Epa Form 3320 1 PDF Details

Understanding the Environmental Protection Agency (EPA) Form 3320-1 is essential for entities dealing with hazardous metals in inland waters under the National Pollutant Discharge Elimination System (NPDES). This form serves as a Discharge Monitoring Report (DMR), a critical tool for compliance and environmental management. The meticulous structure of the form demands accurate entry of various data points, including permittee information, monitoring periods, and specific details about discharged substances such as quantity, quality, frequency of discharge, and the types of analysis conducted. Additionally, the form requires a certification by the principal executive officer or an authorized agent, affirming the accuracy and completeness of the information under the penalty of law, emphasizing the seriousness of the report. Violations or inaccuracies can lead to severe penalties, including fines or imprisonment, highlighting the importance of careful compliance and the role of the EPA Form 3320-1 in safeguarding environmental quality and public health through stringent monitoring of hazardous metal discharges into inland waters.

QuestionAnswer
Form NameEpa Form 3320 1
Form Length3 pages
Fillable?No
Fillable fields0
Avg. time to fill out45 sec
Other namesepa no 3320 1, epa form 3320, epa dmr form, npdes discharge monitoring report form

Form Preview Example

NOTE: Enter your authorization number in the underlined space in the upper right hand corner of this page. Example: STW/ TXR05J102/ CO
STW / TXR05____________ / CO

HAZARDOUS METALS - INLAND WATERS

PERMITTEE NAME/ADDRESS (Include Facility Name/Location if Different)

NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)

NAME

DISCHARGE MONITORING REPORT (DMR)

 

 

 

 

 

 

 

 

 

 

(2-16)

 

 

 

 

 

 

(17-19)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

N/A

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PERMIT NUMBER

 

 

DISCHARGE NUMBER

Only If required, mail to: TCEQ (MC 213)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

P.O. Box 13087

 

 

 

 

FACILITY

 

 

 

 

 

 

 

 

 

 

 

MONITORING PERIOD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Austin, TX 78711-3087

 

LOCATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YEAR

MO

DAY

 

 

YEAR

MO

 

DAY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

01

01

 

 

 

 

 

12

 

31

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(20-21)

(22-23)

(24-25)

 

 

(26-27)

(28-29)

(30-31)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PARAMETER

 

 

(3 Card Only)

QUANTITY OR LOADING

 

 

(4 Card Only)

QUALITY OR CONCENTRATION

 

 

 

 

 

FREQUENCY

 

 

 

 

(32-37)

 

 

(46-53)

 

( 54-61)

 

 

 

 

(38-45)

 

 

 

(46-53)

 

 

(54-61)

 

 

 

 

NO.

 

OF

 

SAMPLE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EX

ANALYSIS

 

TYPE

 

 

 

 

 

 

AVERAGE

 

 

MAXIMUM

 

UNITS

 

MINIMUM

 

AVERAGE

MAXIMUM

UNITS

 

 

 

 

 

 

 

 

 

 

 

 

(62-63)

(64-68)

(69-70)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Arsenic

 

SAMPLE

*******

 

 

*******

 

 

*******

 

******

 

 

******

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MEASUREMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAMPLE

*******

 

 

*******

 

 

*******

 

******

 

 

******

 

 

0.3

 

 

 

 

 

 

1/Year

 

Grab

 

 

 

 

 

REQUIREMENT

 

 

 

 

 

 

 

 

Daily Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Barium

 

SAMPLE

*******

 

 

*******

 

 

 

 

*******

 

 

*******

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MEASUREMENT

 

 

 

 

*******

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAMPLE

*******

 

 

*******

 

 

*******

 

*******

 

 

*******

 

 

4.0

 

mg/l

 

 

 

1/Year

 

Grab

 

 

 

 

 

REQUIREMENT

 

 

 

 

 

 

 

 

Daily Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Cadmium

 

SAMPLE

*******

 

 

*******

 

 

 

 

*******

 

 

*******

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MEASUREMENT

 

 

 

 

*******

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAMPLE

*******

 

 

*******

 

 

*******

 

*******

 

 

*******

 

 

0.2

 

mg/l

 

 

 

1/Year

 

Grab

 

 

 

 

 

REQUIREMENT

 

 

 

 

 

 

 

 

Daily Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Chromium

 

SAMPLE

*******

 

 

*******

 

 

*******

 

*******

 

 

*******

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MEASUREMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAMPLE

*******

 

 

*******

 

 

*******

 

*******

 

 

*******

 

 

5.0

 

mg/l

 

 

 

1/Year

 

Grab

 

 

 

 

 

REQUIREMENT

 

 

 

 

 

 

 

 

Daily Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Copper

 

SAMPLE

*******

 

 

*******

 

 

*******

 

*******

 

 

*******

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MEASUREMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAMPLE

*******

 

 

*******

 

 

*******

 

*******

 

 

*******

 

 

2.0

 

mg/l

 

 

 

1/Year

 

Grab

 

 

 

 

 

REQUIREMENT

 

 

 

 

 

 

 

 

Daily Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME/TITLE PRINCIPAL EXECUTIVE OFFICER

I CERTIFY UNDER PENALTY OF LAW THAT THIS DOCUMENT AND ALL ATTACHMENTS

 

 

 

 

 

 

 

 

 

TELEPHONE

 

 

 

 

 

DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WERE PREPARED UNDER MY DIRECTION OR SUPERVISION IN ACCORDANCE WITH

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

A SYSTEM DESIGNED TO ASSURE THAT QUALIFIED PERSONNEL PROPERLY GATHER

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AND EVALUATE THE INFORMATION SUBMITTED. BASED ON MY INQUIRY OF THE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PERSON OR PERSONS WHO MANAGE THE SYSTEM, OR THOSE PERSONS DIRECTLY

SIGNATURE OF PRINCIPAL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

RESPONSIBLE FOR GATHERING THE INFORMATION, THE INFORMATION SUBMITTED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IS, TO THE BEST OF MY KNOWLEDGE AND BELIEF, TRUE, ACCURATE, AND

 

 

 

EXECUTIVE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT

PENALTIES FOR

 

 

 

 

 

AREA

 

NUMBER

 

YEAR

MO

 

DAY

 

 

 

 

 

 

 

 

SUBMITTING FALSE INFORMATION, INCLUDING THE POSSIBILITY OF FINE AND

 

OFFICER OR AUTHORIZED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

IMPRISONMENT FOR KNOWING VIOLATIONS.

 

 

 

 

 

 

CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TYPED OR PRINTED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AGENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EPA Form 3320-1 (3-99)

 

 

(REPLACES EPA FORM T-40 WHICH MAY NOT BE USED)

 

 

 

 

 

PAGE

 

 

 

OF

 

 

 

Form Approved OMB No. 2040-004

 

 

 

 

HAZARDOUS METALS - INLAND WATERS

 

 

 

 

 

 

 

 

 

 

 

 

 

STW / TXR05____________ / CO

 

PERMITTEE NAME/ADDRESS (Include Facility Name/Location if Different)

 

 

 

NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)

NOTE: Enter your authorization number in the

 

NAME

 

 

 

 

 

 

 

 

 

 

DISCHARGE MONITORING REPORT (DMR)

underlined space in the upper right hand corner

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(17-19)

 

 

of this page. Example: STW/ TXR05J102/ CO

 

 

 

 

 

 

 

 

 

 

 

(2-16)

 

 

 

 

 

 

 

 

 

ADDRESS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

N/A

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PERMIT NUMBER

 

 

 

DISCHARGE NUMBER

Only If required, mail to:

TCEQ (MC 213)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

P.O. Box 13087

 

 

 

 

 

FACILITY

 

 

 

 

 

 

 

 

 

 

 

MONITORING PERIOD

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Austin, TX 78711-3087

 

LOCATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

YEAR

MO

DAY

 

 

 

YEAR

MO

 

DAY

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

01

01

 

 

 

 

 

12

 

31

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

(20-21)

(22-23)

(24-25)

 

 

 

(26-27)

(28-29)

(30-31)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PARAMETER

 

 

(3 Card Only) QUANTITY OR LOADING

 

 

(4 Card Only)

QUALITY OR CONCENTRATION

 

 

 

 

 

FREQUENCY

 

 

 

 

(32-37)

 

 

(46-53)

 

( 54-61)

 

 

 

 

 

(38-45)

 

 

(46-53)

 

 

(54-61)

 

 

 

NO.

 

 

 

OF

 

SAMPLE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EX

 

 

ANALYSIS

 

TYPE

 

 

 

 

 

 

 

 

AVERAGE

 

MAXIMUM

 

UNITS

 

MINIMUM

 

AVERAGE

 

MAXIMUM

UNITS

(62-63)

 

(64-68)

 

 

(69-70)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Lead

 

SAMPLE

*******

 

 

******

 

 

*******

 

 

******

 

 

******

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MEASUREMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAMPLE

*******

 

 

******

 

 

*******

 

 

******

 

 

******

 

 

1.5

 

 

 

 

 

 

 

1/Year

 

Grab

 

 

 

 

 

 

 

REQUIREMENT

 

 

 

 

 

 

 

 

 

 

Daily Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Manganese

 

SAMPLE

*******

 

 

*******

 

 

 

 

 

*******

 

 

*******

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MEASUREMENT

 

 

 

 

*******

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAMPLE

*******

 

 

*******

 

 

*******

 

 

*******

 

 

*******

 

 

3.0

 

mg/l

 

 

 

 

1/Year

 

Grab

 

 

 

 

 

 

 

REQUIREMENT

 

 

 

 

 

 

 

 

 

 

Daily Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Mercury

 

SAMPLE

*******

 

 

*******

 

 

 

 

 

*******

 

 

*******

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MEASUREMENT

 

 

 

 

*******

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAMPLE

*******

 

 

*******

 

 

*******

 

 

*******

 

 

*******

 

 

0.01

 

mg/l

 

 

 

 

1/Year

 

Grab

 

 

 

 

 

 

 

REQUIREMENT

 

 

 

 

 

 

 

 

 

 

Daily Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Nickel

 

SAMPLE

*******

 

 

*******

 

 

*******

 

 

*******

 

 

*******

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MEASUREMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAMPLE

*******

 

 

*******

 

 

*******

 

 

*******

 

 

*******

 

 

3.0

 

mg/l

 

 

 

 

1/Year

 

Grab

 

 

 

 

 

 

 

REQUIREMENT

 

 

 

 

 

 

 

 

 

 

Daily Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Selenium

 

SAMPLE

*******

 

 

*******

 

 

*******

 

 

*******

 

 

*******

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MEASUREMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAMPLE

*******

 

 

*******

 

 

*******

 

 

*******

 

 

*******

 

 

0.2

 

mg/l

 

 

 

 

1/Year

 

Grab

 

 

 

 

 

 

 

REQUIREMENT

 

 

 

 

 

 

 

 

 

 

Daily Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME/TITLE PRINCIPAL EXECUTIVE OFFICER

I CERTIFY UNDER PENALTY OF LAW THAT THIS DOCUMENT

AND ALL

 

 

 

 

 

 

 

 

TELEPHONE

 

 

 

 

DATE

 

 

 

 

 

 

 

 

 

 

 

 

 

ATTACHMENTS WERE PREPARED UNDER MY DIRECTION OR SUPERVISION IN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ACCORDANCE WITH A SYSTEM DESIGNED TO ASSURE THAT QUALIFIED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PERSONNEL PROPERLY GATHER AND EVALUATE THE INFORMATION

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SUBMITTED. BASED ON MY INQUIRY OF THE PERSON OR PERSONS WHO

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MANAGE THE SYSTEM, OR THOSE PERSONS DIRECTLY RESPONSIBLE FOR

SIGNATURE OF PRINCIPAL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

GATHERING THE INFORMATION, THE INFORMATION SUBMITTED IS, TO THE BEST

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OF MY KNOWLEDGE AND BELIEF, TRUE, ACCURATE, AND COMPLETE. I AM

 

EXECUTIVE

 

 

AREA

 

NUMBER

 

YEAR

 

 

MO

 

DAY

 

 

 

 

 

 

 

 

 

 

 

AWARE THAT THERE ARE SIGNIFICANT PENALTIES FOR SUBMITTING FALSE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OFFICER OR AUTHORIZED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

INFORMATION, INCLUDING THE POSSIBILITY OF FINE AND IMPRISONMENT FOR

 

CODE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TYPED OR PRINTED

 

 

KNOWING VIOLATIONS.

 

 

 

 

 

 

 

AGENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EPA Form 3320-1 (3-99)

 

 

(REPLACES EPA FORM T-40 WHICH MAY NOT BE USED)

 

 

 

 

 

PAGE

 

 

OF

 

 

 

 

Form Approved OMB No. 2040-004

NOTE: Enter your authorization number in the underlined space in the upper right hand corner of this page.
STW / TXR05____________ / CO

HAZARDOUS METALS - INLAND WATERS

PERMITTEE NAME/ADDRESS (Include Facility Name/Location if Different)

NATIONAL POLLUTANT DISCHARGE ELIMINATION SYSTEM (NPDES)

NAME

DISCHARGE MONITORING REPORT (DMR)

ADDRESS

FACILITY LOCATION

 

(2-16)

 

 

 

(17-19)

 

Example: STW/ TXR05J102/ CO

 

 

 

 

 

 

N/A

 

 

PERMIT NUMBER

 

DISCHARGE NUMBER

Only If required, mail to: TCEQ (MC 213)

 

 

 

 

 

 

 

 

P.O. Box 13087

 

 

MONITORING PERIOD

 

 

 

 

 

 

Austin, TX 78711-3087

 

 

 

 

 

 

 

 

YEAR

 

MO

DAY

 

YEAR

MO

DAY

 

 

 

 

 

01

01

 

 

12

31

 

(20-21)

 

(22-23)

(24-25)

 

(26-27)

(28-29)

(30-31)

 

 

 

 

 

 

 

 

 

 

PARAMETER

 

(3 Card Only)

QUANTITY OR LOADING

 

(4 Card Only)

QUALITY OR CONCENTRATION

 

FREQUENCY

 

(32-37)

(46-53)

( 54-61)

 

(38-45)

(46-53)

(54-61)

NO.

OF

SAMPLE

 

 

AVERAGE

MAXIMUM

UNITS

MINIMUM

AVERAGE

MAXIMUM UNITS

EX

ANALYSIS

TYPE

 

 

(62-63)

(64-68)

(69-70)

 

Silver

 

 

SAMPLE

*******

*******

*******

*******

*******

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MEASUREMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAMPLE

*******

 

*******

*******

*******

*******

 

 

0.2

 

mg/l

 

 

1/Year

Grab

 

 

 

 

REQUIREMENT

 

 

Daily Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Zinc

 

 

SAMPLE

*******

*******

*******

*******

*******

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

MEASUREMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SAMPLE

*******

 

*******

*******

*******

*******

 

 

6.0

 

mg/l

 

 

1/Year

Grab

 

 

 

 

REQUIREMENT

 

 

Daily Max

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

NAME/TITLE PRINCIPAL EXECUTIVE OFFICER

I CERTIFY UNDER PENALTY OF LAW THAT THIS DOCUMENT AND ALL

 

 

 

 

 

TELEPHONE

 

 

DATE

 

 

 

 

 

 

 

ATTACHMENTS WERE PREPARED UNDER MY DIRECTION OR SUPERVISION IN

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

ACCORDANCE WITH A SYSTEM DESIGNED TO ASSURE THAT QUALIFIED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

PERSONNELPROPERLY GATHER AND EVALUATE THE INFORMATION SUBMITTED.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

BASED ON MY INQUIRY OF THE PERSON OR PERSONS WHO MANAGE THE SYSTEM,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

SIGNATURE OF PRINCIPAL

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

OR THOSE PERSONSDIRECTLYRESPONSIBLEFOR GATHERINGTHE INFORMATION,

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

THE INFORMATION SUBMITTED IS, TO THE BEST OF MY KNOWLEDGE AND BELIEF,

 

EXECUTIVE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

TRUE, ACCURATE, AND COMPLETE. I AM AWARE THAT THERE ARE SIGNIFICANT

 

 

 

AREA

 

NUMBER

YEAR

 

MO

DAY

 

 

 

 

 

 

PENALTIES FOR SUBMITTING FALSE INFORMATION, INCLUDING THE POSSIBILITY

OFFICER OR AUTHORIZED

 

 

 

 

 

 

 

 

 

OF FINE AND IMPRISONMENT FOR KNOWING VIOLATIONS.

 

 

CODE

 

 

 

 

 

 

 

 

 

 

 

TYPED OR PRINTED

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

AGENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

COMMENTS AND EXPLANATION OF ANY VIOLATIONS (Reference all attachments here)

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EPA Form 3320-1 (3-99)

 

(REPLACES EPA FORM T-40 WHICH MAY NOT BE USED)

 

 

 

 

 

PAGE

 

 

 

OF

 

Form Approved OMB No. 2040-004

How to Edit Epa Form 3320 1 Online for Free

Using PDF files online is always super easy with our PDF tool. You can fill in 3320 1 here and try out various other options available. FormsPal development team is constantly working to develop the editor and enable it to be much better for clients with its cutting-edge functions. Take your experience to the next level with continually developing and exciting possibilities available today! Here's what you would want to do to get started:

Step 1: Open the PDF form in our editor by hitting the "Get Form Button" in the top part of this webpage.

Step 2: The tool will allow you to modify PDF documents in a variety of ways. Change it by writing customized text, correct original content, and include a signature - all close at hand!

To be able to complete this form, make certain you enter the information you need in every single blank:

1. The 3320 1 requires certain details to be typed in. Ensure the next fields are complete:

epa form 3320 completion process outlined (part 1)

2. Your next part would be to complete the next few blank fields: Cadmium, Chromium, Copper, REQUIREMENT, SAMPLE, MEASUREMENT, SAMPLE, REQUIREMENT, SAMPLE, MEASUREMENT, SAMPLE, REQUIREMENT, SAMPLE, MEASUREMENT, and SAMPLE.

epa form 3320 conclusion process described (step 2)

3. The next section is fairly straightforward, HAZARDOUS METALS INLAND WATERS, STW TXR CO, PERMITTEE NAMEADDRESS Include, NATIONAL POLLUTANT DISCHARGE, NAME, ADDRESS, FACILITY LOCATION, DISCHARGE MONITORING REPORT DMR, PERMIT NUMBER, DISCHARGE NUMBER, MONITORING PERIOD, YEAR MO, DAY, YEAR, and DAY - these blanks is required to be filled in here.

Part # 3 of filling in epa form 3320

Always be very mindful while filling out YEAR and DAY, because this is the part in which a lot of people make mistakes.

4. This next section requires some additional information. Ensure you complete all the necessary fields - Mercury, Nickel, Selenium, SAMPLE, MEASUREMENT, SAMPLE, REQUIREMENT, SAMPLE, MEASUREMENT, SAMPLE, REQUIREMENT, SAMPLE, MEASUREMENT, SAMPLE, and REQUIREMENT - to proceed further in your process!

epa form 3320 writing process clarified (step 4)

5. The document needs to be finalized by filling in this area. Below you can find a detailed listing of blank fields that require appropriate information to allow your form usage to be faultless: HAZARDOUS METALS INLAND WATERS, PERMITTEE NAMEADDRESS Include, NATIONAL POLLUTANT DISCHARGE, NAME, ADDRESS, FACILITY LOCATION, DISCHARGE MONITORING REPORT DMR, PERMIT NUMBER, DISCHARGE NUMBER, MONITORING PERIOD, YEAR, DAY, YEAR, DAY, and STW TXR CO.

Filling out part 5 in epa form 3320

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