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P INSTRUCM . FOR DISCHARGER CALIFORNIA STATE WATER RESOURCES CONTR( BOARD { <br /> T,. Remove COPY 4 (dark yellow) and use for your n forms. <br /> DISCHARGER SELF MONITORING REPORT <br /> 2.. Use ballpoint pen or typewriter for data entry rt forms. U4 TRACY, f.ITY e1F <br /> 3. Provide dates for beginning and ending in reporting period blocks. <br /> d. Provide data as specified under column headings. C AL I � ,'`CV IA R C-6,i `""SAI.. WATT. a)UALITY LL� TRACY STP <br /> 5. Enter monthly summary dota.(MONTHLY AVERAGE,MONTHLY HIGH, etc.). CONTROL. BOARD <br /> 6. Appropriate signature is required at the bottom of the form. TRAE VALLEY REf.; <br /> 7. Remove COPY 3 and retain for your records. '�-�- D FrQ CX R M29 <br /> ` 6. Send COPY 2 to EPA, Region.9,}gpW(F7farS345ifsAdb ��f7(XW. XXX .32'a 1 S S7RFF T iw TRACY CALIF <br /> Au,;;A"4EVTClr G 958I6 a$ 95,76 <br /> YOUR REPORTING PERIOD IS 740NTtHLY AND YOUR REPORTS MUST Fa <br /> BE SUBMITTED BY IT51 DAYS FOLLOWING THIS PERIOD. State NPDES Permit NAME i <br /> Year Mo. Day Year Mo. Day Code Number Year Mo. Day <br /> Q2 Transaction Facility o Year/Month for Reporting Date form was <br /> Code LD. 583aIL$ I this report period: Beginning E7-1 Ending 7 v �$ �6 `:';']<j]�5tt. computer printed T£I v'9/,;-,.,B <br /> STATION DESCRIPTION ` r ',„ <br /> CONSTITUENT NAME. <br /> UNITS I <br /> SAMPLE TYPE <br /> FREQUENCY <br /> MONTH DAY 5C;F6 <br /> 7T �117'1'1 71,111,711171,11,171771 <br /> --- d o <br /> .33 ��p� <br /> LL f <br /> --- / ++r„w �+ri*++z .v+a. ` i+..nc <br /> --- L2. r.:.,.,_..a...u.,...,...,.. ,.,,�,,,. t 3+- ' r• .,y. <y.yy 'Y'f .......... <br /> i <br /> "J'S 5'^ '` :. w'm P r:. � 4 e4M.-.F,^ ^7 <br /> }AMN+4}'Ymk4ti�'X+"F.M4y'lf'tlY 'YfM'tM" l'^,'4+� tM. T +Ni�f ".iY`�3Fh H+IY^ +✓.4u.ir `Y�yj4 ✓ ; <br /> — Lu ,. ,T ,+.GSc, '2'.Yw° ,:.n, •Je" —.S<vt1LL.J y.,_Y < .,� " 4 N4 �b <br /> L � <br /> -- �-� U yw z <br /> a �� i <br /> y .i`. j L r+ . .!nr � S µ; L1 <br /> M. t <br /> 7777 +47 <br /> 7 <br /> 7 <br /> h+ <br /> --- ! <br /> w 11, <br /> w'1111111 -h � <br /> x <br /> -- --- <br /> --- �� <br /> 77,97 <br /> � <br /> 7 + . <br /> ----- —__— <br /> x <br /> ,y 'P. --- --- -- -----_— <br /> �. — -- ,:q".. ———— syr —————————-- <br /> I <br /> ---- ------ ° ———-- -- -- <br /> --- <br /> t MONTHLY A RAGE ' <br /> MONTHLY HIGH <br /> MONTHLY LOW 12611 <br /> TOTAL RECORDIN /MO. -< <br /> REQUIREMENT #1 �, <br /> Times Exceeded <br /> REQUIREMENT #2 <br /> Times Exceeded <br /> REQUIREMENT #3 <br /> Times Exceeded <br /> :Enter number of samples Type Name of Prmupal Executive Officer I declare under penalty of perjury that the foregoing is true and accurate, and that . p <br /> taken during the day. SCOT' the sampling procedure and analysis used for the column constituents was as speci- 1 <br /> Form Oz-9/74 Last First MI fled in the Waste Discharge Order for this facility: �9 f9tore of Pn nc pal-Exec Yr. Ma. Day CQ >I <br /> O icer or Auihanzed Agent Date 9 <br />