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IN5TRUCTION5 FOR DISCHARGER CALIFORNIA STATE WATER RESOURCES CONTROL BOAR,. <br /> 1. Remove COPY (dark yellow)and use for your DISCHARGERS SELF MONITORING REPORT <br /> 2. Use ballpoint pen or typewriter for data entry onn forms, <br /> F <br /> 3. Provide dates for beginning and ending in reporting period blocks. ua TRACY' CITY 17F, <br /> , <br /> 4. Provide data as specified under column headings. CzALIFnRNIA REGIONAL WATER �,, :tALITY wz <br /> 5. Enter monthly summary data (MONTHLY AVERAGE, MONTHLY HIGH, etc.). !..afV T`c{GL BAD TRACY STP <br /> 6. Appropriate signature is required at the bottom of the form. L <br /> 7. Remove COPY 3 and retain for your records. C F'-4 RAL VALLEY REGI � a <br /> 8. Send COPY$Y 1C p 16KnXF7(db2Es1(aCdb CdPR$ 1(XX 7( Pe r)x 9.01!4 <br /> 3 >u9 c STR~FT � TidA.1 <br /> YOUR REPORTING PERIOD IS MJNT°-sLY aACRAP �hPT - rA 459=�' <o 93376 =ACIP <br /> AND YOUR REPORTS MUST sa <br /> BE SUBMITTED BY 0 DAYS FOLLOWING THIS PERIOD. <br /> Transaction Facilit Year Mo. Da State NPDES Permit <br /> Y Year Mo. Day Code Number P;!� <br /> Q2 Code y ]849.c^e to i9 Year/Month for Reporting IL ❑ YeMo. J.y <br /> I.D. j this report /y' (� ? <br /> Period Beginning Ending 7�S `f 39, 06 �1t7 cS/t Date form was computer printed �' 4:i'`,� <br /> STATION DESCRIPTION r4, f° �., r T <br /> t <br /> ' CONSTITUENT NAME .} X 4 <br /> c , P <br /> l L <br /> 77 <br /> -4— _ ----------- <br /> – --- – <br /> r+✓ns'E L.4l*5^^*{w717 <br /> +4�.. < <br /> t <br /> X1 -111 'sv <br /> tiff , r _ <br /> �,{ 67 <br /> 7-7 <br /> N f r L <br /> --- ✓s ` ` aad - - ----------- <br /> ----------- <br /> 777 <br /> �t <br /> p > <br /> — ` <br /> _ <br /> v...`cE;....+� .i.,.,_u ...L �",�� ; ,✓r f,.0 Wiy.+«< � f 4r„^f+.t`f�McW: <br /> --- �� 1L?� 1 17 �„ � _ - <br /> 4 <br /> ^uwszr } t <br /> + wx — <br /> r«, .r ✓,.,.b:,v. <br /> Ynwvuwpq ,h <br /> --- Jil <br /> �r <br /> wr, r 4R sfL r fs x 4 <br /> or, us 4 <br /> K <br /> --- 6 <br /> `w iJi <br /> --- – --- --- 1vla — _b�----------- <br /> + <br /> ----t MONTHLY AVERAGE <br /> MONTHLY HIGH <br /> MONTHLY LOW <br /> TOTAL RECORDINGS/MO..d °7o I O <br /> REQUIREMENT #1 <br /> Times Exceeded <br /> REQUIREMENT #2 "fit,, <br /> Times Exceeded <br /> REQUIREMENT #3 <br /> Times Exceeded <br /> � 4 <br /> ;CEnter number Of samples Typed Name of Principal Execotive Officer <br /> g <br /> I declare under penalty of perjury that the foregoing is true and accurate, and that <br /> taken during the day. Scott Darrell D the sampling procedure and analysis used for the column constituents was as spea <br /> Form 02-9/74I 9/�4 Last First MPied in the Waste Discharge Order for this facility. <br /> Sip nator of Prinapal Execotive Yr. Mo. Day COPY <br /> Off cer or Autho razed Agent Date <br />