NCG080461_DMR_20200625

r> . u
JUL 2 0 Z02O
i- FJLES
. , �CTIOiV
STORMWATER DISCHARGE OUTFALL (SDO)
MONITORING REPORT
GENERAL PERMIT NO. NCG080000 SAMPLES COLLECTED DURING CALENDAR YEAR: 2020
CERTIFICATE OF COVERAGE NO. NCG08 0641 (This monitoring report is due at the Division no later than 30 days from
the date the facility receives the sampling results from the laboratory.)
FACILITY NAME TmvelCenters of America #329 COUNTY Orange
PERSON COLLECTING SAMPLES Stephanie Hempel PHONE NO. (U9-)304-7474
CERTIFIED LABORATORY Pace Analytical Lab # 12
PLEASE SIGN ON THE REVERSE -)
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? _ yes _no
(if yes, report your analytical results in the table immediately below)
Outfall
No.
Date
Semple Collected,
mo/dd/ r
00530
00400
00556
Total Suspended Solids,
m
pH,
Standard units
Oil and Grease,
111911.
New Motor Oil Usage,
Annual average aVmo
Benchmark
100
Within 6.0-9.0
30
1
04/20/20
M5
55
NO
Approx. 1,000
Note: 11 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 Pemdl text.
Part B: Oil/water Separators and Secondary Containment Areas at Petrnlenm Rulk Stalin. and Terminals
Outfall
No.
Date
Sample Collected,
mo/dd/ r
00556
00530
00400
Oil and Grease,
mpJLm
Total Suspended Solids,
pH,
Standmd units
Permit Limit
30
100
6.0 - 9.0
STORM EVENT CHARACTERISTICS:
Date 4/20/20 (first event sampled)
Total Event Precipitation (inches): 0.6
Date (list each additional event sampled this reporting period, and rainfall anw nrt)
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
SWU-250-102107
Page 1 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 is, 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 possibility of fines and imprisonment for knowing violations."
O�gtMf�rpm0A M0►.rY�
�irMCwMw� d 4.wa�
M�(nw�rM.hl <n- IIM Ipr�
(Signature of Permittee)
6-25-2020
(Date)
S W U-250-102 l 07
Page 2 of 2

10
EnvjrorunenMl
Quality
Stormwater Discharge Outfall (SDO)
Qualitative Monitoring Report
Forguidance on,>illing out thisjonn, please visit hops://deg.ne.cov/about/divisions/eneri v-mineral-land-
resources/enerev-mi neral -land -perm its/storm water-permitstnpdes-indust rial-swktab-4
Permit No.: N/C/_/ /_/_/_/_/_/ or Certificate of Coverage No.:
Facility Name: J tin �, , o,�P ss�[ GF y—�Z�
County: _C)OL�, t\y f% Phone No.
Inspector: PlAAtts4' HTonPCA
Date of Inspection:
Time of Inspection:
Total Event Precipitation (inches): -"- O, G
All permits require qualitative monitoring to be performed during a "measurable storm event."
A "measurable storm event" is a storm event that results in an actual discharge from the permitted site
outfall. The previous measurable storm event must have been at least 72 hours prior. The 72-hour storm
interval does not apply if the permittee is able to document that a shorter interval is representative for
local storm events during the sampling period, and the permittee obtains approval from the local DEMLR
Regional Office.
By this signature, 1 certify that this report is accurate and complete to the best of my knowledge:
or Designee)
1. Outfall Description:
Outfall No. i Structure (pipe, ditch, etc.): pt
Receiving Stream:
1'e-*�hs phtt�
Describe the industrial activities that occur within the outfall drainage area:
Page 1 of 2
S WU-242. Last modified 07t2812017

2. Color: Describe the color of the discharge using basic colors (red, brown, blue, etc.) and tint
(light, medium. dark) as descriptors:�u��tSH Gt4`A
3. Odor: Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak
chlorine odor, etc.): NX)N14..
4. Clarity: Choose the number which best describes the clarity of the discharge, where 1 is clear
and 5 is very cloudy:
1 O 3 4 5
5. Floating Solids: Choose the number which best describes the amount of floating solids in the
stormwater discharge, where 1 is no solids and 5 is the surface covered with floating solids:
0 2 3 4 5
6. Suspended Solids: Choose the number which best describes the amount of suspended solids in
the stormwater discharge, where I is no solids and 5 is extremely muddy:
2 3 4 5
7. Is there any foam in the stormwater discharge? O Yes W No.
8. Is there an oil sheen in the stormwater discharge? oyes Q No.
9. Is there evidence of erosion or deposition at the outfall? O Yes a"No.
10. Other Obvious Indicators of Stormwater Pollution:
List and describe
Note: Low clarity, high solids, and/or the presence of foam, oil sheen, or erosion/deposition may be
indicative of pollutant exposure. These conditions warrant further investigation.
Page 2 of 2
sWU-242, tact modified 0728/2017