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-r''~~,;. °„ ~Jr.~ T.erluction Aet ?'~iutace
<br />', °ublic reporting burd~ ~. f~. r .Ws ,. .. ~: •.~ ::F ;itfurotatiun is .•stirnalw~ t~ v:;ry train a range of 10 houta as an
<br />averege per response I v scn,e mmt r la,:,;iti.s, w 110 he ~ . .tit averae ~ tte; re;x~ns:e for sonre~ major facilities,
<br />~, with a weighted avers"a for major end miour facilitir<.~.'-_; Lour ;kr respons<, including time for reviewing
<br />~ irsirutlinns, searchin} exi<rng data sources, galh~:r::, ..a..:Wia..~~ ti„ ~.4Va nrcded, and completing and
<br />:evid•aing ?he rullecti n'` ~~ilanr~~: ~:~•~ S-r:d ru:wren's :agarding It•c ~urlen esntmrle or any other aspect of
<br />~ this :rdlr~tinn of inl~:.n,r,~ ~., •r•- • ~ _ +etgestioos ;ar r,:Jucinp this hw)ro, to Chief, Inlormation Policy
<br />Brar;ut, Phf-223, 'J.5 dr,rir~,-,ma.,;..! ; r ,.ection Aganrr, 401 Pd Street, :i'>r' W;,:hutgtoo, DC 20460; and to [he
<br />Office of Information a,d f:egulalurj Altai n, Office of Management and Bud;;et. W".rshmgwo, UC 20503.
<br />General Instructions
<br />I. If form has been :~ortially con.,-Ic4-J by preprinting, disregard mslmclions directed at entry of that information
<br />already preprinted.
<br />2. Enter "Pernrillee ::nn~~~.llailinh :IdJress (and facility narneJloration, if diflcrenQ," "Parrnir Number," and
<br />"Di.rchnrge Numbv%" tshere indicated (A separate faint is r~uired for c.ch dis.hvgeJ
<br />3. Enter dales begim;r;,; :r;L cndit~~; ":',ltrnrtoring Period" covered by torn. where indicated.
<br />w. Euta: each "Party,, ~.-r" a, s,ca~~c,i tit rnotritoring rcquiremeutsofpcn,tit.
<br />" I r~~ru~d" is note..: . ,, h:
<br />~,r : tch paruutek~r b: i _,.
<br />;. u;; low measur, .. ,. ;.. 4..
<br />o; santplc nrcasur_r•„u, oL:~
<br />.:ach parameter undo "Quunr.;, and "~)uali(v" in units specified in permit
<br />:+'c (geonnaric uvcracc for 'ox;cna par.unctcn) of all sample measurements
<br />l.,nrtr.ring Period"; ",tlurra:am" and ".1 Gni,reuur" are normally extreme high
<br />..tag "ilonimnn;~ Pcr,~,,. Woic u, n,unicip:ds with secondary trratmem
<br />d a;tniptc mcasurcutcns rmd.r ".l veruge," acrd enter maumtun 7-day average
<br />r,i~g monitoring peria) under ":Llmirnvnr. "/
<br />:~. En;cr "Pernul Re;~~:r„nr,•nr" :r : ,;.;ramctcr under "Quaniry" and "O,rnlity" as sptxified io permit.
<br />.. Uudar "Vu F1" ar,:r nnc:;.•~ ~ :~r,ipie weasurn _. ~ during monitor, nt. pc;ial that exeecxl maximum (and/or
<br />~
<br /> minimum or 7-day r. er;:~.. ;~ „pi rement (or each ~:.:r„mcf?:. ]f none, enter "0".
<br />:;,:,.riate) penni: r -,~
<br />£. / .a~l ..i.." '
<br />Enter "h7e,ryenc -;l~ as ".Sur;, r./~ .tlcu.rurmenr" (ac[ua; :nqucnc~r of sampling and analysis used
<br /> _
<br />during monitoring period, aaJ ~niJ ;;,flu:ienrcnt" specified in ~:rnu;. (e g., Enter "Goof," for continuous
<br /> monitoring, "1 %7" fu; ate 1a~ qc. . , .,, "1 '30" Cor one day per month, "1 • la" for one day per quarter, etc.)
<br />9. Enlcr "J'ample 7vp:•" Iwtl.:a ':' ~ llcusurer.7en1" (actual sample I>7te usal during monitoring period) and as
<br /> "Penmr Requiremcer," (cg., ~ . ,~ "t Groh" for individual sample '711!C"' for 24-hour composite, "NiA" Cor
<br /> continuous monitoring, etc.)
<br />l0. Where violations of pennrt regr~ !..nc;rts are aported, attach a brief e.ytlfmaVion to describe cause and corrective
<br /> actions taken, and r,:ference each ~. i:~.~,;iou by date.
<br />) :. If "no discharge" oc.urs d.,ring r: c:n, r i ^g periods, enter "No Discharge" .reross form in place of data entry.
<br />12. Enter ".Name.Title of Frurcipal !iacwrre O~cei' with "J':gnatvre nJ !'nncipnl Executive Officer of Authorized
<br /> Agen(," "Telephone A'umhrr." ant' '7lule" a[ bottom Of form.
<br />C3. Mad signed Report :'.n Otlice(s) b } due(s) specified in perntit. Retain copy Cur your records.
<br />14. More detailed iustrud+ocs for us ::.f ;iris Dischnryr,ilnnilur:ng Report (DkIR) f~rtn may be obtained from Office(s)
<br /> specifed in permit.
<br />Legal Notice
<br />?'his report is repaired by law t3~ U.S.C. ; ~ i3; 40 C.F.R. 125.27). Failure to report nr failure to report truthfully can
<br />result m civil penalties ant to cr.o:cd $10,Oit0 pu day of violation; or is crimina; )enal[ias not [o excxd 525,000 per day
<br />of violation, or by imprisoomer f for oat more than one year, or by both.
<br />EPA Form 3320-1 (Rev. U8-9.5'r
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