NCG080231_MONITORING INFO_20150129

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PERMIT NO.
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DOC TYPE
STORMWATER DIVISION CODING SHEET
NCG PERMITS
I-1 HISTORICAL FILE
MONITORING REPORTS
YYYYMMDD

STORMWATER DISCHARGE OUTi'ALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO NCGO80000 SAMPLES COLLECTED DURING CALENDAR YEAR
CERTIFICATE OF COVERAGE NO NCG08 0231. (This monitoring report is due at the Do. ision no later than 30 days from
the date the facility receives the sampling results from the laboratory )
FACILITY NAME Holiday Tours In / aroliria Travel Management, Inc COUNTY Randolph
PERSON COLLECTING SAMPI,,ES -,J cl 1 PHONE NO [phone]
CERTIFIED LABORATORY Lab #
%,�1%. ,t eY.5.aL Lab#F
PLEASE SIGN ON THE REVERSERECEI ED
Part A Vehicle Maintenance Areas Monitoring Requirements
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _K yes —no
(if yes report your analytical results in the table immediately below)
JAN 2 9 2015
CENTRAL FILES
DWR Sr=CTION
Outfall
No
Date
Sample Collected,
mo/dd/ r
00530
00400 -
00556
Total Suspended Solids,
m
pH,
Standard units
Oil and Grease,
m
New Motor Oil Usage,
Annual averse al/mo
Benchmark
-
100
Within 6 0 - 9 0
30
-
Z 2
`Z�
Note If you report a sampled value in excess of the benchmark value or outside the benchmark range for pH you must implement Tier I or Tier 2 responses
See General Permit text
Part B Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals
Outfall
No
Date
Sample Collected,
mo/dd/vr
00556
00530
00400
Oil and Grease,
m
Total Suspended Solids,
m
pH,
Standard units
Permit Limit
-
30
100
6 0 - 9 0
STORM EVENT CHARACTERISTICS
IVz Iz/s,.
Date (first event sampled)
Total Event Precipitation (inches)
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches)
Mail Original and one copy to
Division of Water Quality
Attn DWQ Central Files
1617 Mail Service Center
Raleigh North Carolina 27699-1617
5 W U-250-102107
Page I of 2

"I certify, under penalty of law, that this document and all attachments were prepared under my direction or
supervision in accordance with a system designed to assure that qualified personnel properly gather and evaluate the
information submitted Based on my inquiry of the person or persons who manage the system, or those persons
directly responsible for gathering the information, the information submitted IN, to the best of my knowledge and belief,
true, accurate, and complete I am aware that there are significant penalties for submitting false information, including
the posse'^ OTRnes and imprisonment for knowing violations "
re of Permittee)
! -zc- � S
(Date)
s'� 0102107
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