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Paperwork Reduction Act Notice
<br />'Public reporting burden for this collection of information is estimated to vary from a range of 10 hours as an
<br />average per response for some minor facilities, to 110 hours as an average per response for some major
<br />facilities, with a weighted average for major and minor facilities of IS hours per response, including time for
<br />reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
<br />completing and reviewing the collection of information, including suggestion for reducing this burden, to
<br />Chief, Information Policy Branch, PM-223, U.S. Environmental Protection Agency, 401 M Street, S.W.
<br />Washington, DC 20460; and to the Office of Information and Regulatory Affairs, Office of Management and
<br />Budget, Washington, DC 20503.
<br />general Instructions
<br />1. If form has been partially completed by preprinting, disregard instruction duectcd at entry of that information akeady
<br />preprinted.
<br />2. Enter "Permittee Name/Mailing Address (and facility Dame/location, if different)," "Permit NumEer," and "Discharge
<br />Ntrmt;er" where indicated. (A separate farm is required for each discharge.)
<br />3. Enter dates beginning and editing "Monitoring Period" covered by form where indicated.
<br />4. Enter each "Parameter" as specified in monitoring requirements of permit.
<br />5. Enter "Sample Measurvment"data for each parameter under "Quantity" and Qualigr" as specified in permit. "Avzrigz" is
<br />no*ma11y arithmetic average (geometric average for bacterial parameters) of all sample -+casurementc for cacti parameter
<br />obtained during "Monitoring Peri:!'; ".'d-xiunu;t" znd tL1i++irzum+" are normally e;:irc ne high and low measurements
<br />obtained during "tll;nito.•ing Pzri :~". (T:otc to r,.uricinals with secondary treatment rqu rcment: ~atcr 30-day s.vercgc
<br />of sample measurements cinder "Avaraga,"and cn:erma::imum 7-day average of sec:. Ic measurements ob~a~ned dining
<br />monitoring period under "Masimunr.")
<br />v. Enter "Pe;rrit Ra,Jui.~.:ment"for each parameter under "Quanttity"and "Quality" as _pccified in perm:<.
<br />7. Under "Th. Cz" ['Yrr number of sa.~,p!c measurement ?string ;no~i;c~ing pcrioc t'^.i : __x' ma:•.imu.n (and/or ninim~+~n
<br />ar 7-day average as appropriate) permit requirement for eacb parameter. If none, n-tr "0".
<br />8. rrter "Frzlt: ~;r_y of ~ht ~!ysis" both as "5.,,.;.1.: ;vL' nm•e,oe;~t" (actual f;zquency of ss.mpling end :aialysis useL durng
<br />monito~ng perod) a,~d as "Pe+;,til Re.7uir ~;..:nt"specified in permit. (e.g. rntcr "~s,>r,' for confnuous monitorrg, "//7"
<br />for one day per e: cc'c, "1/30" for e~1e day per month, "I/90"for ore day per e,ua'tur, cic)
<br />9. Dntcr "Sarq-t~ TyFz"both as "San;~/_ ;.lzzcv.•etxe;:!" (coral sample type used w=ng monito=ng pc~od) and as "Fcr,ai~
<br />liCqu%rzme,±t," (ag. !inter "vraF" for individual sample, "2s'I-~'O" for 24-hour composite, "h%A" for continuous
<br />monitoring, etc.)
<br />10. r;Jhere violations cf ncrmit rcquiroments ara rcpci'.ed, at+ach a brie` ezplanaticn *.c c'escribe carsc and corrective zc;ions
<br />to be taken, and reference each violation by date.
<br />] 1. ] f "no discharge" occur dw-ing monitoring period, entcr'T'o Discharge" across fon in place of data entry.
<br />12. Enter "Name/Tide of Frinci~al T_.rsctttivs Gfji: r" with "Sigt:aturz cj Prin:i~~1 ceecuriva O~c~r uj Authorizz~.f
<br />Agent, ""Talephone NttmCer,"and "Dale" at bottom of form.
<br />13. Mail signed Report to Office(s) by date(s) specified in permit. Retain copy for your recores.
<br />14. More detailed instructions for use of this Discd:azga N.unitoring R2/vrt (Czbfl2J form may be obtained from ORicc(s)
<br />specified in pem»t.
<br />I.tegal Notice
<br />Tlils report is required by law (33 U.S.C. 1318; 40 C.F.R. 125.27). Failure to report or failure to report truthfully can result i^
<br />civil penalties not to exceed $10,000 per day of violation; or in criminal penalties not to exceed $25,000 per day of violation,
<br />or by imprisonment for not more than Doe year, or both.
<br />EPA Form 3320-1 (Rev. 03/99)
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