Form 5600-FM-BMP0488 "Discharge Monitoring Report Cover Sheet" - Pennsylvania

What Is Form 5600-FM-BMP0488?

This is a legal form that was released by the Pennsylvania Department of Environmental Protection - a government authority operating within Pennsylvania. As of today, no separate filing guidelines for the form are provided by the issuing department.

Form Details:

  • Released on August 1, 2019;
  • The latest edition provided by the Pennsylvania Department of Environmental Protection;
  • Easy to use and ready to print;
  • Quick to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of Form 5600-FM-BMP0488 by clicking the link below or browse more documents and templates provided by the Pennsylvania Department of Environmental Protection.

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Download Form 5600-FM-BMP0488 "Discharge Monitoring Report Cover Sheet" - Pennsylvania

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5600-FM-BMP0488
Rev. 8/2019
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF MINING PROGRAMS
DISCHARGE MONITORING REPORT
COVER SHEET
REPORTING PERIOD
(
month(s)/
year)
Operator:
Operation Name:
Permit Number:
Township(s):
County:
Noncompliance reporting (Permit Conditions, Part B, Sect 2(l))
I have reviewed the data for the above referenced reporting period and compared it with the permit
requirements and have identified the following non-compliant samples:
There are no noncompliant samples.
Description of
Outfall
Date
noncompliance
Parameter
Cause
Action Taken
Cessation of Discharge: List outfalls for which the discharge has ceased (Note that
92a.76 does not require
§
prior notice for mining discharges-this notification provides the basis for no longer reporting data):
Outfall NPDES ID
Outfall Description
Explanation
Subchapter F/G Reporting
Not Applicable
I have reviewed the data and it has not exceeded the quick trigger.
The data exceeded the quick trigger. Accelerated monitoring was initiated on
.
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5600-FM-BMP0488
Rev. 8/2019
COMMONWEALTH OF PENNSYLVANIA
DEPARTMENT OF ENVIRONMENTAL PROTECTION
BUREAU OF MINING PROGRAMS
DISCHARGE MONITORING REPORT
COVER SHEET
REPORTING PERIOD
(
month(s)/
year)
Operator:
Operation Name:
Permit Number:
Township(s):
County:
Noncompliance reporting (Permit Conditions, Part B, Sect 2(l))
I have reviewed the data for the above referenced reporting period and compared it with the permit
requirements and have identified the following non-compliant samples:
There are no noncompliant samples.
Description of
Outfall
Date
noncompliance
Parameter
Cause
Action Taken
Cessation of Discharge: List outfalls for which the discharge has ceased (Note that
92a.76 does not require
§
prior notice for mining discharges-this notification provides the basis for no longer reporting data):
Outfall NPDES ID
Outfall Description
Explanation
Subchapter F/G Reporting
Not Applicable
I have reviewed the data and it has not exceeded the quick trigger.
The data exceeded the quick trigger. Accelerated monitoring was initiated on
.
- 1 -
5600-FM-BMP0488
Rev. 8/2019
I certify under penalty of law that I have personally examined and am familiar with the information for all of the
sample results attached herewith, based on my inquiry of those individuals immediately responsible for
obtaining the information, I believe all of the submitted information is true, accurate, and complete. I am aware
that there are significant penalties for submitting false information, including the possibility of fine and
imprisonment.
Signature of the Permittee or Responsible Official or
Date
Authorized Representative
Print or Type Name and Title
Phone number
Instructions
Written notification of delegation of signatory authority must be submitted to the Department if the
signature is other than a company official.
Unsigned reports will be returned as incomplete which may result in a violation.
The date may be either an individual day, for daily or instantaneous limit violations, or a month for
monthly average violations.
In reporting the description of the noncompliance, include the limit violated. For example: “monthly
average limit exceeded.”
If the cause of the violation is unknown, you may indicate that by inserting “unknown” in the cause
column.
25 Pa. Code § 92a.76 provides an exemption to the 90-day notice requirement prior to cessation of
discharge. The Cessation of discharge section of the report is intended to document that DMR data is
no longer needed for that outfall.
Use additional sheets if there is not enough space on one sheet.
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