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t,a ,.i.—.i t IN51. - :TIONS FOR DISCHARGER CALIFORNIA STATE WATER RESOURCES CONTROL BOARD I. Remove COPY 4 darkyellow)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. v SEVEN RESORTS* IN A � f C: f�❑� A. Provide data as specified under column headings. CA'LTFORNIA REGIONAL WATER QUALITY LLz PARADISE POINT MAi 5. Enter monthly summary data (MONTHLY AVERAGE. MONTHLY HIGH. etc.). CONTROL BOARD IS. Appropriate signature is required at the bottom of the form. 7. Remove COPY 3 and retain for your records. CCNTRAL VALLEY REGION 711 We KIMBERLY•E: e. Send COPY2k7cwtxflxolx<'xR%)((A")(N9(%h3AIRPI\YXX9(XXXX 3443 POLETIFR ROAD iw PLACENTIA 'CIL ACRAMENTi, CA 958.27-3098 ao )2670 YOUR REPORTING PERIOD IS hCh! f< Y AND YOUR REPORTS MUST BE SUBMITTED BY I`' DAYS FOLLOWING THIS PERIOD. State NPDE5 Permit PAGL- 1 Year Mo. Day Year Mo. Day Code Number Year Mo. Do Transaction Facility Year Month for /� ReportingDate 0 2 Code 1 LD. l3�tU4IDD 1 his repo /303 I Period Beginning " S l) 0t Endinq 9T D3 3I �6 CA00823 ccmnp Termrn�ed y? 12 14 STATION DESCRIPTION V it I i4f:41J`1Ff AF"1 101 11:7�' 1 FEL LILNr EFFLUENT EFFLUENT EFFIL-UrNy FIF FL Ut.lv CONSTITUENT NAME 31 SUS•rF' MATTrx (s:3 SLfSP 1-:ATTEk BOO SUSP MATTER 301) _uw 7m TT— CONSTITUENT UNITS I ii" f u f7S;/L. 'lt:dt. fur, 'SAMPLE TYPE . . - 'd •+ Mp a •tu GR IWABsa t3GRAN (W AM FREQUENCY T Tt MONTH DAY C ---- -- ----- ----�- - - -- -'3------- -- ------------ 4 x/90 - -/-Z-` ----- --------------- Al ----------------- - -� ----- ---- -'1 ---- '' � -Q=� -- ---------- -�-- --�- ----------y---'`--°-------- '-3- ---------o'er`'---------- ��? ---- Jg,.�7:��---- � --giL b'_=�✓`3�--- ---� -----1'/_'�=-- -/ —---��-------- ---/ - `y%---- - ---- --- - -- - ---- , 6 --- -L------- 300 �Q -T 7--- _-�' ------- -- -- ----- 0---LL -o�--. 1 L------ - --- — -------------- ' 0------- ----------- -- -- ------- ------- -7 - - �/'`)---- -ro?K4 7 ---- -- ----- 3--- --------- ------- - - 3 --o - - ----- -- ------ -- - _ --- -r _--- -3----- -/ ----- 00 ---- ` w ---- ------------------ --- - ---V= '----- - C9, / ,s i _ ---- ----M- ----- 3 ---�`�U----- ----i 3_ov--- - ---- 6=5"-�-- -I ---- ---- -z---- -L ----0- -- ' ----y90----- --- `1�----- 3 1-- -/ ----- =-L---- -X -� ---- -L ----a'-�N-- ---- -- - -1 ----�._©5--- -- ----L-- - -- 1 . 3-------LJ!VO-------- --- ------- --- �._r_'a -- '3------ /-9_� - -� ------1'-j---- -� =�---- - --0, 7(. - - -------------- ------ `/D ial ---- ---- - ----`�Go ---- 3 ---dao----- 3 - --L')-��- --I ------�''�7�--- -L - ---c)•-3---- -/ ,U-- - L -- --a. �75 1 O. If ---- L3 3----- -`�`-'- --- 3 --- w---- ----13 L JyJ - j -7�J� - -- -�-- - -/ - - - -- -L -0- 1 ---- �5-. - ---- L� -`�f ---- `/Ire) ---- =� -- xu------ ---------13.0`1--- -� - -- -�'� -- --- - r-`3-- -- -� --- 6 _ -i ---- --- ---- - --- 3 ----z3.2�--- 7 L L Z - -- -------------------- - -� ---o'Q�� - - -- It ---goo : ' � / ---- '� --- -........- -- Z - --------- -- -L ---- ©/ --- --- GJ -------------- - -----1!io---- '3 l o a t O - --- - --- - - - �>,r�5-- ------- -- --- -, 3 ono---- -5! - --- -- - --- - - - ----- ---- 2� -- - >rflo. ---- S _� , 5�_ 1.0 �-- 1 - ---3-e- / 1 ---x --- -- --------- --- Jr ---- - l �=G- ------�-� -- --- 13 - ------ - -� -- -z - - 1 D --- - --- 3 �.3 L 4 -----Q -- J ----a -- ---- Z3 ------ ------ ---''��----- �� ----l�!fi - _/O.-/2� -- -v -------rasp --- - ---- ------- -- ----- -- G ------- --- ---- ��/ 3 -- ----sJsiO---- ---- ��j_� l7 3 --/1�_/�O__ ---- - ----- -1 - - ----- ---- Zs -----=1- --- 3 - --Uuo----- --- �_ i; 3 ! ?� -- -/ -----§,z, - - -L ----- Z---- -- ---------- ----- ------------------- ------------- 0. a4�.Zl7 -- r. , ----`-'�-- - -- ----- �------ -/ ---- ----- Z ---- - ----- - ------------- ----------------------- ---- 3_ o. y3 3 7 h .o o..-v 3-- -i 11 'if < 3 5 ---- 3 ---- -y-��- ---- - -- ----- ------ - ------ ---- -- ----- -- -L ---- O-- ---- ? - --- - -- ---- -� - z -L - -�. -o Y - -- ------------- -- ____ ____ ___ _ _ ____ 2 ---- z9 1i,1 -- ---- Jho ---- ----! =3�-- 3 -----7. 0�- - - ---y'-�-- -� / o oet / li ---- 3 ----- 4/",) -- - - ----- ---- - ---- - ------- ------ I -- -- ------ ------ -- --- �4n----- 3 ----r 3-� -- --------------- -/ ------�- --- - -- r 5,'� `S j f ------ - "--- -/ -----a. -- ---- - -- t MONTHLY AVERAGE ,r/'',� '..�j Y •'j S 0. 30 MONTHLY HIGH10 3 1� 7 11"5 MONTHLY LOW < <� 1 ,60 6.52 8. 0 Z ! 0 L' TOTAL RECORDINGS MO. 31 f 1 1 REQUIREMENT Nl Morsrrnt.y nlrnrr yyL-/ .vy a,vrn�Y �+r orvrn�y Times Exceeded — . /.� a. 3n � /• � d lr 5 �" REQUIREMENT N2 r.2a,e y kl-alre.y eJ-¢rc. .y Lege% Times Exceeded U0 � tl0 /0 1 O REQUIREMENT N3 Almay A,�y vC>H„ ,mac Times Exceeded Y 17N / J �- :a o E3- I z,5 Ik Enter number of samples Typed Name o1 Pi mcipal Executive Officer cernly u�der penahy I lay.lhal I hove uersonally exommrm and am lamihor wuh the inlormatlon submit J� y 93 ,� EPA ted m t s dote me of and all altar hmems ,d shot bored on my Inquvy of those mhv.duols n ,edimely taken during the day. L r/�,:. (� rasponvble for oblammg the mfonnanon I behe.e that the mlormatmn is true accurate and complenr I am COPY aware he here there are sigo,hcont permlims for submoung false Information. mclodmg the possibility of line S' oture of Pri ipal ecullye Yr. Mo. oay form 01.9 ra last First MI and imprisonm. Sign or Auth d Agent. Date