|
STRUCTIONS FOR DISCHARGER CALIFORNIA STATE WATER RESOURCES CONTROL BOAR, I
<br /> 1. Remove COPY 4 (dark yellow) and use for your worksheet. DISCHARGER SELF MONITORING REPORT =f
<br /> 2. Use ballpoint.pen or typewriter for data entry on forms. u< TRAL.Yy CITY DE
<br /> 3. Provide dates for beginning and ending in reporting period blocks. CAL TP1R`,f LA REGIONAL, WATER. -UAL TTY _Z TR ACY STP
<br /> 4. Provide data as specified under column headings. CONTROL. 8(1kQTJ
<br /> 5. Enter monthly summary data (MONTHLY AVERAGE, MONTHLY HIGH, etc.).
<br /> 6. Appropriate signature is required at the bottom of the form. C E'VTRAL VA.L,L-('Y REGI(N PO 8C X 2(29
<br /> 7. Remove COPY 3 and retain for our records. 3 S <Tit'�E.T i TRACYCAllh
<br /> 8. Send COPY ffi.Xli2% XgK7l(�CX�fF�Pu° aisottdGfKYo...XKk. Qo 953-x•6
<br /> SACRAMENT',Io CA 95816
<br /> +CONTHLY s<
<br /> YOUR REPORTING PERIOD IS��AND YOUR REPORTS MUST State NPDES Permit PAL+E.
<br /> BE SUBMITTED BY DAYS FOLLOWING THIS PERIOD. Year Mo Day Year Mo. Day Code Number Year Mo. Day
<br /> Year Month for Reporting Date form was
<br /> QrL TraCodeion l Facility Beginning T t ; l � Ending 'C9 6 .54 computer printed T. C9 28
<br /> D 5B 39J2.d3N,t]. I this report 7`/ /J I Period: g
<br /> STATION DESCRIPTION
<br /> CONSTITUENT NAME.
<br /> .UNITS
<br /> SAMPLE TYPE
<br /> FREQUENCY
<br /> MONTH/ DAY 0030 Lk3Caa {D(f4pfS OS?4(�d G 7Q L®LSTQ a GL92.Ls G :32*�
<br /> — —
<br /> ''�4 i} ;r ...._—? —.._. ef,r¢•,�, .,�,�-..;r+'ir✓•, -«m�+x�� '�'.Ls��cx.fwr I1
<br /> 3
<br /> — — '--
<br /> - - !
<br /> rz — -
<br /> - tt+ +Yro ,c»..i.a++++ar' *n ri-wa tw,^.^5•`f+.'.ttE'+'r� '^' "^'.°".'
<br /> ___ «...yr f�4�,yl.+.c'M^Y �r.4My" 'MifbiY•^Y4',.fMv.Xu+,. r.�^>bf�'4v"{YeN + ,^`(.4:"? �'h•J+a2k N/+�' N
<br /> _ _
<br /> s77,7177, 7RZR'5, 2 z $ 77
<br /> z� _— —_ r m
<br /> ! f+ " 8f"H .c` aaa��kGkGk4�4�4��� --_—_--_._ ;.W?;..�t+, au ,uwA.++•,c.cdtWey' rr
<br /> -- /� ,c.;3Y' Fuw yy.,w,.«nr+; xv axP+rr+n +m:,,v+. x v ". "` '7"}4"•"7"''y, . §^''."s,... �. ---'__�,.,,
<br /> I ..W.41 .V.a.f .v' ^w'✓. +/u2u✓u"..u`.'.S-^•'"s" v au — — — �y
<br /> __ L�
<br /> zs•. f ..: t r'[t",sNt"'T Mrd". x.v'z`�r? W�/,.f`ztf f 4 zx:� ....--_ — - —�...._— .r —:.:. 1
<br /> ,-
<br /> -- ,: rr*n+fu+r •cswf,...a-a+rr+s.r++,Y»wtiris`w pfiwlWjy;�, .f >;
<br /> ——`-- -------
<br /> r v
<br /> �,,;� v+.�usnm.�,•++.✓✓ti•L N.,f,a ..... ,v .u.......a.' Sin...-s»+r2rc,,.,.uo,.,z�;.,r.Y+� a1.da.:,.,muo-,�._ou-.as�.v --
<br /> _ - I
<br /> —_— pp f .i^^„c i`; h,z .'f y'z'xYz �rz*+' � ,'w,✓ 2
<br /> - ---_—_—_-- �—a,Z'.1/23/ 4xF•f+*Y-£'suy .w.tF,£i.`hY,eh'n+ �,'rhvav�...p.,..n-.6l�+,w...'.5D..',.c,..,...,y...3!w4.+..(�e_.w,.c+..�ef.'w+..r+.,Z.».w...w'a.kf<,"t.,"''t,^r^.',,, �?;v'M�.?�,•'J,'.'�y"`,'k.rcF.sfl$,�lk1.s�..t^is..,oiv,t''2wr 5i�.7 ;.Y;�6.'�"(m;:L'� fi^�f2�LzA'Lm'_""�erkf��ur.rL�€�`}wa1'-�+t,.',,t'�`y9'"-,uyas-,`�afi,"""roz, "1s�-.-- _--
<br /> --_—_-
<br /> smyG
<br /> "
<br /> ---------
<br /> -----------
<br /> r—_
<br /> — -777,777,-77_
<br /> m
<br /> . ?
<br /> ]q — —_
<br /> y
<br /> _«_xt
<br /> u
<br /> --- -+r ..✓ �+,. /'f + `?,HnY+ .F 4m � "w.uv r 'S'E""+*
<br /> ,c..y..r+ . rw'+f+sF+w -•rv�^r ++yrxq :w..m+s>4rwwcsw.v � ,.Mar,�r.w++w+,.s5wf++�+ac,Mwsiis; _
<br /> 22
<br /> ac K —
<br /> �7
<br /> W --- -7� `�--- "r ; - ---
<br /> 7-�'�-
<br /> t MONTHLY AVERAGE 91 Q
<br /> MONTHLY HIGH
<br /> MONTHLY LOW
<br /> TOTAL RECORDINGS/MO.
<br /> REQUIREMENT #1 v �"•".M' `A' "'°
<br /> Times Exceeded s ``� '"r���" s rrx�w�rf"»'�'•"'• �^'�
<br /> REQUIREMENT #2
<br /> Time Exceeded
<br /> REQUIREMENT #3 4 mp hNN
<br /> �� Times Exceeded ��a"a�yT'��,•��". ��' �u��fi-�•s>�'•y/x �F'Y�. , x ;, �' ' ,,r c
<br /> i1
<br /> : Enter number of samples Typed Name of Prinnpal Executive Officer 7 d6
<br /> I declare under penally of perjury that the foregoing is true and accurate, and that
<br /> " taken during the day. 8 er Tnhn TAT the sampling procedure and .analysis used for the column constituents was as speci- Sig tura-of. Principal Executive Yr. Mo. Day COPY
<br /> Last First MI fied in the Waste Discharge Order for this facility. Vff cer or Authorized Agent Date
<br /> Form Q2-9/74 II
<br />
|