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---------------------------------------------------------------- -- INSTRUG a FOR DISCHARGER CALIFORNIA STATE WATER RESOURCES CONTROL BOARD I. Remove COPY 4 (dark yellow) and use for your worksheet. 2. Use ballpoint pen or typewriter for data entry on forms. DISCHARGER SELF MONITORING REPORT 3. Provide dates for beginning and ending in reporting period blocks. <SEVFN RE SART Sr INC 4. Provide data as specified under column headings. CALIFORNIA REGIONAL NATER QUALITY LL PARADISE POINT MARINA 5. Enter monthly summary data (MONTHLY AVERAGE. MONTHLY HIGH, etc.). CONTROL BOARD 6. Appropriate signature is required of the bottom of the form. CENTRAL VALLEY REGION 711 We KIMBERLY AVE• STE 200 7. Remove COPY 3 and retain for your records. 8. Send COPY 2(t0,kPA'f"1p�ipp49,(VXyrK'KiXt;XgfV;CWWWRMXXXXX 3443 ROUTIER ROAD i,"uPLACENTIA eCA SnCP-AMENTO. CA 95827-3098 Qo '32670 YOUR REPORTING PERIOD IS MUNTNLY AND YOUR REPORTS MUST F` BE SUBMITTED BY [E] DAYS FOLLOWING THIS PERIOD. state NPDES Permit PAGF 2 Year Mo. Day Year Mo. Do Code Number Year Mo. Da 2 Tran section Facility y Year Month for ] Reporlrng -3/D_ 70 �) ) {}rt 31 O6 CAD0823 Dale loan was 92 12 14 Code I LD, i041 D0 I his report I PenoI Beginning 9 1 Ending ❑ cam user rioted STATION DESCRIPTION EFF LUENT EFFLUENT LUENT EFFILU! NT EFFLUENT CONSTITUENT NAME FLJ4 PH C,40R W-SOL TOT COLIFORM SET MATTER UNITS m-') Pit UNITS M /L MPN/LDOML HL/L SAMPLE TYPE CJINTIMOUS f kA3 6 R A 3 GRAB GRAB FREQUENCY CIATLY DAILY DAILY _ DAILY DAILY y MONTH DAY .' !!C �C J'C �C * !�C A r _—___ __ _____________ __ _____ _ ----------------------- ----------------------- -_ _____________ __ _____________ - --- -- ------ ------------------------------------- _2 - ------------- -- ------------- -- -------------- - ---- -.=r T ri:no_/big- -� -----�-3---- / ---- - - ----- - ------------- -- ------ -- --------------- -- ----------------------------------------------- -------------- -------------.7 7 0. on 3oJ': F T 7, z / /c/t i "--�7+J ------------- ---- ll----- - -- -------- -� 7 "/ 0-no 3 `: Z� ---------- ;-------------------------------J ---- U---- -- -- --- ------ -- ------ E --- -- ------------ -- ------------- -- ------------- i5 .ou 97EX / ---- 7 v ---�---------- ------------ ------------------------- - - -� ----- y----------------------------------------------- ------------- o ----- / ------------- -- ------------- -- ------ ----------------------- - -- ----------------------------------------------- ------------- /� % J r.')o job` F, / / ----- - --p7J -------------------------------- --------- - ----------- - ---- -- ----- ---- 3---- - / /N�--- - ---------- --------------------- ----- ------------- ------Wu -- ------------- -- -- - - - ---- ----- - --- -J -----7 ---- -J ---- N J ---- ------------------- _-W ------� ---- - ------ - -- -- - -T �•po3o1` -- -- ------ -- ------------ -- ------------- -- - - -- _� -----7;2----- -T -- --D�lf- --- - -� --- l - ------------ - ------------- -- -------------- ---------- ------------ / i7 no b / -z---- ` - - f - -- ------- -- - - -- - --- -- -- -------- - -- ----- >- - - - ---------- � -- --------------- ----/a / 1-x.00 3��s / �, / -----dL�J_---- -------- / ------�v--- -- ------------- --- ---- --------- ---- - --• -- --- -- -------- -- -- ----- ----------- -- ------,------ ------------- ---- -------------- -------/ ------/LJJ -- ------- ---- -� ------�� ----------------- ----------------------- -------------- 7, 7-/ ci. c7v is f V o / / N ---- / ------A7a -- ---- -- - ------------------------ Zi T , ) < 's`64 _5 -- - -J - - �.1�-- ----------- , ------- -- ti®r ------------------ -- ------------------ -------------- 7 , -603�;G.- -T ----7-z---- i gri ---- -- ------------- -- vn ------------- ------------- -- ------------- ---- -- -- ----------- -----M------ -- ------------- ------T I----- ----------- -- ------------- Z4 -_0,-/°6tt5T- -T ---- -------- -- -- ------------- -- -- ---- -- - ,- , F��- ---- ----- ------ J---- _ aJ�---- -- ------------- -- ------------- -- -- ----- ---- / -;. ,, st.7- ---- -- ----- --- --- ----� - -------- -------- ---- -- ------------ ------------------ -- ------------- Y ------- -- U, � 7 / / Tt --------------------------- ------ -- - ---- --------------- ------------------ -------------- -- - ---- ' / --- or� _ ---� J_ __ ---- --------------------------- ,� ----------- ----------------- -- -------- -- -- -------------- ----- -- --------C-g-g-- -� ----- -- ---- -- ----- ----- --- --------------- �- + MONTHLY AVERAGE O.o0 ^ 7• k I MONTHLY HIGH '')") - 767 7. S- LL• 4 ? .MONTHLY LOW (1> OU/ C, - 7• '> G �� TOTAL RECORDINGS/MO. / '51 / ✓ / REQUIREMENT Nl 71 0 JO o'\�t a t" 1 �� r + 1 /.I ,• t p,A &)0'1r11( yAl Times Exceeded �• ��, \_--�-- G. 7 �� / �, H 0. / REQUIREMENT N2 AJO T G- '12G t .'f-),c-V r- t )AK ; ILS (k)Al_ Times Exceeded i71 R,.l 4S. ::J c- �7(J[? -"� /_7, z.. REQUIREMENT N3 Times Exceeded JIC Enter number of Samples Typed Name of Pr mupal .ecehve Officer I cern 1y under penally of law that ho,e personally e.a ed and am tom or w m rhe lormalbn subma- / I n rh s dacum nl and all onachmenu o.d that bosednon my 'nqu.y of rhos. nd✓duals edla rely / ( f -�� , i copy taken during the day. O /° ., !d 7 /) respons ble for obtoining rhe mformat an bel a+e Thal the ef.rmaron s nuc accurate and corXp.Je I am WPY aware Thal (here are signilicant T enothe•far wb 11 ng false Orate.,on, educing the possib Ji lit of Ilne Sg oture of r a secWiv Yr mo. Day W Porm a1.9 ,a Lasf First MI and'repr sonmenl.'- SII ler or Au or zed Ag an Dale