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INSTRUCI,—.4S FOR DISCHARGER CALIFORNIA STATE WATER RESOURCES CONTROL BOARD 1 1. Remove COPY 4 (dark yellow) and use for your worksheet. s- 2. Use ballpoint pen or lypewnter for data entry on forms. DISCHARGER SELF MONITORING REPORT zj� SEVEN RESORTS* INC. �. 3. Provide dotes for beginning and ending In reporting period blocks. I-CALIFORNIA REGIONAL WATER QUALITY LLZYARAOISE POINT MARINA 4. Provide data as specified under column headings. 5. Enter monthly summary data (MONTHLY AVERAGE, MONTHLY HIGH, etc.). CONTROL BOARD 6. Appropriate signature is required at the bottom of the form, CENTRAL VALLEY REGION 711 W• KIMBERLY AVE s STc 211U �i. 7. Remove COPY 3 and retain for your records. 8. Send COPY,Qj�J�rF `"R�$yQ Q(Ac�(Sjf �FR j(c X�LK�LxXXX 3443 ROUTIER ROAD 0„i'LACENTIA sou SACRAMENTO* CA 95827-3098 -092670 YOUR REPORTING PERIOD IS t40NTLLLY AND YOUR REPORTS MUST BE SUBMITTED BY [M DAYS FOLLOWING THIS PERIOD. state NPDES Permit ' Year Mo. Day Year Mo Do Code Number Yeor Mo. Da 2 Troa=ion F'cDity ,,t•)39I'J41QQ Year Month (: ) Reporting Beginning 92 12 b1 Ending 9'Z 12 31 06 CA0082.3 cool form was, 92 Cb 11 I 01 L P Y I 9 9 g I P P STATION DESCRIPTION -3 R-4 CONSTITUENT NAME TOP COLIFORM TOT COLIFORM TLIT CIULIFORM TOT CGLIFORM UNITS r.y NW GO MIL MPN/100NL MPN/10OML SAMPLE TYPE C.P.A A r PA X1 GRAB GRAB FREQUENCY k,,ELKI Y y- dtL ' 9C L.Y WEEKLY Dyy _ yy yy MONTH AY �' T * * * T T T —____________ _ _____________ __ ______ __ __________ ___ __ _____________ _____________ __ ______ _ _ _____________ _ ---- a ------- '`l n---- -I -----i --- ----1ao_-- --I ----- -� -- -- ------------- -- ------------- -- ------------- -- ------------- ---- - -- ------------- -- ------------- -- ------------- -- ------------- -- ------------- -- ------------ - ----------- - -------------- ---------------------------- ------------ -- ------------- --- ------------ -- ------------- -- -- -------- -- ----------—- -- -------------------—--—------ -- ------------ -- -- ------------- ------------------------------------ ------------------ ------------- -- --------------------- ----------------------- ------------- -- ----------- - ------------ -- ------------ -- -------- -- ------------- -- ------------- ------------- -- ------------- ---- -- ------------- --- ------------- -- ------------- -- ------------- -- ------------- -- ------------- -- ------------- -- ----- ---- -- ------------- -- ------------- -- ------------- --------------- - ------------- -- ---—------ -- ------------- -- -- ------ - -- �� -- ------------- -- ------------- -- ------------- -- ------------- -- ------------- -- ------------- -- ------------------- ------------- ---- -- ------------- -- ------------- -- ------------ -- --------------------------------------------------- ----------------------- ------------- --- -Y -- ------------- -- ------------- -- ------------- -- ------------- -- ------------ -- ------------- -- ---------- -- -- ------------- - ------------- -- ------------- -- - ------------ -- -- ------------- -- ------------- -- ----------- -- ------------- - ------------- -- ------------- -- ----- ------- ----------------------- --- ---------- x ------------- -- ------------- ------------------------ ------ ------------- -- -------------- -- ------------- -- ---- - - ------------- -- - ---- -- ------------- -- ------------- - -- ------------- -- ------------ ---- -- ------------- -- ------------- ------------------------------------------ ------------- -- ------------ -- ------------- -- -- ------------- -- ------------- -- --------- --- -- ------------- - ------------ ---- -- --- ----------------- -- -------- ---- - -- ------------ ------------------------------------------ ------------- -- ---- - -- ------------- ----------------------------------------- - -- -- -- ------------ ------------------ ----- --------------------------------------- ------------ ----------------------- -------------- ------------------- ----------------------------------------- -� -- ------------- ------------------------------------------ ------------ Y __ __ -----------__ __ _____________ Q ____ _� _____________ __ _________ _ ------------- ---------------------- ____________ __ _____________ __ ----------------- __------------ ____--______ + MONTHLY AVERAGE </!9 MONTHLY HIGH i/0 0 MONTHLY LOW TOTAL RECORDINGS:MO. / REQUIREMENT #1 Times Exceeded REQUIREMENT #2 Times Exceeded REQUIREMENT #3 Times Exceeded _ �C Enter number of samples Typed Nome of Prmu pal Ere ove Officer I<en Iy..do,penaby of lay.Ihol I hove personally exom nein d m familiar with the formol on subm r led nn Ih sndocume t and all anachmenls and Ihat. based on y inquiry of (hose nd✓duols r ed otely ( i - -'z /).�� / EPA taken during the day. (� respons ble lorobt 'n ng tha nformot on bel eve thol the color at'on's,rue occurme and cample le am ys. Mo. Oa ..are that there a e vgn Y2onl penah es Io, submithng false informahon nrlud ng the possib lily of 1 n S-g otuoe o Pr n a}Ex cutiv y COPY Form a]-< 71 Lost First MI and mpr sonmant SllTer or or zed ge Dole :. _.�._.___�,1-.�.�.._�-_ --'—:—.—.—,—.- --r---�--�.r—..--.,—.._.—.�.a--._—^...-.-m..•.M—:c—.ter--a—...__