NCG080231_2022 DMR_20220731

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCGO80000
Transit and Transportation
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDES permit Data Monitoring Report (DMR) Upload form within
30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the )22LOR,,Ote DEMLR Regional Office.
This DMR form is only applicable to stormwater discharges from the following areas that have been specifically design ted by the
Division as subject to the requirements •�f Part F-1 and brought under NCGO80000: (1) oil water separators (2) containment
structures at petroleum bulk stations and terminals with a total petroleum storage capacity of less than 1 million gallons (3) other
stormwater discharges specifically designated. For stormwater discharges associated with vehicle maintenance areas at
categorically captured facilities under NCGO80000, please use the standard NCGO80000 DMR form.
Certificate of Coverage No. NCG08 0231
Person Collecting Samples: David C. Moody
Facility Name: Carolina Travel Management Inc
Laboratory Name: SGS
Facility County: Randolph
Laboratory Cert. No.: 573
Discharge during this period:
✓
Yes No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?®✓ Yes No
If so, which Tier (I, II, or III)? Tier 1
A copy of this DMR has been uploaded electronically via htt s: ed2 sale .nc, rov Forms SW-DMR ®✓ Yes No
Date Uploaded: 7/31/2022
Analytical Monitoring Requirements for Oil/Water Separators and Secondary Containments Areas at Bulk Stations & Terminals
(Those Designated and Brought Under NCG080000) — Effluent Limits in in" cfl
Parameter
Code
Parameter
Outfall 001
Outfall
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
C
N/A
Date Sample Collected MM/DD/YYYY
06/27/2022
46529
24-Hour Rainfall in inches .25
C0530
TSS in mg/L g10"'. V 'gib"
67.8
00552
Non -Polar Oil & Grease in mg/L g>)
< 5.3
00400
pH in standard units (6.0—%0 FW,
5.48
v 101IN w vuuLanamg resource Waters (UKW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS limit of SO f g,1 . All other water classifications have a benchmark of rnv,/;
-\X (Freshwater) S�V (Saltwater)
Notes (optional):
"I certify by my signature below, 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 thee t of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting
a formation, incding h ossi ity of �n__e_s and imprisonment for knowing violations."
of Permittee or Delegated
[e-mail]
Email Address
7•z�.Zy,11--2.
Individual Date
[phone]
Phone Number