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CALIFORNIA REGIONAL WATER QUALITY CONTROL BOARD <br /> MONITORING REPORT COMPLIANCE CHECKLIST <br /> FOR <br /> WASTE DISCHARGE REQUIREMENTS <br /> FOR <br /> DISCHARGES REGULATED BY TITLE 27 AND/OR PART 258 <br /> Order No.: 5-01-148 <br /> Reporting Frequency: Quarterly/Annually <br /> Facility# 5B392011002 Monitoring Period: Annual 2003, 1st Q2004 <br /> Discharger: Fox River Paper Company Date Due: 30 January annually, 30 April <br /> Facility: Ripon Mill Date Received: 2 Feb. 2004, 3 May 2004 <br /> RWQCB Reviewer: Kim A. Schwab, R.G. Date Reviewed: 22 July 2004 <br /> RWQCB <br /> Reference Parameter Yes No N/A Reviewer Comment <br /> Standard 1. Transmittal Letter <br /> Provisions <br /> (1993,1997,2000) a. Is there a transmittal letter signed by X <br /> an authorized representative? <br /> b. Does it include the required X <br /> Certification Statement? <br /> Noted impacts from <br /> c. Is there a discussion whether any X discharges. In the process of <br /> violations have occurred since the determining background for <br /> last monitoring report was submitted? Water Quality Protection <br /> Standards. <br /> d. If any violations did occur, does it <br /> describe actions taken or planned for X <br /> correcting those violations? <br /> Standard 2. Compliance Evaluation Summary <br /> Provisions x <br /> (1993,1997,2000) a. Map/Photo: Is there a map or aerial <br /> photograph indicating the locations of <br /> all monitoring points? <br /> b. Standard Observations: Is there a x Please include a form to certify <br /> summary and certification of completion by signature re: Standard <br /> of all standard observations for the Observations per Standard <br /> WMU, and for receiving waters? Provisions and Reporting <br /> Requirements, August 1997. <br /> Sr.Initials SWIM Entry�� T �/� <br />