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~a~erwork 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 18 hours per response, including time for
<br />reviewing instructions, 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, BC 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 dtrected at entry of that information already
<br />preprinted.
<br />2. Enter "Permittee Nome/Mailing Address (and facility name/location, if different)," "Permit Number," and "Discharge
<br />Number" where indicated. (A separate form is required for each discharge.)
<br />3. Enter dates beginning and editing "Monitoring Feriod" covered by form where indicated.
<br />k. Enter eac;t "Poranteter" as specified in monitoring requirements of permit.
<br />5. Later "Semple iri~asu%eaent" data far each parameter undo "~~na,r!ity" and Quality" as specified in permit. "Average" ~s
<br />normally arithmetic err=rage (geometric average for bacterial paramaers) of all sa:*,p'c me~su*erncnts fur each pa-a~cier
<br />obtained dw-ing "i/ion~toring Period'; ";i;ui,nurn" and bfininnrnv" aze normally extreme bigh and low meastu_ments
<br />obiaured during "i,doeitoring Pe,iod". (Mote to municipals aiih secondary trea~roent re ;uiremen[: Enter 3C-day ave:-age
<br />of sample measu,emcn[s under "Avz;vee,"and enter maximum 7-day average of sarzpL mcasticmenis obtained du-irg
<br />monitoring period under ",'vfaximum.")
<br />6. L•u.e- "Per,ait R.•:lt~irtnr3nt" for eac:r parameter under "Qua~ntiN"and "~mality" as spcci ied in ^,e-mi:.
<br />7. Under "A/o Cr" ea:cr member of sample mcasurcnent during :noniloring food ll:~i :,xcc:;d maximum (rnd/rr nii'mum
<br />o. 7-day avcrae as appropriate) pcmut requiremect for cacti p2ramctcr. If acne, enter "0".
<br />8. °n.c. "Fr ,au^nc7~ of Analysis" both as "Sa,.tFk iris_srn•rrnz,v" (ec[ual E~cqu.,cy ~` same ling ind anzlysis recd dw-~ g
<br />Tonitoring period) and as "Pr,-,ni! Re7uirtnrznl"specified in pc;,ni:. (e.g. °ntcr "C~,:rt,"for contm!ous monitoring, "I /7"
<br />fur one day per vice'.:, "1/30" for one day per month, "1/90" for one day per quarts:, etc;.)
<br />S. Emcr "Sar;¢-le TyFa" both as "S_rtl e ibi ~~svn-,r,;taut" (actual sample typ,: usc3 taring menitoring period) and as "~'_,-„ri!
<br />kelvirz;neat," (e.g. Winter "Groh" for iadividua! sample, "24HC" for 24-hour composite, '7V/A" for cootiuuous
<br />monitoring, etc.)
<br />10. lWlrere violations of permit requi,ements err reported, attach a brief explanatica to describe cause and corrective actions
<br />to be ta!cen, and reference each violation by date.
<br />11. If"no discharge" occurs during monitoring period, enter "IQo Discharge" across form i^ place of data entry.
<br />12. Enter "Name/Titls .f Principal Exactrtn~e ~~er" with "Sign ~ture: of Po-inaiEal cxzcutiva G~~cer of Authoriczd
<br />Agent, ""Telephone A'umber, "and "Date" at bottom of form.
<br />13. iviail signed Report to Office(s) by date(s) specified in permit. Retain copy for your records.
<br />14. lriore detailed instructions for use of this Discharge lrloniforing Repot? (DAB form may be obtained from Office(s)
<br />specified in permit.
<br />Legal Notice
<br />This report is required by law (33 U.S.C. 1318; 40 C.F.R. 125.27). 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 yeaz, or both.
<br />EPA Form 3320-1 (Rev. 03/99)
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