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Monitoring Report Submittal Transmittal Form <br /> Attn: Brendan Kenny (916)464-4635 <br /> Central Valley Regional Water Quality Control Board <br /> 11020 Sun Center Drive#200 <br /> Rancho Cordova, CA 95670-6114 <br /> Discharger: Steve Gikas and Family <br /> Name of Facility: California Nuggets, Inc. <br /> WDRs Order Number: R5-2007-0715 <br /> WDID: 5B39NC00055 <br /> County: San Joaquin <br /> I am hereby submitting to the Central Valley Water Board the following information: <br /> Check all that apply: <br /> Monthly Monitoring Report for the month of <br /> 1 st/2nd/3rd/4th (circle one) Quarterly Monitoring Report for the year of <br /> 1 st/2nd (circle one) Semi-annual Monitoring Report for the year <br /> Annual Monitoring Report for the year <br /> Violation Notification <br /> During the monitoring period, there were/were not (circle one) any violations of the WDRs. <br /> 1. The violations were: <br /> 2. Have the violations been corrected? Yes/ No. If no, what will be done to correct the <br /> violations: <br /> Certification Statement <br /> "I certify under penalty of law that I have personally examined and am familiar with the <br /> information submitted in this document and all attachments and that, based on my inquiry of <br /> those individuals immediately responsible for obtaining the information, 1 believe that the <br /> information is true, accurate, and complete. 1 am aware that there are significant penalties for <br /> submitting false information, including the possibility of fine and imprisonment." <br /> Signature: Phone: <br /> Printed Name: Date: <br />