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INSTRUCTI01 OR DISCHARGER CALIFORNIA STATE WATER RESOURCES CONTROL . OARD <br /> 1. Remove COPY 4 (dark yellow) and use for your worksheet. DISCHARGER SELF MONITORING REPORT <br /> 2. Use ballpoint pen typewriter for data entry on forms. �¢ TRACY# CITY OP <br /> 3. Provide dates for beginning <br /> ginning and ending in reporting period blocks. <br /> 4. Provide data as specified under column headings. CAL TF:1.xc JIA ^ir"1 J'gAL. 4ATER 'JUALI LY LL� TRACY STP <br /> 5. Enter monthly summary data (MONTHLY AVERAGE,MONTHLY HIGH, etc.). CCT�C� `C}li✓;a <br /> 6. Appropriate signature is required at the bottom of the form. r".�1TRAL. VALLEY Y RD lL <br /> 7. Remove COPY 3 and retain for our records. Pt(�, k' lC�$ <br /> S. Send COPY XYV"X)Ili "g36Df:X)tdnYF�`d6Ms`Co`cAXKOXXYCXXXX 3zal: S STFwET Z2 RACY lrr,: <br /> SACSBAMENT(.'�t CA S5&26 95376 i <br /> MONTHLY REPORTING PERIOD IS AND YOUR REPORTS MUST f° <br /> BE SUBMITTED BY �' DAYS FOLLOWING THIS PERIOD. State NPDES Permit Pt6E. <br /> Year Mo. Day Year Mo. Day Code Number Year Mo. Da J <br /> Transaction I F ic'Dlity Year(Mo nth for � Re ortin Date form was Y <br /> �' 2 Code 5�339fi11Q9G�1 this report 7�71 I Pe riod:g Beginning 79 . '`^ Ending179/04/3C 06 (, (;`j'gL54 <br /> computer printed <br /> STATION DESCRIPTION <br /> CONSTITUENT NAME. J <br /> UNITS � <br /> SAMPLE TYPE <br /> FREQUENCY D - <br /> 'MONTH DAY <br /> Lt —� ���'-� <br /> — ' , <br /> � -m. <br /> I <br /> ___ . ," ,� .f•fvrkx+*, ,�v+r*ww1,y. _A•+.+x''uss .� 1+t/'te+ i +w rX�+✓wr Fah'x„�Fh�} W i ? >x'��5k .+ -+4+«s+,.+ �;�+s~.4.,+ c�A,"'r, �r w- <br /> uc����v <br /> --- yy' r- as �! - <br /> MYT"+4 +AK +M•.++Y++ M�•"�"°'h+R?jr 'FT 4in N+✓ "ufn+h ' 4• t� f ' <br /> x+w'H,.,. <br /> .ux .,.. °r rS.vZ .. ,`is&r.;, '� ; _ r, i pq'�""dL 1,.,.,i• #' a <br /> --- l/1Z -aL l} 2 <br /> Lit 7,17: <br /> --- a�S1 �,..,. �.,.,. ,... '+ hxY^'+ <br /> .uuwe.. xN � f ,,:, Fv vn d k '`i.wr+.,.-� ..+.+,+ .a: w.n+-u. }� +„ 7,✓ warx/S. <br /> --- L �6 S J-7 ! <br /> --- d6 <br /> vt*wtacr > m*>w: +..,.:,. rrs-.. .x '� — — — — <br /> ".'W <br /> as --- -- — ------ -- --- -a ------ <br /> J Z <br /> -- -- <br /> --- 35-2---- -- L <br /> f MONTHLY AVERAGE — <br /> MONTHLY HIGH ' r <br /> MONTHLY LOW 417 <br /> TOTAL RECORDINGS/MO. <br /> REQUIREMENT #1 ,. O <br /> Times <br /> REQUIREMENT #2 Exceeded <br /> gY <br /> r � <br /> �§w ' <br /> Times Exceeded ,;. H <br /> REQUIREMENT #3 <br /> Times Exceeded <br /> t <br /> *Enter number of samples Typed Nome of Pnnupal Executive officer _ <br /> taken during the day. SCO't"t I declare under penalty of perjury that the foregoing is true and accurate, and that �x . � ' �/ r^ <br /> Darrel the sampling procedure and analysis used for the column constituents was os spec •l• <br /> Form os-9wa Last fled.in the Waste Discharge Order for this facility s. naro a ot..prin pal Exec r.e Yr. Mo. Day COPY <br /> First MI Off cer or Aurhonzed Agent Date <br />