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CALIFORNIA REGIONAL WATER QUALITY CONTROL BOARD <br /> MONITORING REPORT COMPLIANCE CHECKLIST <br /> FOR <br /> WASTE DISCHARGE REQUIREMENTS <br /> FOR <br /> DISCHARGES REGULATED BY TITLE 27 AND/OR PART 258 <br /> Reporting Frequency: Semi-Annual <br /> Order No.: C&A Order 5-01-722 Monitoring Period: 1"-2" Quarter 2005 <br /> Discharger: MonierLifetile Date Due: 15 July 2005 <br /> Facility: Lathrop & French Camp Date Received: 19 September 2005 <br /> rR—W—QCB Reviewer: Ross Atkinson Date Reviewed: 29 September 2005 <br /> RWQCB <br /> Reference Parameter Yes No N/A Reviewer Comment <br /> Standard 1. Transmittal Letter <br /> Provisions <br /> (1993,1997,2000) a. Is there a transmittal letter signed by X <br /> an authorized representative? <br /> b. Does it include the required X <br /> Certification Statement? <br /> X Chromium and diesel impacts <br /> c. Is there a discussion whether any to groundwater are increasing. <br /> violations have occurred since the <br /> last monitoring report was submitted? <br /> X <br /> d. If any violations did occur, does it <br /> describe actions taken or planned for <br /> correcting those violations? <br /> Standard 2. Compliance Evaluation Summary <br /> Provisions R <br /> (1993,1997,2000) a. Map/Photo: Is there a map or aerial <br /> photograph indicating the locations of <br /> all monitoring points? <br /> b. Standard Observations: Is there a X <br /> summary and certification of completion <br /> of all standard observations for the <br /> WMU, and for receiving waters? <br /> Sr. Initials SWIM Entry <br />