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—.-- __ INSTRV )N5 FOR DISCHARGER CALIFORNIA STATE WATER RESOURCES CONTROL BOARD I. Remove COPY d (dark yell. ,and use for your worksheet. DISCHARGER SELF MONITORING REPORT 2. Use bollpoint pen or lypewriter for data entry on forms. 3. Provide doles for beginning and ending in reporting period blocks. tp ,I r ! O¢ 5L Vk-N RESORTS* INC. S. Enter 4. dmonthly summorydata (MONTHLY hAVERAGE, MONTHLY HIGH, etc.). EH�IRrOP,,11EPTALHEALTH CALIFORNIA REGIONAL NATER QUALITY LL� PARADISE POINT MAkINA 6. Appropriate signature is required at the bottom of the form. P Oft 1 Si-RVIGF CONTROL BOARD 7. Remove COPY 3 and retain for your records. CENTRAL VALLEY REGION 711 We KIMBERLY AVE* STE 200 8. Send COPY 27CX4LPRaRI`'9C'iPY�iP7t�f9CX'IEX9l^] %9,%)(XXXXXX 3443 ROUTTFR ROAD �w PLACENTIA *CA SACRAMF 'T !, CA 95827-3098 ao 92670 YOUR REPORTING PERIOD IS tt AND YOUR REPORTS MUST F< BE SUBMITTED BY M51 State NPDES Permit PAGE I DAYS FOLLOWING THIS PERIOD. Year Ma. Day Year Mo. Day code Number Year Mo. Do n Tra Code ion I E l Dlty rj;,r,39I 04I 00. . 1 Yea' repo hllor �' Q R Perri ador Be innin P� ', (' ' l '/ � Ory 3] 06 CA0062 3 Dale for m wos n 9? 12 I4 L I g g I Ending computer rioted ;STATION DESCRIPTION jr,Pf w-NT 1 e,31-1 I UT I NF UENT EFFLUENT EFFILUENT E 1!! :N CONSTITUENT NAME 1(i0 yUyP ;ATTFd 6-X) SIrSP ;ATT: " "ilU SUSP TATTER 5U0 SUSP PATTER UNITS r„- <- - c *It' MIG MG/L M€u/L i SAMPLE TYPE CP�412 24W2 C _ s tr rr-I24 2,171IMP „'709 GRAB GRAS GRAB . FREQUENCY p MONTH DAY __ * I I � - '- ---- _20---- ---Zoa-- -- ---�-sr ---- .- -------- --- ---- - - Q�--- .i '.7_h------------ ---- -! -3 ------ ! ---- -- -- ----Q ,ti -- ---- - --- ----- -- ---- - -- ------ ------ -- ---- - -- - ----- - --- ---- ------ - - ---- ------------------ - -----------------------/ ---- ------ -1 ----� - -------- ----Q,--�-- ---- -- -- ----- ��---- --- X 30---- -- ---1 a_u6__ r= __ 6,a�--- -' ' ? ! _ .ate _ _o,r - ---- ---- <i6b ---- -------------------------- z.a_ _- - --- IQ --- - ---- ----- -= -'�- ---- -� ----Q= 3-- - Y-- ---- -L ----��1D---- ----zz----- 3 --- /�'� --- --- ''�------ -� ------a------ -/ ----1------------ �-- ---- ') - -U a'7 -- -- - sib----- ---- z�---- ----`L/• 7--- 3 _ _/_7_,y3--- ------ -- -/ ----�------- -- -/ --- �.<! ' ---- / °---- ----X30_---- 3 ---x '04---- 3 ----�'�S -- ---- - ----- -� ----J------- -2 -G -�� � -- - ---�=- ----- --'�------ - ----Q-ate-- - - - '! Y ---- 124---- Z�! ----moo---------�! ----1�o -------- �7a- - J - ----- -' - a - °'' 3--- _/ ---- 0,09 -_- --- ---- `--- ----- - ------- --- -i ------- .3y----- ---- 3 ----Z1'---- ---- ---6a --- -� ---- � p -� ---- dD,•l -/ - , 3- --- ---- --- ----- -� ---- ------- ---'o;o7S�- -1 =---- ---- - , - - - - ------------- -- -- ��'-�-x- 3 - --- - -----`-------- ---K ------- - --- -e- 510 ----Q L-- ---- 11 3 ---- ---- " ---- Zu7 --. ----------- _-- ,- ------ / Al Ego---- 3 ----z`��o- - 3 1�,Q -t ----`�--- --- � - -d. < `- -- Z_[ -i _ 7_[ _-- ----s� _-- ---- ----zi�o------ ---19r_ -- 3 ---e11_ °--- a- ---- - ----- -'- ----�'------- 1- ��- -� ---Q -- ---- ----2/94) ---- - - s0 -- --- -- rl / 7 F dtj ----- '7---- -- - - --------- A/60 - ----�1`' '--- - ----�=-= --- c 4�� ---- - ----��---- --� k_ -S--- 3 ----�� bo - -----`L6--- - ----3------- -� ---- =3�--- _/ -------------- -------- ----- - --------- ---- �7 3 IQ---- 'a --- Z6 - -- ---�9, / -- - 3 ---- Q-6 ---------------- U -- ! ----5� ----- ! ----- ------ -- o' -� ----0._/ --- /�o---- -'-- a ---- �°�---- '� ---- �0'---- 3 'b�/ ---- -------- -------------- �50 -1- MONTHLY AVERAGE ,C 4 -- e, MONTHLY HIGH - K c� /rS / 10, p, ' ! D 6 MONTHLY LOW /t/Q �!� 02 3 a ! TOTAL RECORDINGS/MO. ' f I 3! -5' / (91 N%/ 3 REQUIREMENT NI MO../%rl<. MO >/-V MY' ON /T�-y /✓lO.A/r Times Exceeded _ ! o y .,,4, / �, �. - REQUIREMENT #2 �— u�QkK�Y - eG yr .e2 K.c..y ! e y Times Exceeded F rC REQUIREMENT N3 �art� ,arty �iflc•y Times Exceeded Fc- •7 x- - 4C Enter number of samples lyped None of P,,m po Executive Office, I cern ly under penalty of low Thai I ho,e personally e.o ed and am lomihar,weh the lormanon subme ted n t s docume t and all almchmems o sd that. bused on my nqu ry of chase ndNduah edbiely :�7// ._ / EPA AA taken during the day. wT . respons ble for obto' sg the nlormot on t bel ere thin the nlormm on's vue accurate and complege Ian — COPY L aware Thal there are mgnil wnt pemiluc, lot sob nlrng lolse'nformot on ncludng the po,,b ty of line Si hu e of Princ xecul ive Yc Ma. Day ra:m p1-v ya Last First MI end imprisonment.' 9 �p Olfcer dc.AvMforimd.Agem. Dote I