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Paperwork Reduction Act Notice
<br />Public reporting burden for this collection of infotmatioui is estimated to vary from a range of ]0 bouts as an
<br />average per response for some minor Facilities, to 110 tours as an av~rr~ge per response for some major
<br />facilities, H~i?h s weighted average fur major and minor facilities of I8 hcurs per response, incluiGng time for
<br />reviewing instructions, searching exi:;ting data source., gathering anti maintaining the data Deeded, and
<br />completing and reviewing ffie collection of information, including sugp~eslion for rt~uciA2; this btu~den, to
<br />Chief, hiformation Policy Branch, PPd-223, U.S. Envircnmental Proteaic,n Agency, 401 M 'Strew, S.W.
<br />Washington, DC :20460; and to the Office of Information and Regulatory Affairs, Office of Mansgerr,ent and
<br />Budget, Washington, DC 20503.
<br />G~E~neral In~tructic-ns
<br />1. If form has been partially compLled by preprinting, disregard instruction direcrrd at entry of that informtrtion already
<br />preprinted.
<br />Z. Enter "fznui!.'ze M1~ma/rblJiling .t1lrr.cs ;and facility narne/loeation, if difi:rent}," " t'zrmit Nu/nber," ancf "Dischargz
<br />1~'unrtrr' where iroiicated. (A separate form is required for each discharge:)
<br />3. Enter dates beginning and editing "rt4,,:ih.ring Pzrio;i"covered by form where indicated.
<br />4. Enter each "T,n~.une!er" as specif ed ut monitoring requirements of~errnit
<br />5. Enter "Smrt fa h/awsur~•mznr" den fnr each parameter under "~uantir;"ar.d ;_u,drh•" a:, :pecified io permit. 'Avzrag~" is
<br />nornalh• arithmetic average (,geo,, art ~ ... eragc for bactc rial parameter.+~ c,f ;II o-a,nple nteasu,emr, tts fur ~:ach pazameter
<br />obtained d icing "Msni!.:rGrr; F • . ,.l" ",tfzti, rrnn" and ,lluanrum" apt nn n;ilh ezl.emc high aad low measurements
<br />obtaimi fitting "al.nit,rur~, F.ri ./". (Ttiote to municipals : i[b secund:,n tro:m,ent reyuiremenl: Enter ,0-day average
<br />of .ampic measurements un,l•. r " rr ~_i~.~ " mad enter w ;imam 7-day a, r- i~c nl'sanq le measun; nenis eb:ained dtuing
<br />monitoring period under ",b/xrinr un.")
<br />G. L-ntcr "f'dnuil2~.pru.rmant"' i~t ~ :.I. ! 3rametcr under "~ ..r.ih'"and "tu rh'r' :r, sfx.rfied in penitit.
<br />7. Umi,:r "F; ,C r" _n4•r numh:r of .,~ c n~casurement dwin~ monitoint fr: ut,' il~ut ~ x.:eed ma/.iruum (and/or minimum
<br />or'-d :y ac.rgc a:: appmpria.c) :.•..r rcquv~ment for e:,rh parameter !f n: m_, .:nD=r "0".
<br />R. Enter "I'~r rrr~n_~ ~ ~ .ln.rh d " b ~fi i.nnf L A/e.nm m .rt" (acb.'.,1 G ry u•r:p of , rnplmg mul analytic; used doting
<br />moniu,rm~ period) a! d a~"I. sru'! !~_-.zrir~m ant" specifies i,t permit. (:. ,; Li tee ' ' r!, 'for cuntiruiou:; monitoring, "1~"'
<br />fi/r orte -lay per adel:, "1/30" 1,r nac ~F;y i,er month, "L 9C" ti3r one dac her: uar;cr, cao.1
<br />S. Elver ":7~nq !t Ttp~"both as ".;. ,~~. 'e .tf ,rsru rment" (; cu,; l sample tyhc a•. d ~'i nt B n~:onito-ing teiil ~d) and as °Fc'l7nfl
<br />Re.(ui~tm_nt," (eg. Enter "ir;;~" ix indi,idual sannlc. "14H"' 11:r ?4-!taw composite, °N :4" fca continuous'
<br />monitoring. etc.)
<br />10. When' viola[ioc; nF pemtit rryu r~nnads arc r: ported, ar.xh a brief eel lair. ii, , :o Jacribe cause and corrective actions
<br />to be ial;en. and reference each violatiom by date.
<br />1 L [f "no discharge" occurs during inur`:rri~,g period, enter "h.~ Discltar~c" as is~ fnrrn ;n place of data entn.
<br />]2. Elver ":L'_.n-:~T.Ir.r cf £'rvn~iF_r! 1't-;uri,•~ '~c:r" with "Sisnsnrr,r .J f/r~rfr.ll F..rrcutiwz ifJi ~-r ,' Aurfr,ri~_1
<br />Ag gin/ ""T~ (~f,ir~ina M1'umF~r, "and "f .~:: " at bottom of Conn
<br />f 3. Mail si~med E:eport to OtTiee(s) h~. fiat _(s) specified in pcm~it. Retain copy ,nr your records.
<br />14. More detailed instructions fur t~s:, :f this Gic~•lrarbr ,Lf.nirorinb hr; , t ~'" tlf~r form may be nbuuned fFum OfFcc(s)
<br />specified in permit.
<br />Legal Notice
<br />This report is required by law (33 U.S.C. 1318; 40 C.F.R. 125 ~7). Faihtre to report or failure to report truthfully can result in
<br />civil penalties not to exceed $10,000 per day of violation; or in criminal penalties ^ot to exceed $25,000 per day of violation,
<br />or by imprisonment for not more than one year, or both.
<br />EPA Form 3320-1 (Rev. 03/99)
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