ML20127E388
| ML20127E388 | |
| Person / Time | |
|---|---|
| Site: | Peach Bottom  |
| Issue date: | 05/31/1985 |
| From: | Daltroff S PECO ENERGY CO., (FORMERLY PHILADELPHIA ELECTRIC |
| To: | |
| Shared Package | |
| ML20127E386 | List: |
| References | |
| NUDOCS 8506240535 | |
| Download: ML20127E388 (7) | |
Text
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17rb: sT%T104 5tiDEaTNTruoc9T a *21e a m i a4J5 a6 m am gui, NOTE: Read instructions before completing this form. l (J CarJ Only) QU ANTITY OR LOADING (4 E'ard Haly) QU ALIT, OR CONCEN TR ATION PA R A M ET ER (4641) (5441) (33 df) (46 53) (344J) NO. ' " MyE C S A M PLE (3my - Ex A N a os .. TYPE AVERAGE M AXIM UM UNITS MINIMUM AVERAGE M AXIMUM ; UNITS t424 D (64sMp (69.70 >
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r GI.NFR Al. INSI RUCTIONS
- 1. If form has been partialls completed by preprinting, disregard instruc0ons dirceled at entry of that [nformation already preprinted.
2 J nier "Pl R\lli Il l N \\ll /\l AllING 4DDRI'S5 f and faciht) name/ location. if different i." "PI'RNill NUNIHI R." and "DISCll \RGF NU\litt R" w here mdicated i A separate foa m a required for cash d%harge )
^t. I nter dates bermmng and ending 110NilORING PI-RIOD" coscied by form where indicated
- 4. I nier cash "P \R \\ll Tl R" as speci6cd in monitormg reqmrements of per mit.
- 5. I:nter "S \\lPI I Nll ASURI \ll'N I" data foi cash parameter under 'QU ANilTY" and "QU Al ITY" in units specified in permit.
"AVI R \GI ~ is nor malb .u ithmetic aserage # geometrie aserage f or bacterial parametersi of all umple measurements for each parameter obtained dur ing "MONilORING Pl RIODf' 11 ANI AlU Al" an.l "illNIN11 \l" aic noim.dly estreme high and low measurements obtained dming "ilONITORING PI RIODJ' (NOll' to manicipals with secondar) treatment requirement, enter 30-da) aserage of sample ms a su r eme nt s un&r "A\ l R AGl
- and enter masunum bda) asei.,pe of umple measurements oluained during mon:toring period under "SI ANIN!Uht".
- 6. I nier "PF itMI T RI'QUIRFNIENT" for cash parameter under "()UAN IlI Y" and "QU Al ITY' as specified in permit
- 7. Under *NO. I'N" enter number of umple measmements during monitormg periad that eseced masimum t and/or -minimum or 7-day aserage as a ppropriate ) per mit icquirement for each parameter. ll none. enter "O".
18 I nier "I RI QUI NCY Of AN \1 YSl%" both as "S \\lPl i Nil A5URI Nll NT" lactual ficquenes of umpling and anal > sis used during monitoring periodi and as "Pl~RN11T RI QUIRI MENT" speeitied in permii. t e g . I nter
- CONT." for continuous monitoring.
"l/7" for one das per w eek. "l /10" for one da) per month. "l/90" for one da) per qua r ter. cre. )
- 9. Fnter "ST\lPi l' I YPI'" both as "S \\lPl.I' \ll' A5t'Rl3t FN I" t actual umple ty pe used durmg monitorinc period t and as "PI R N!I T RI QUIR F N!I NT/ s e g.. l~nter "G R \ll" for mdisidual sample, "24llC" foi 24-hour somposite. "N/ A" for contmuous monitormg. ete.n
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- 10. \\lli'Rl' VIOL TTIONS OF PI'RNilT RI QUIRITII Nis ARF RI POR 16 D. \I I Atti \ HRil'I I NPI AN ATI()N TO Di M Rlill:
CAUS! .\ND CORRI CIIVI \C 1 IONS I AKI N. RI II.Rt M i l \Cil Viol \ lit)N ItY DXIl'.
- 11. If "no disbarge" occurs durmg monitoring reisod. enter "N(I DIM'll \R(.1 ~ asion foim m plase of data tnti).
- 12. Fnter "N \\l! /TITII of PRINCIP \1 i NE( t TI\l OI-l'Irl-R" u uh " SIGN \ l t'RI Of PRINC IP \1 1 Nill'Ti\ l Of FICI'R OR
< AUlll()Rl/l'D TGl N I/ "II:t ! PilONI' NU\lHI R" and "D A ll" at bo'iom of toi m.
- 13. \l.nl signed f.. por t to ()tlicet s t by datei o specified m peimit. Retain copy for sont records
- 14. \loie deladee mst r us tious for use of thn Dl%CllTRGl \lONilORING R1 POR I ( D\lR for m may be oMained fiom Oilkei s i specified in permo.
I FG \l. NOTICF
< . This report is required by law 133 US C.131R 40 C.I'.R.125.27 L F.ulure to repou or 1.nlure to ieroi t u uthfu'Is san t esult m snd penalties not
<to,eseced $10.000 per day of siolation; or in criminal penahies not to esceed $25.000 pei d.n of siolation. or by unmisonmem for not mor e ihan one y ear. or by both.
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'*'J"'**""'"*'*P*"""^"'"I4'"'*"*"***'#5* OFFICER OR AUTHORIZED AGENT 4 NUMRER YEAR
} , TYPED OR PRINTED C Qp L. MO DAY COM M ENT .A.N.D EXPL AN ATION OF ANY VIOLATBONS 1Referrn< r all ustachments here) 1 No flev at sample point for 2 consecutive weeks.
EPA Form 3320-1 (Rev.10 79) PREVIOUS EDITION TO BE USED * (REPLACES EPA FORM T-40 WHICH M AY NOT DE USED.) PAGE OF UNTIL SUPPLY IS EXH AUSTED #
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GI NFR AI. IN5I RUCTIONS
- 1. If form has been partially completed by preprinting. disregard instructions directed at entry of that information already preprinted.
- 2. l'nier "PI R\ll! Il l- N Oli /\l All ING ADDRI SS (and faaht) name/kication. if dillerent 1." "PI RNilf NL'\llil R/f and "DISCil ARGE N L'\llti R" w here mdicated i A ser.oare foe m is requiicd for eash dxharge )
1 I nier dates beginnmg and endmg -NIONilORING PF-RIOD" coseted b) form where mdicated.
- 4. I nier each "P \R Oli Il R" e teatied m monitoring respmements of pernut.
- 3. I ntes s OlPl I \ll' Ast:RI \ll N T" data for cash parameter under '()t' \N'lli Y" and "(JU \1 ITY" in unia specified in permit.
- T\ l R \GI ~ h nor malls anthmetic nerage s peometric ecrage for bacterial parameters t of all sample meeurements for each parameter
- oblamed durmg "%IONilORING Pl RIOD " "31 \Niilld!" and "\llNiilU\l" are nor malh estreme high and low meeurements oblamed during "\lONfit) RING PI RIOD " t NOli to manicipah with secondary treatment requirement. entes 30-day aseiage of sample meem ements un&r "A\ l R AGI
- and emet maumum %ta> m eispe of sample menm ements obducJ Jurmg monitoring periOJ under "N1 \ \ll!UN!".
- 6. I'nter "Pi RNII T RI QUIRI'NIENT" for eash parameter under "QU AN ill Y" and "QU Al IW e speedied in pernuL 7 UnJer "NO. l'N" enter number of sample meeurements duimg monitoring period that esceed masimum (and/or -minimum or 7. day aserage e appropriate s peimit r etpm ement for each parameter. If none. enter "0".
R l~ nter "I Ri QLTNCY Of AN \1 YSis" both e "S ulPI I Nll OURI \lFNT" iactual frequency of samphng and analpis used during monitoring period! and as "PI R\llT RI Qt IRf N11 NT" specified in permit. t c g , i.nte: " CONT." for continuous monitoring.
"l/7" for one da) per week. "l/ 1 0" for one da) per month. "l/90" for one da) per qu.u t er, cre. )
- 9. I nter "S OIPl I I) PI " both e "N OlPI I \ll' A5l'RI.N1FN I" t actual simple ty pe used dur mg momtoning period i and e "Pi RNili RI Ql'IRI N11 NTJ t e p.. I nier "G R All" for endnidual sample. "24llC" for 24-hour c omposite. "N/ A" for continuous monitormg. etc.
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- 10. % lli RI \ 101 \TIONS OF Pl RNilT RI QUIRI \ll N is ARI RI'POR ll D. Yi I \( 11 \ llRll i I .\PI AN A flON ~I() Di V MllW
( At si' AND ( ORRt C Il\T AC 1 IONS 'l Alsi'N. RI I I:RI NCI' I Acil Vitil T1it >N ItY DA1l'.
I 1. If "no das h.u pe" occurs during morntoring period. enter "N() Dl%( li \R(il ' asrow foim m Plase of data entry.
- 12. I nter "N \\ll / IIII I ( >l i RIN( IP \1 i NEl I fl\ F ()! I 101 R" w ith "Sl(eN \ll'RI 01- PRIM iP\1 i Ni(l 11% 1 of IICI R OR AU lll( PRl/l'D AGI N 1. "I El 1 Pilt INI- NU \llil R" and "DA I t ai bonom of for m l _1 \ tail signed Repor t to Othech) by datea u spectied m per mit. Retain cops for sour record-
- 14. \ lor e det.uted instinstions for use of thh DINCll ARGt AlONilORING RI PORI D\lRe for m may be obtamed from Othseis 6 specified m peinut.
I FG AI NOTICI This report h required by law t .1.1 U.S C. 1.11)t 40 C.I .R. 12 *.27 L Failuie io repor t or t.nluie to a eroi t o uthin'is can re uh m en d penalties not to esceed $10.000 per day of uolation: os in erinunal penallies not to eweed M5.000 pei dn of uolation or by unp'isonment for not mot e than one ) car. or by both.
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ON Mr *NouiRY OF THO%E INDIVIDlJ AL S IMME De A TT L Y RE SF'ON98t E FOR 1 /^ e OH T AiNtNG THE tNF ORM ATION 1 FIE LIE VE T HE. SUBMITT E D tN> oRM A Y aoN ,,
h[3 C DCdT1D es TRUE ACC UR A T E AND COMPL ET E e AM AW ARE THAT A RE SPG b, . .s . ' Da rOff N F ic ANY PE N AL tie s FOR sueMiTTiNo Fatst .NeohMAYoN THE RE Netuo, N<_G Mt_-fen Tpe r !_ n t n - 4 -s n_ t
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t., s tre non OFFICER OR AUTHORIZED AGENT W^ N UM B ER YEAR 'MO DAY CODE COMMENT SPjD EXPLANATION OF ANY VIOLATIONS (Rr/rrrnre all affac hr ents hers)
EPA Form 3320-1 (Rev.10-79) PREVIOUS EDITION TO AUSTED BE USED / (REPLACES EPA FORM T-40 WHICH M AY NOT BE USED.D PAGE OF UNTIL SUPPLY 1R FXH Q "j { } Q / p ,(', 3 } r, 1gj2 {
GI NFRAL INSI RUCTIONS
- 1. If form has been partiall> completed by preprinting. disregard instructions duceted at entry of that s'nform..ian already preprinted.
- 2. I nter "PI RNil Fil I N \ Nil /NITil ING ADDRIM iand faedity name/ location. if ddTerent )." "PFRhlll NU\lliFR." and "DISCil \RGF NUNilt! R" where mdicated. ( A separate for m is required for cash JNeharge.)
.t . I nier dates beginmng and ending "NIONilORING Pl RIOD" smered by form where indicated.
- 4. I nier each "P \R \\ll Il R" as specified in monitoring reqmrements of pernut.
4 I!nter
- S \\lPl l' Sll A%URI Nil'N T" data for cash parameter unde r -QU ANTI TY" and "QU Al ITY" in units speedied in permit.
"A\ l R AGI " n nor mally arithmetic aserage igeomenie aserage for bacterial parameters) of all sample measurements for cash parameter obtained dutmg "\lONilORING PI'RIOD." "\l \NINIUNt" an.1 "NIININIUN1" are normall> csucme high and low measurements obtained during "NIONIIORING PI RIOD " t NOli to manicip ds with secondary treatment requirement. enter 3o day aserage of sample me.nm ement s under ~A\lRAGl' and enter maumum ?-day asciage of sample me.nurements obtained during momtoring period under "NI ANIN!UN1".
- 6. Fnter "PI RN!l f Rl'QUIRFNIFN T" for each parameter under "QU AN ill Y" and "QU AI ITY" as specified in permir,
- 7. Under "NO. FX" enter number of sample measurements duimg monitonng period that eseced maumum (and/or -minimum or 7-day aserage as appropriate t per mit requirement for each parameter. If none. enter "0".
- 8. I nier "FRI QUI NCY OF AN \l.YNir both as "S \\tPI I Nil ASU RI NIFNT~ iactual ficquency of umpling and analy sis used during monitoring period s and as "PFRNilT RFQt IRFNIFNT" speciried in permit. t e.g.. I nter " CONT." for continuous moniton ng.
"l/7" for one day per week. "l/t0" for one day per mont h. "l/90" for one day per qua r t er, etc.)
- 9. Fnter "SANIPI F l YPl " both as "S \\lPl.F \ll' \SURFNIFN I" (actual sample t> pe used dunng monitoring period i and as "ITRNilT RI QUIR13lI NTJ ie g . I nier "GRAir for mdisidual sample. "24 tic" foi 24 hour2.777778e-4 days <br />0.00667 hours <br />3.968254e-5 weeks <br />9.132e-6 months <br /> composite. "N/ A" for sontinuous momformg. etc. )
. . . _ _ _ _ _ _ _ . _ _ _ _ . . . . . _ _ _ _ . . . _ _ _ _ . . _ _ _ _ _ _ _ _ _ _ _t_i_S _u l_d_3_ u_3_H.. .Q_7 0 J .i
- 10. WilFRF VIOI -\TIONS OF Pl RN!IT RI QUIRI Nll N IS ARF Rl'PORil D. \11 \Cli \ IIRil F i NPI ,\N ATION T O DI N RiftF CAUSF AND CORRi CilVI ACl~lONS I AKI N. RI 11 Rl M i F Aril Vit)I \ TION llY DAI F.
- 11. If "no d% har ge" onnis dunng monitoring reined. enter "N() Dl%( 11 \ R(el ' aciow for m in plase of data (ntry.
- 12. Fnte: "N \ \ll / flIl l' OF PRINCIPTl I NF( ("Il\ l OLI ICL R" w uh "NlbN \ ll RI Of PRiv IP\1 iNillIl\l Of FICI R OR Al'IllORl/FD \GI Nil "I Fl l- PilON E N U \llit R" and "D -\1l ' at bottom of f or m.
11 \l.nl signed Repor t to Ollicch i by dateis t spetitied m per mit. Retain (ops for sour resor Js
- 14. \ lose detailed inso ns tions for use of this DISCil ARGl \lONIIORING R1 POR T (D\lR t for m may be oNa:ned (som Oilisci s i speedied u. pc.mit.
I FGAl NOTICF This report is required by law t .13 U.S C.131 A 40 C.F.R.1253 ). Failure to report or t.nlute to ic por t o u!htu'l> san result m eiul penalties not to esceed $10.000 per day of uolation; or in criminal penalties not to esceed s25.000 per Ja3 of siot.uion. or by unpr e-onment for not moie than one year or by both.
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PERMITTEE NAME/ ADD % EGO (lmelude NATION AL POLLUTANT Dl2CHA2GE ELIMIN ATION SYCTEM (NPDES) Form ApprOWPd l achts we/Lmation el dderens) DISCH ARGE MONITORING REPORT (DMR) OMB No. 2040u0004 NAME hi j g Q f f Q R C_^11*.U Q _ _ _ _ (2-16' (El-09) f= pCJNSL [gpirg$ 2 2984 ADD:t E*S ' " Qg fJg yQQg';;;_,,:Qggg _ _ _ * g ] O T ' ? $_ 1 1 1J3 CA7CM $)3[h
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-- TELEPHONE DATE AND AM F AMILIAR *t TM THE INF ORMATION SUBMITTED MEREIN AND BASED .s ON MY INQUIRV OF THOSE INDveDUALS iMMEDI ATEL Y Rf bPON54RL E FOR ,' "
OtfT A'NeNG THE eNFORMa f f0N I BE L E VE THE SU DMITT E D INFORM AY60N [/d leiggkggn e d' L,
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l TYPED CR PRINTED *ad "' me simum (mPr8**nment of hera ren 6 months and l wrere i OFFICER OR AUTHORIZED AGENT g ' NUM EER YEAR "MO 'D Y COMMENT A.N.D EXPLAN ATION OF ANY VIOLATIONS (Referrns t oli utruchments here) t
- No Flow Throggh Sample P66nt for 2 consecutive week.
EPA Form 3320-1 (Rev.10-79) PREVIOUS EDITION TOAUSTED BE USED *. PAGE OF UNTIL SUPPLY IS EXM / (REPLACES EPA FORM T-40 WHICH M AY NOT BE USED.)g g g ,' / 0 ' -i; S - 1 '+ 2 2 1-
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Gl:NF R AI. INSI RUCTIONS
- 1. If form has been partially completed by preprinting. disreg.ud instructions directed at entry of that information already preprinted.
- 2. I nier "PI R%Ill Tl l N \\ll'/AI All ING. ADDRI % (and facility name/ location. If different if "PFRN!!I NUNil41 R." anst "DISCll ARGF NU%11tl R" where mdicated i A separate foi m n required for eath dhch.n ge.)
1 l~nter lates begmmng and endmg ".\tONiiORING PI RIOD" coscied by form where indicated.
- 4. I nter cash "P \R \\11 Il-R" .n specified in monitering reymremenh of permit.
; 9 I'nter ' N \\t PI I \ll ASU Rl'ill N T" data foi cash parameter under 'QU AN'll TY" and "QU \1 ITT " in units specified m permit.
~ \\ l R \GF" is nor mally arithmetic aserage i geomet r ie .netage for bacterial parameters) of all sample measuremenh for each parameter obi.uned doung "NION i l ORING PI RIOD." "%l \NiilON!" and ."NilNi\lU\l" are normally estreme high and low me.nurements obtaineJ during "\lONII() RING Pt Rl(ID" t N()ll to manicip ds with secondary treatment requirement. enter .To-day aserage of sample mea sm e ment . under "AVIRAGl' an I enter maumum 1.sta) aserage of sample measurements obtained durmg monitoring period under
"%! A N i\l U.\l".
- 6. I'nter "PI RNilT RFQUIRI \lFNT" for each patameter under "QUTN'l1 FY" and " QUAL 1 FY' as speatied in permit 7 Under "NO. FN" enter number of sample me.nuremenh dunng mondor ng period that esceed maumum t and/or -minimum or 7-da) as erage .n appr opriate ) per mit reqmrement for each parameter. If none. enter "O".
D. I nter "I RI QUI'NC) OF AN \t VSis" both as "S \\lPi l- NIF ASU RI .\lFNT" t actual frequency of sampling and analpis used during monitoring period i and as "PFR\llT RFQL IRl3tFNT" specified in permit. ie g . Fnter " CONT." for continuous monitoring.
"l/7" for one d.n per week. "l/10" for one da) per mont h. "l/90" for one da) per quai ter. etc.)
- 9. I~nter "S \ \lPl l' 'l VPl " both as "SA \lPl.F All ASU RF\t FN I" t actual sample t> pe used dur mg momforing peruid i and as "PI R Nill RI QUIRI Nil NT." t e g.. I nier "G R All" for mdiudual umple. "2411C" for 24-hour composite. "N/ A" for contmuous monitormg. etc. )
___.__.____.___.__...____._________.__...___.il_S_uf_i_3_M_3_M__07031.____________._-___...____.....___..._____
- 10. WilFRI It >l TTIONS OF PI'R\llT RFQL IRI NIFNis ARI RI PORil D. \'I I \('ll \ IIRilT l'NPI ANTil(IN 1() Di M Rift!
C AUsi? A ND CORRI C'llVF AC'llONS I AKFN. R1 I I RI N( I i \Cil VIOL \llt)N ItY DXI F. I 1. If "no dns harge" occuls duhng monitoimg ret tod. enter "N( ) DIS ( 11 \R(.1 avow form in pixe of data entr>.
- 12. I nie "N \\ll / flTI I (>F PRINCIP \1 i NF( l'Il\ F ()FI 101 R" u i!h "%I(.N \ f l'RI Of PRIN(IP\1 i Ni(.1 IIVI (11 F ICI R OR Al'l fit tRl/l D AGFN l'J "I Fl.I' PilON F NUilitt R" and "O \ l I ' .o bonom of tor m.
IL \f.nl signed Repoit to (Illicet s) b) datei s i speatied m peimit. Retain cops for som re,or Js
- 14. \ lose det.uled mstrustions foi me of thn DINCllTRG) ilONilORING RI POR I i D\lR i im m ma> be oMamed from Ottisei si spealled in pernur, 1 FGTI NOTICF This report is required by law t .13 U.S C.1118- 40 C.I .R.121271. Failuie to ierm t o; t.ulm e to r croz . o u:htu'!s can ie-uh m en il penalues not to eseced $10.000 per da) of siolation; or in criminal penalti es not to exceed s25.000 per d.n of sio Hion. or by imp nonmem for not more than one year. or by l'oth.
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Facehrs game /Lucetw= ef ddareas)
' DISCH ARGE MONITORING REPORT (DMR) OMB No. 2040a)04 N r.u E Mi.C,2.tLL1.1L';fC LRLC-. M?.!> ity_ _ _ _ wIs n (17-I9) F- FINAL Expires 2-29-84 ADDREf;jfd b i d N M _ SED O [,g[d d $Y U M _ _ _ p g g q rM 7 ' l 17'
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as a n 2850633490 - t 9TTN! 5TiTT04 % M 3 5~ 0 7 M T c o w A! T 0041 0243) 0443) ve m as-n> uudi. NOTE: Read instructions before cornpleting thiS folm. (3 Card Only) QU ANTITY OR LOADING (4 Card Only) Q U A LITY OR CONCENTR ATAON PA R AM ET E R (46-33) ($441) (3845) (46-33) (3441) N O. FREQUENY gp S AM PLE EX gg ,gygg, TYPE l gyg7y AVERAGE M AXIM UM UNITS MINIMUM AVERAGE M AXIM UM UNITS g g l
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THRU TREAT 4EWT PLANT M EASu a EM ENT .086 .086 1/31 Est. ! iOOSJ 1 } PERM IT ****** ****** ****** *****c ~****** e*** s ONCE/ ESTIU 1
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PERMIT ' P 4 R EQ UIR EM ENT ,, j S AM PLE i MEASUREMENT PERMIT R EQUIREM ENT SAMPLE MEASUREMENT PERMIT REQUIREMENT NAME/ TITLE PRINCIPAL EXECUTIVE OFFICER I CE RTir Y UNDE R PE NAL TY OF Law TMAY 0 MAVE PE RSON AL LY E R AMINE D TELEPHONE DATE AND AM F AM6LI AR wtTH THE INFORMATaON susMeTTED MEREIN AND BASED ' ON MY INQUIRY OF TMO%E INDVIDU ALS fMME D A TE LY RESPONS4GL E FOR OBT AtNING THE INFORM A TION I BE LIE'VE TMr %UBMsTTED *NF ORM A TION 'Q ChgT4,, -. # t$ TRUE ACCURATE AND COMPLETE t AM Awa#E THAT THE RE ARE SeG S. L. *Daltroff NwiCANT eE NALu s rOR sueMiTTmG ALst me ORM A f ION acLuDNc. THE PO %#BttTV Or F AND eMPRISONMENT SEE 18 U S C 4IOOf AND
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' (REPLACES EPA FORM T-40 WHICH M AY NOT BE USED.) PAGE OF EPA Form 33201 (Rev.10-79) PREVIOUS EDITION TOAUSTED BE USED / "
UNTIL SUPPLY IS EXH 00136/040385-1922 1 __ .. - _ . . . . .. -- . -- - . . . _ .,_ _ ~ -. _ . - + . _ . - - , - -
GE:NFRAl. INSI RUCTIONS
- 1. If form has been partialh completed by preprint ng, disregard instructions directed at entry of that information already preprinted.
- 2. I nter "PI R\lli ll l ? 'T \ll'/NI All.ING ADDRI SS (and faality name/ location. if different s." "Pl.RNilT-NU.\litFR." and."DISClf NRCE NUNilti R" w here indicated i A separate form is required for cash discharge.)
- 3. ' l'nter dates beginning and endmg "NIONIIORING PERIOD" coseted by form where indicated.
- 4. I'nter cash "P \R \ Nil Tl R" .n specified in monitoring reymrements of permit.
- 5. Enter "S ulPI l' All ASL Rl' Nil'N T" data for cash paranwter under 'QU AN11TY" and "QU Al ITY" in units specified in permit.
"A\TR \Gl~ n nor mall > arithmetic aserage 8 geometrie .ncrape for bacterial parameters t of all sample measurements for each parameter obtained duimg "NIONilORING PI RIOD." ".\l ANINIUNI" and "N!!NINIU\l" are normally estreme high and low measurements obtained dming "\tONI TORING PI RIOD." ( NOll' to m:mieipals with secondary treatment requirement. enter 30-day aserage of sample meenrements under "A\TR AGI ' and enter masunum 1-sta) .ncrape of sample measurements uNained during monitoring period under "N! ANI NI UNI".
- 6. Fnter "PI'RN!!T REQUIRFNIFNT" for eash parameter under "QUAN III Y" and "QU3l ITV' as specified in permit.
- 7. Under "NO. I X" enter number of sample measurements during monitormg period that exceed masimum a anJ/or -minimum or 7-day aserage as appropriate t per mit req mrement for each parameter. If none, enter "0".
D. Enter "l RI' QUI NCY OF AN \l YSIS" both as "S ulPi l: Nil TSU Rl3tFNT" 4 actual fiequenev of samphng and analysis used during monitoring gwriodi and as "PFRNllT RFQUIRFNIENT" specified in permit. t e g . Enter " CONT." for sontinuous monitoring.
"l/7" for one da) per week. "l/10" for one day per month. "l/90 for one day rcr quarter etc.)
- 9. Enter "S u!Pi l 'l Y PF" both as "S ulPl.I' NIF ASU RI3tl N 1" (actual sample t> pe used du mg monitoring period i and as "PFRN11T RI QUIRI N11'NT." t e g.. I:nter "GR Alt" for inJisi.lual san.ple. "2411C" foi 2&bour composite. "N/ \" for sononuous momformg. etc.)
.........__....__.._.....__..........__...._t_1_S.ul.d.3.H.3H_.Q.10.J).__........_. . .._.___._____...._....._______.
- 10. Will RF Vint A'iloNS OF PFRNilT RI QUIRI Nil N fS ARF RFPOR II D. VII At il \ IIRil F i NPI AN AllON IO Di M Rlill CAUSI: AND CORRI Cll\T ACTIONS 'I AKI N. RI FFRI-NCI i \Cil Vl(>l \ll(W ltY DAll..
- 11. If "no d% har ge" oaurs dur mg inomtoring period. enter "NO Dl%( 11 \ R(il " across for m in plase of data enn y.
- 12. Enter "N \\ll /TITi l OF PRINCIP \l i NECl"IINT OFFICI R" w ith "Sl( A \ll RI OF PRIV IP \1 1 NTC U ll\ 1 Of FICI R OR AU lllORl/i'D AGl'N i f "TFi l PilONI N Uhllti-R" and "DAll~ at bonom ot f or m.
- 13. \l.ul signed Repoti to 00iceM by datee s) specified m permit. Retain cops for som recor A
- 14. \ lose detailed instinstions for use of this Dl5Cil ARGF N10NilORING RI PORI s D\lR i form may be ot tamot from Orbsem spealied in permit.
I FGAl NOTICF This report is required by law 133 U.S C.131R 40 C.F.R.125.27 L l ailme to report or f athu e te s cpor t te mbl'u'l> can r esult msnil penalties not to eseced $10.000 per day of siolation; or in criminal penalties not to esceed 424.000 per J.n of siolatton. or by unprisonmem for not more than one year or l') both. QNO33S 363H G10J 3hi3H d WV1S 33v7d .._._........................_. .__.. ...___........__...__._.... -..-....................---._....-__-e_. GUlHL 363H G101 383H 37dvis g' A
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U, eT, tr **m. A .a. qqh7H "4 SAMPLE M E ASUR EM ENT , PERMIT REQUIREMENT S AM PLE MEASUREMENT PER$1IT" REQUIR EM ENT N AME/ TITLE PRINCIPAL EXECUTIVE OFFICER 8 CERTTY UNDE R PE NAL TV OF LAW THAT ? MAVE PERSONALLv E x AMtNED ' TELEPHQNE DATE AND AM F AMILI AR WITH THE INFORM ATON SUBMITTED HE REIN AND BASED ON MY INQUsRY OF TMOSE WOsv80u AL S IMME DI ATELY RESPONSIBLE FOR [/ OBT A NWG THE tNF ORM A TION t BE' lie VE THE SUDMr TT E D INF ORM A TON )1.- $ - l e i Citm My m - -- .
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D 1t ff NIFIC ANT Pf h ALTtf 5 FOR SUBMtTTsNG FALSE tNFORM ATON tNCLUDING NA 4M DN MIMbnD Y. Nrep.r ElGOtric ProductiO; '"E u Is , e u$r ' i e, a sa be b, SIGNATURE OF PRINCIPAL EXECUTIVE 717 456-7014 85 06 15
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] TYPED OR PRINTED E NUM BER YEAR MO DAY COMM ENT AND EXPL AN ATION OF ANY VIOLATIONS (Rr/rrence alJ attachments here) ss t
.* No flow through sQmple point for 2 consecutive weeks EPA Form 33201 (Rev.10 79) PREVIOUS EDITION TO BE USED t (REPLACES EPA FORM T.40 WHICH M AY NOT DE USED.) PAGE OF gg UNTIL SUPPLY IS EXH AUSTED /
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Gl% FR AL INS'I RUCTIONS
!. If form has been partially completed by preprinting. disregard instructions directed at entry of that information already preprinted.
- 2. i'nter "Pt R\1lTil I N ANil /NI All ING ADDRI SS Iand facility name/ location if different )." -PI:RNilf NUNIHliRlf and *DISCll ARGE N UNilt!'R" w here indreated. I A separate foim is required for cash discharge.)
- 3. I'nter dates beginning and enthng "NIONilORING PI RIOD" cosered by form where indicated.
- 4. I nter each "P \R \\ll'TI R" as specified in monitoring requirements of permit.
- 3. Enter NANIPI l' ill ASURI Nll N F" data for cash parameter under 'QU AN11TY" and "QUTI ITY" in units specified in permit.
"A\ l R AGl* is nor mall) ainthmetic aserage i geomeir ie .nerage for bacterial parametersi of all sample measurements for cash parameter obtained durmg "NIONIIORING PI RIODJ M1 \NINIUNt" and "NllNINIUN1" are normally esueme high and low measurements.
obtained during "\lONITORING PI RH)D " ( NOl f to manicipah with econdary treatment requirement. enter 30-day aserage of sample measur ement s under ~ A\T R AGI ' and entes maximum bda) aserage ni sample measurements obtained during m.mitoring period under "N1 ul \l C Nt".
- 6. I nier "PI RNilT RFQUIRFNIFNT" for cash parameter under "QU ANTITY" and " QUAL ITY' as specified in permit.
- 7. Under "ND. I X" enter number of sample me.nurements during monitoring period that esceed masimum (and/or minimum or 7-day aserage as appr opriate ) per mit requnement for each parameter. If none. enter "0".
it . I nier "I RI QLTNCY Of AN \1 YSis" both as "S \NIPl F N!!'TSU RI'NIFNT" beiual frequency of samphng and analysis used during monieoring periodi and as "PF R NilT RI Qt IRFNIFNT" specified in permit. e g.. Enter " CONT." for continuous monitoring.
"l/? " for one dai per w eek "l/10" for one s'as ner month. "l/90" for one dai per quar ter, etc. )
- 9. Fnier "S \NIPI F 1 YPF" both as "S \NIPl.F N!! ASURFNIFN I" tactual sample type used during momtoring period s and as "PFR \lll Rt QUIREN11 NTT te g.. I nter "GRAll" for indisidual sample. "24tlC" for 24. hour composite. "N/ A" for contmucus monitoring etc.)
. _ _ _ _ . . . . . . . . . _ _ _ . _ _ _ _ _ . . _ _ _ . _ _ _ _ _ _ _ _ . . . . . . .t.1.S .u l_J. 3. H.3.H. 0 7 0 3 .i....__...._.... ........_........._...._____
- 10. Will RI: \ 101 ATIONS OF PI RNIIT RI-QUIRI NIFNTS ARF RI POR ll'D. \1 I At il \ ItRil F l'NPI AN A flON ~10 Dl3CRilli CAUSF AND CORRI Cll\T ACllONS TAKl'N. RI Fl.Rl V F l' \ril VIOL \110N ItY DX11'.
- 11. If "no JNhange" oesurs during monitoring period. enter "M) DistilTR(el ~ asrow form in plase of data entry.
- 12. I nter "N \NIF/TITI I: OF PRINCIPTl i N& L Ti\ F OFI ICI R" w ith "%I(.N \1l RI Of PRIM IP\1 1Ni(t11\l Of FICI R OR AU Ill(IRl/l D AGI N FJ "I El l'PilONI NL \llil R" and "DXil ' at bottom of for m.
13 \ tad stgned Report to Olliech t by datet o speci ied in per mit. Retain copy for your records
- 14. \loie det.uled instr us tions for use of this DINCil \RUF \f 0NilORING RI P(lR I : D\lR i for m may be obtameJ fiom Oi!iset o specified in pernut.
I FGAl NOTICI: This report is required by law 13 3 U.S C.131M. 40 C.F.R. 125.271. Failu re to repon or f.nlure to s cror t o u:hfu'Is can r e-uli m enil penalnes not to eseced 510.000 per day of siolation; or in crimin.d renait es net to eseced %25.000 pei das of siolition. or by imtw isonment for not moie than one y ear. or by both. GNO335 3M3H Q10J 383H dWY1S 33Y7d QMtHA 3u3H Q10J
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V'L'i' t :O n S A M PL E MEASUREMENT PERMIT R EQUIR EM ENT SAMPLE MEASUREMENT PERMIT R EQUIR EM ENT N AME/ TITLE PRINCIPAL EXECUTIVE OFFICER e C E RT sFY UNDE R PE N AL TV OF LAW THAT s HAVE PE RSON AL L Y E n AMINE D f ', j TELEPHQNE DATE AND AM F AMaL I AR WIT H THE INFORMA TION SUMMITTE D HEREtN AND EtASED ON MV INQUIRY OF THOSE INDeVO I ALS iMME DI A TE'L V RE SPONS>BL E FOR f /, ~. , . ** OST AsN6NG THE INFORM A TION e BE L'E VE THE SvaMtTTE D INF ORM ATION , g, lg { g g'pygg --- IS TRUE ACCUR ATE AND COMPLETE e AM An ARE THAT THFRE A RE' StG - >-2 S. 7..*Dlatroff NirCANT PE NAtT'E S FOR Sut MiTviNo eAtsE Ne ORM ATioN .NC6 uDiNo 1-
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D'? 3 3 u sC 41319 . Prealtsr n oeider theer eterate. men am t de /.nre up ru s tra m,,, A # k _, TYPED OR PRINTED e'id ue ma nmus= saiPo=**i+eir ut Arruern 6 months and 5 seer, i OFFICER OR AUTHORIZED AGENT E 1.J M B E hl*kR MO MAY COM M ENT QO EXPLAN ATION OF ANY VIOLATIONS (R.ference un su.n hnsents here) t
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- HPDF. S LE' a Filed (REPLACES EPA FORM T-40 WHICH M AY NOT BE USED.) PAGE OF EPA Form 3320-1 (Rev.10-79) PREVIOUS UNTIL SUPPLY EDITION IS EXH TO BE USED AUSTED # ] ] } g ] / p 4,] 3 p g, J -l } } }
GI:NFRAI. INS 1 RUCTIONS
- 1. If form has becq p otially completed by preprinting, disregard instructions directed at entry of that l'nformation already preprinted.
- 2. I neer "PI R\lli 11 l' N AMI'/\l All ING ADDRI SS Iand facility name/ location. if different i." "PERMil NUM HFR." and "DISCil ARGF NUMHI R" where indicated i A separate form is required for cash discharge.)
- 3. I'nter dates beginning and endmg "SIONilORING PERIOD" cosened by form where indicated.
- 4. Fnter caeh "P \R \\ll ITR" as specified in monitoring requiremenis of perrmt.
- 5. Enter "SAMPI i \ll: ASURIT11:N F" data for cash parameter under 4)UANTIT Y" and "QU A! ITY" in units specified in permit.
"A\TR AGl* is normall> arithmelic aserage t geometric aserage for bacterial parameters e of all sample measurements for each parameter obt.uned dur mg "MONIIORING PI RIOD." ."\l ANIM U\l" and " MINIM U M" are noim.dh estreme high and low measurements obtained during " MONITORING PI'RIOD " # NO~ll: to manicipah with secondary treatment requirementcentes 30-day aserage of sample measm eme nt s under "A\T R AGI ~ and enter maumum 7-sta) aserage of sample menorements obtained durmg monitoring period imder
-M AXI\l U NI".
ft Fnter "PI RMIT RFQUIRFMENT" for each parameter under "QU AN ilTY" and "QU Al ITV' as specified in permit,
- 7. Under "NO. FX" enter number of sample measurements during monitormg period that exeeed masirnum land /or -minimum or 7-day aserage as appropriatel pei mit requirement for each parameter. If none. enter "O".
D. Fnter "FRI QUI NCY OF AN \l.YSIS" both as S \\lPI F MI' ASU RI MENT" lactual frequenes of samphng and analpis used during monitoring periodi and as "PFRMIT RI QUIRFMFNT" specitied in permit. te.g.. Enter " CONT." for continuous monitoring.
"l/7" for one das per week. "l/10" for one das per mon t h. "l/90" for one day per quarter, ete. t
- 9. Fnter " SAM Pi l- l YPl" both as "SSMPl.F MF ASU REMFN1" t actual umple t>pe used during momtoring permd i and as "Pl RMll RI QUIRI:M FNT." d e g., Enter "GR AH" for mdisidual umple. "24flC" for 24-hour i.omposite. "N/A" for conimuous momtormg. ete. 6
.......___........_____..._______________.___t_i_ sui.a.s.u_s_H__a.lo.o_..........______________...__.__...........
- 10. WilFRF Vlot \TIONS OF PI'RMIT RFQUIRFMI Nis ARF RI'PORll D. VII Aril \ IIRilT l'XPI ANATION 'IO Dl3CRIHI CAUSF AND CORRI CilVI AC~l lONS I AKl:N. RI l ERI N( 1: I \Cil VIOI \1[ON llY DXil-I I. If "no ihwhar ge" occut s during monitoring period. enter "NO Dl%CitTR(el ' astow form in plasc of data cntry.
- 12. I nter "N \\ll /TITI I OF PRINCIPTI l NE( UTi\ F OFI ICF R" u ich "SR.N \ l U RI Of PRIV IP\1 1 Ni (. L 11\ l' OF FICI R OR AUlllORl/I'D AGFN IT "lEl FPilONI NUMHI R" and "l) A ll ' at bottom of toim.
I t. M ul signed Repoii to Odice10 by datet si specified in per mit. Ret.un cop > for 3our records
- 14. More det.nled instinstions for use of this Dl%Cll ARUF MONilORING RI PORI i D\lR form may be oMained from 00kes u specified in perm:1.
I FGTl NOTICE This report is required by law ( 33 U.S C.1310 40 C.F.R.125.27 ), f ailuie lo repon or t.nlut e to repot t tr uthfu'ly un r e-olt m en d penalties not to eseced Situlod per day of siolation: or in criminal penalties not to eseced 525.000 per Ja) of siolation. or by impi nonment for not moie than one Scar, or by both. ONO335 3u3 H Q104 3W3H d W Y1S 33V7d QulHA 383H G70J
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