Laserfiche WebLink
1NSTRU VS FOR DISCHARGER CALIFORNIA STATE WATER RESOURCES CONTROL BOARD <br /> t. Remove COPY (dork yellow) and use far your worksheet. DISCHARGER SELF MONITORING REPORT <br /> Y. Use ballpoint pee m <br /> n or typewriter for data entry on Toe' � <br /> 3. Provide dales for beginning and ending in reporting period blocks. i SEVEN RE SORTS* INC* 0I <br /> 4. Provide data as specified under column headings. CALIFORNIA REGIONAL MATER QUALITY LLz PARADISE POINT MARINA <br /> 5. Enter monthly summary data (MONTHLY AVERAGE, MONTHLY HIGH, etc.). CONTROL 8 }ARD <br /> 7. Remove COPY 3 and retain for your <br /> records.. Appropriate signature is required the bottom of the form. CENTRAL VALLEY REGION 711 We KIMBERLY AVE* STE 200 <br /> 7 <br /> R, Send COPY 2nIxW xRAV)L9xWxXxxiuy,"XRFWXXcxxxx 3443 ROUTIER ROAD Zw PLACENTIA *CA <br /> SACRAMENTO* CA 95827-3098 �t 12670 <br /> YOUR REPORTING PERIOD IS MONTH Y AND YOUR REPORTS MUST <br /> BE SUBMITTED BY I5 DAYS FOLLOWING THIS PERIOD. PAGE 3 <br /> Year Mo. Day Year Mo. Day Cods Numbe NPDES Permit Year Mo. Do <br /> 2 Tran Beton I F ICD ty 5ES39104100 L Yelhis epont hllor �/j O " I RPe�ialdg Beginning 9 0 OI Ending 93 0 31 �6 CAOOB23 omtutermr n�ad 9 12 I4 <br />'STATION DESCRIPTION o. o- -4 R-1 R-2 "- <br /> CONSTITUENT NAME 00 DL 01 UO PH PH PH C'f! <br /> UNITS <br /> f <br /> SAMPLE TYPE GRAIIII- GRABGRAB GRAB GeAll <br /> FREQUENCYur - r Y WEE' XLY NECKLY WEEKLY WFLKLY <br /> MONTH DAY * * !�C 7(C 7IC <br /> Z <br /> ____ <br /> ---- `� -- ----------------------- ------------- -- ------------- -- ------------- ------------- <br /> --- ' -- ------------- '-- --------------------------------------- <br /> -- - -- -------------- -- -- ----- -- - <br /> -- ----- P - - -- ---- ----- - <br /> -- - ---------- <br /> ---- ----�_ ---- �L ------------- --11--l' ----- -I -----I ---- -- - i -- i <br /> -- ------------- ------------ -- ------------- -- ------------- -- <br /> ------------- -- ------------- -- ------------- -- ------------- -- ------------- -- ------------- -- ------------ <br /> ---- -- ------------- -- <br /> ------------- -- ------------- <br /> - -------------------------------------———------------------------------ -------------- <br /> Z-Z---- ------ ------ -- ------------- <br /> ---- ------------- <br /> ---- - -- ------------- <br /> -- ------------- -- <br /> -- ------------- -- - ------------- <br /> -- ------------- ------------- <br /> -- ------------- -- ------------- <br /> -- -- ------------- ------------------- ----------------- -- ------------------ -------------- ------- ------------- ---------- ----- ---- ------------- <br /> -------- - ------ ------ -- ------------- ---------------.. -- <br /> --- iz --------------------- ------------- ----------------------- ------------- <br /> -- <br /> - ------------- -- ------------- -- -------------- -- <br /> ---- �' -- ------------- -- ------------- - <br /> r ------------- <br /> Zo <br /> ---- -- -- <br /> -- ----------------------------------------- <br /> ------------- -- <br /> - ------------- -- ------------- <br /> -- ------------- -- ------------- <br /> ---- s -- ------------- <br /> ---- - -- ------------- <br /> ----- - ----------------------- -------------- <br /> ------------------ -- ------------- -------------------------------------------------------- ------------------ ----------------------- ------------- <br /> ---- - -- ------------- <br /> ------------------------ <br /> ------ -- ----- ------------------- -- -- ------------- -- ----- ------- -- <br /> ------------- -- --------- <br /> r � i ---- -U---- �- ---- ----- !- ----- ------ �- -----�!-�-- I- ---- =-�---- ----- -- ---- -� -----Z'7_.....I- -----Z'-� --- <br /> Y <br /> __ _____________ <br /> ----------------- <br /> --- -------- <br /> r <br />+ MONTHLY AVERAGE . <br /> MONTHLY HIGH �- , /> �/ .GJ /D. O � . S' <br /> -7. �s a 7 . 5S <br /> OONTHLY LOW G 'J 4' Gj- ej 7 . 7 7. -) 7. <br /> TOTAL RECORDINGS/MO. 153 3 3 -45 <br /> IEQUIREMENT #1 <br /> Times Exceeded - E} <br /> tEQUIREMENT #2 <br /> Times Exceeded <br /> tEQUIREMENT #3 <br /> Times Exceeded <br /> Enter number of samples Typed Name of Pimupal Executive Officer I <br /> <ertdy undo.penally I low that hwe person oily e.am nem and%la mdmr wuh rhe mfonnan m submit- _ <br /> ted n t s docum enl and all of mchm cols msd shot bm ed on my ngmry of those nd✓duols ed mely / < EPA <br /> taken during the day. - respons ble for obto n ng the nfo nom on bel e.e that the inform tion's True o<c wale and<om le to am <br /> aware that there are sign <br /> tort pemll es for zubn,n ng false 'nformmmn. ndud ng the poss'b Qty of line Si aNre 1 Pri a Execpt• a N,o. poy <br /> Fo.m ozc za <br /> Los, _ Test MI <br /> and imprisonment gg /^.�^ <br /> Olbc er or A orized Age Dale COPY <br />