Paperwork Reaiuction Act Notice
<br />Public reporting burden for this collection of information is estimated to vary fmm 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 18 hours per response, including time for
<br />reviewing inshvctions, seazching 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. i
<br />~~~eral Instructions
<br />I. If form has been partially completed by preprinting, disregazd instruction directed at entry of that information akeady
<br />preprinted.
<br />2. Enter "Permittzz Name/iYtailing Address (and facility name location, if different)," "Permit Nvmber," and "Discharge
<br />NumEet•" where indicated. (A separate form is required for each dschage.)
<br />3. Enter dates beginning and editing "tYioni[oring Pericd" covered by form where indicated.
<br />4. Enter each "Parameter" as specified in monitoring requirements of permit.
<br />5. Enter "SamFle iv/azsw~•men!"data for each parameter under "watt:i.ry"and QrrJliq~"as specifieri in per;nit. "Avsra;,~r"is
<br />nornafiy arithmetic average (geometric average for blcurisl parameters; of ail sample roeasure-iens for each pzrameter
<br />obtained dv ing ";viwtitorinb Pericd'; ';',axi,tr;,;" z.-td fdir-,irmr." are norinal:y eatrcmc high and low measmemu:.s
<br />ob4t:ncd during ':rio.tftol'ido Pdrio,t". (Vote io mvnicipafs ~:~illi seconda~y'sce.me~t rc:luimncnt Gnrer 3C-day average
<br />of saapfe mcastrcments under "Av_..~dz,"and enter mz.imum 7-dr y average of sample measuremen!s oStatned du itil;
<br />monitoring period under "ivlaximum.")
<br />b. Lc:cr "P.:n,lii i>2e?7'!.-~;nent"for eae,: Para-n:al;r t'i:~'1' "~7~.~i1!1h," £n'I "~tta!i~~"as S,:eCIfiC~ In p.;-m'..
<br />7. Jndcr "?L GL" c..:.: number oCsampte r ;ti• -:r~r.:n: Ju,ing c~oni!er:.i~ ~eccd Jtct c~ceed rra:cimum (and/or rain~mun
<br />or 7-eay ~•~crage as a,,propriatc) pe,7rtit rcquirzr.:.: Cor each parameer. ?f none, enter "0".
<br />8. ~c-er "r'ra?c,';r_;~ y`A,ul~sis"both as "S_,.rF r_ .~;_.~,-r~,.7',.[" (actual =squ_cc; o: ezmpling and ena'ysis vscd dv~`ig
<br />mcu`to.i~tg p,;rior:) a.td as "Psrai! R_iuirr: ;_e: "spec ,red ill t7:i'[ rli, (L'.o'. _ntL; "L'I:1~," fCr ec inuous r„onitorini;, "t/7"
<br />fcr one dry per wee';, "//30" for one day ,rte moa(a, "J/90" fe: ouc day per quarts;, ttc,)
<br />S. Fntar "S":7/;k Tj,F~"both as "S_,.;Fhr 6; .~s:•,~,,;:_ .7" (ech~cl eamot~ t;~oe used drr:;,b m~nito=~ng per,oci) and as "Pe.vn;~
<br />k~,/eireutov," (r..g. enter "Graf" fcr individu=l s:u.tple, "Z41iC" for 241tcu: composite, 'Yd/A" Cor eont:nuou;
<br />monitoring, etc.)
<br />10. P.lrete vioiauons of ,ermi[ rcqu;rcmcnL a.re reported, al :ch is brei e;:planati::n to dcsoihe catse and corrective actions
<br />to be taken, and reference each violation by date.
<br />11. if "no rlischargc" occurs dying monitoring Pericd, r,..izr "A'o Cischatgc" across tarot in place o'data entry.
<br />12. Cntcr "AramelTide of P7 in~ipal ExsLYrtiv~ OJJi~sr" tvillt "Si~nmrre Of PrlliaF'a~ E'Sd(.41t1'q; (7~wr GJ ANtI1Gl'iZeLt
<br />Abent. ""TeleF'h one A'umhtr,"and 'Date" at bottom of form.
<br />13. A pail signed Repot to Office(s) by date(s) specified in pcrm~t. Retain copy for your records.
<br />I~.`'.dore detailed instructions for use of this Uisrhargz tYlmitoring Rpa9 (DhfR) form may be obtained from Office(s)
<br />specified in permit.
<br />Legal NotIlCe
<br />This 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 in
<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 one year, or both.
<br />~~
<br />EPA Form 3320-1 (Rev. 03/99)
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