|
Paperwork Reduction Act Notice
<br />PubLc reporting burdeo for tltis collection of information is estimated to vary from a range of :: ;tour s v v ~ r
<br />average per response for some minor facilities, to 110 hours as ao average per response fo- some :rajor ~sci'i;;s,
<br />with a.weigh+ed average For +najor and minor facilities of i8 hours per response, iocluding time 'nr -o.-~.:~:..~;
<br />ins~ruc[ions, searching existing data sources,~gathtrin;; and tnaidtaining the 1a:a veeded, aid ca!npleting anJ '
<br />reviawm~ the collection of in forma:ion. Send comments.ree•::ding the burden es[in+ate or any other aspect of ~
<br />th+s collection o' informatior, including suggestwns for ryt!u~;ng this burden, to Chief, lnfortnaGoo Policy I
<br />Bran_h, ?M-?23, U.S. Eovircnmen~al ?ro~zrtion Agency, 401 M Street, SW Washington, DC 20460; audio the
<br />Office of Infnn»ation and Regulatory Affairs, Office of Management and Budget, Washington, DC 20503.':,
<br />.- b ,
<br />. .. .a, },S ~ ..
<br />General Instrtiet#oQs . , ~.:..::. - ~ ; . , ; ; '. .- .~
<br />1. If form has been partially completed by preprinting, disregard instrujtitipa"~tlira;4od a1r`.entry of'thiir information ~ -
<br />already preprinted. ~ ~ ~-..- _ : - ~ .:~
<br />2. Enter 'Permiuee Name.~lniling Adrlretss (and fac~itv.. ~Nei1t);' 'Permit Number," and -_
<br />"Discharge Number" wfii:re indicated. (A separate foirn is pbgedtbd i!} ii discharge)
<br />3. Enter dates beginning and ending iLlon+toring Perio$"covered byi8rmi4here fndueated. -. ~.
<br />4. Enter each "Parame(er" as specsed in monitoring requirements Of permit. ~:
<br />. ~ Y
<br />5. Enter ".1'ample AJeosuremect" data Cor each parameter under "Quantity" and "Quohty" in units specified in permit' : '
<br />"Average" is normally arithmetic average (geome(nc average for badenal parameteisl of at: sample measurements .
<br />for each parameter obtained during ":Lfoniutring Period ; "A~aximum" and "Alininumt" are normally extreme high
<br />and low measurements obtained during ",1~onirorutg Period." (Note to municipals tci+h secondary Veaunenl
<br />requirement: Enter 30-day average of sample measurements under "Average," and enter ma:cimttm 7-day average
<br />of sample measurements obtained during monitoring period under "Alriximum. "I
<br />6. Enter "Perrnit Requ+rernen[' for each parameter under "Qunn(ity" and "Quality" as specified in permit.
<br />7. Under "Na Ex" enter numxr of sample measurments dunng monitoring period that exceed maximum (and/or
<br />minimum or 7-day average .ts appropriate) permit requirement for each parameter if none, enter "0".
<br />8. Enter "Frequency ojAnalvsis" both as ".Cmr+ple Afeasurntent" (actual frequenc}• of sampling and analysis used
<br />during momtonng period) and as "Fermi! Require.~nenr" specified in permn. (e g., Enter "Cons," for continuous
<br />monitoring, "1/7" for one day per week, "1,'30" for one day per month, "I/90" for one day per quarter, etc.)
<br />9. Enter ",Sample Tvpe" both +rs "Sample Aleasuren(etrt" (actual sample type used during monitoring period) and as
<br />"Pern+it Requirernen(," (e.g.. Enter "Grob" for individual sample, "2JHC" for 24-hour composite, "N/A" for
<br />.continuous monttoring, etc.) _
<br />10. Where violations of permit requirements are reported, attach a brief explanation to describe cause and corrective
<br />actions taken, and reference etch violation by date.
<br />11. (f "no discharge" occurs dunng monitoring period, enter ".No Discharge" across form in place of data entry.
<br />l2. Enter "Name//'itle 0jPr(nc.'pal Executive Officer" with "Signnrure ojPrincipa! Executive Officer oJAuthorized
<br />Agent," "Telephone Number," and "Date" at bottom oC form.
<br />13. Mail signed Report to Office(s) by date(s) specified in permit. Retain copy for your recdrds.
<br />14. More detailed instructions for ttse of this Discharge A.Jnnitoring Repot( (DAIItj form may be obtainedfrom Office(s)
<br />specified in permit. -
<br />,I,egal Notice
<br />This report is required by law (33 U.3.C. 1318; 40 C.F.R. 125.27). Failure to report or failure to report truthfully can .,
<br />result in civil penalties qot tp exceed 510,000 per day of violation; or iq criminal penalties not to exceed 525.000 per day
<br />of violehon, or by imprisonment for not more than one year, or by both.
<br />EPA Form 3320-] (Rev. OS-95)
<br />
|