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I <br /> INSTRUCTIONS FORI :HARGER CALIFORNIA STATE WATER RESOURCES CONTROL ( 1RD <br /> 1. Remove COPY 4 (dark yellow) and use lar worksheet. DISCHARGER SELF MONITORING DEPORT = <br /> 7. Use ballpoint pen or typewriter for data entrytry on lormz. --� SEVEN RESORTS, INC. <br /> 1 1 Provide dales for beginning and ending in reporting period blocks. -M IFORNIA REGIONAL WATER QUALITY PPARAOISE POINT MARINA <br /> d. Provide data as specified under column headings. <br /> 5, Enter monthly summary data (MONTHLY AVERAGE. MONTHLY HIGH, etc.). CONTROL. BOARD <br /> 6. Appropriate signature is required at the bottom of the form. CENTRAL VALLEY REGION11 We KIMBERLY AVE• SIE 200 <br /> 7. Remove CO eY nd.r r <br /> 8, Send COPY 2� ✓r� g�a�r c �bX,�J�JIt?I.XXXR 3443 R0117IER ROAD u„ LACENTIA SCA <br /> SACRAMENTOP CA 95827-3098 3A9 2670 <br /> YOUR REPORTING PEWD IS MUNIFILY AND YOUR REPORTS MUST PAGE <br /> Fa <br /> BE SUBMITTED BY DAYS FOLLOWING THIS PERIOD. State NPDES Permit <br /> Year Mo. Day Yeor Mo. Da Code Number Year Mo. Do <br /> yyDote form was <br /> 2 Transaction I F lcDity 5839104100 I YearMonth <br /> reportthfor m I R Period g _Beginning 90 ✓'A OI Ending 90 04 30 Q6 00!2316 I computer printed 90 03 23 <br /> 6 STATION DESCRIPTION NV _.,P r re - r. - t.L. ayr.. r <br /> CONSTITUENT NAME E' LPW NA I I -' �Iljjj 1 -It' <br /> UNITS 'Is <br /> /L. M /L Li35/GA9 LE' S/uyY /L H /L N,G/i Mill <br /> SAMPLE TYPEV' ILUPIF 214H < 24HR UliNP z4 CIEMP N :,•; - <br /> FREQUENCY <br /> MONTH D ,t�AY �S xt. * * * T T <br /> -_ -________--__ __ __-__________ __ _____________ __ -_-__________ -_ --_-_________ __ _____________ -_ _____________ __ _____________ <br /> __ _____________ __ _____________ __ _____________ -------------------------------------------------------- __ _____________ __ ____-________ <br /> _____________ __ _____________ __ _____________ _____________ -_ ____-_-______ ------------------------------------------ _____________ <br /> -------------------------------------------------------------- _____________ <br /> ------------------------------------------------------------ <br /> --_-__-___ __ <br /> ---- --------------------------- <br /> ---- 7 ------ <br /> ------ ---------------------------------------- <br /> -- -------------- ---- ---------------------- ---- ------------ - ----- -- -- -- --------------- <br /> ---- - -- ------------- -- ------------- - - - ------ -- -----_---------- ------------- <br /> 9 <br /> - --- <br /> - ---------- <br /> ------------ <br /> -- �-� -- ---- -- --- - ---- -- ---------------------------------------------- <br /> /0 <br /> ----------- -- <br /> /o--------------------- ----------- ------ ------ ------------------------------------------ <br /> -------------------------------------- - ------------ - <br /> ------------- -- -- ----------------------- ------- <br /> ------ <br /> — ------------- -- ------------- -- <br /> --- --------------------------------------------------------- <br /> --- ------------- ------------ -- -------- ---- -- -------------- -- ------------- ----------------------- ------------- <br /> ---------------------------- <br /> -------------- ------------- -- --- --- -- ------------- -- ------------- -- --- --- -- -- ----------- <br /> -- ----------------------- ------------- <br /> -- -- -- -- ------------- -- ------------- -- -- ------------- -- ------------- -- ------------- <br /> 17 <br /> --- /� -- ------------ ------------------------------------ -- ------------ -- ------------- ------------------ ----------------------- ------------- <br /> ---- -- -- ------------- -- ------------- -- ------------ -- ------------- -- ------------- -- ------------- ----------------------- --------- <br /> ------------- -- ------------- -- ------------- -- ------------- -- ---- - ----------------------- ------------- <br /> __ 14 <br /> ----------- -- ------------- ------------------------------------ ------------- <br /> ------------------------------------------ <br /> -- -- ------------- -- <br /> -- ------------ --- ---------------------- --------- -- ------------- -- ------------- -- ------------- <br /> -------------- -- ------------- -- ------------- -- ------------- -- ------------- -- ------------- <br /> I --------4Z55- <br /> ---- ---- ---------------------------------- ---- ------ --- ------- --- -------------- -- -------- --- -- ------------- <br /> ---- -?9- -- <br /> --- -------------- --- -------- ---- - --- ------------- --- -------------- - -- <br /> - -- -- ------------- -- ------------- -- ------------ -- -------------- --- ------------- -- -- -------- -- ---- - ------ <br /> ---- - -- -------------_ -- ------------- -- - - ------ <br /> -- ------------- --- ------------- -- ------------- -- <br /> ------------- -- ------------- -::-Z - -- ------------ <br /> ---- -- ------------- -- ------------ -- ------------- - --- ------------- --- ------------- --- -__��' _> ��A------____ <br /> ---- I--- --- ------------- --- ------ ------ -- ------------- — ------------- -- ------------- -- ------------- -- -- 1VV1ROtVibi = q-TF1 ---- <br /> Y AVERAGE FtHMIE <br /> MONTHLY HIGH <br /> MONTHLY LOW <br /> TOTAL RECORDINGS/MO. <br /> u REQUIREMENT Nl <br /> Rf Times Exceeded <br /> REQUIREMENT #2 <br /> 1 <br /> Times Exceeded — <br /> REQUIREMENT N3 <br /> I Times Exceeded <br /> i J�C Enter number of samples Typed Name of P,incipol Executive Officer 1 erWy under penally 1 lay.Thal have persenolly e.ammed and am familiar wnh the mlo.molmn wbmn - <br /> led In Ili document and all .11. mems a id shot. based an my npu ry of Ihase nd v duals r Ted olely �j.��� y J' <br /> taken citrins.the dey, responz ble for obtoinng rh- nfa mol on I believe Ibar the for of on is True accurate and mmplele I am - p. Mo. Dny EPA <br /> aware that there ore significant penolt es lot submlrng lolse information including the pass b l ly of fine Sig azure of ,pot E ecuti COPY <br /> i ra.m m ri rr Lost First MI and impr sanmenL' fgllicer or Authorize Age Dole <br />