somp(c 'l:'rJ~ " bet, as ":' ;-'. .'.temureruen[" (actwl sample npc usal during monitoring period) and as
<br />"Permit Requirenrcnr," ;.g., F v ';.rah" for utdrvidual sample, 'r?JI'It^' for 24-hour composite, "ti/,~1" for
<br />eonunuous monitoring, etc.)
<br />10. Where violations of perr.ii reGu ,.;arn!s are reposed, attach a brief e.epl:mauon to describe carne and correcUVc
<br />actions Prken, and refertn:;: each .,o!ation by data.
<br />11. If "no discharge" accurs d.rring r, anitoring period, cntar "Nu Discharge" across form in place of data enUy.
<br />12. Enter "A'ame?i:le :~f PrDrcipu! r:rculive O~eer" with "S'ignafure oJ'I'r,ncrpa! Erecufive Officer ujAu[horized
<br />Agrnt," "Telephone ?: umber," and ": +ore" al bottom of form.
<br />13. Mad signed Repot! n~ C11-ice(s) by cL+te(s) specified in permit. Retain espy for your records.
<br />14. More detailed instructio:s for rrs:: of thu Dischar{e dlunimnng Repot[ (D,i/R) form may be obtained from OITi•:e(s)
<br />specified in permit
<br />Legal Notice
<br />'This report is required'oy tow i?i U.S... '.3 23; 40 C.P.R. 125.27). Fadure to report ar failure to report tnrthfully can
<br />result in civil penallie, no; :o ~~ c a.d 5: 1,vCdt par day of violation; or in crirnir+al lenal ties not to exerzd 525,000 per day
<br />of violation, or by imprisunmer: for not ur~rc than one year, or by both.
<br />EPA Form 3320.1 (Rev. itS-9.5'.
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