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Home My WebLink AboutNC0032867_Inspection_20171213United States Environmental Protection Agency Form Approved. EPA Washington, D.C. 20460 OMB No. 2040-0057 Water Compliance Inspection Report Approval expires 8-31-98 Section A: National Data System Coding (i.e., PCS) Transaction Code NPDES yr/mo/day Inspection Type Inspector Fac Type 1 IN 2 u 3 I NC0032867 111 121 17/12/13 I17 18 I p I 19 I s I 20L] 21111I I I I I I I II I I I I I I I I I I I I I I I I I I I I I I I II I I I I I r6 Inspection Work Days Facility Self -Monitoring Evaluation Rating B1 QA ---------------------- Reserved ------------------- 67 70 J 71 L72 Ln73 74 79 I I I I 80 Section B: Facility Data Name and Location of Facility Inspected (For Industrial Users discharging to POTW, also include Entry Time/Date Permit Effective Date POTW name and NPDES permit Number) 01:10PM 17/12/13 14/01/01 Kings Mountain Travel Plaza 400 Dixon School Rd Exit Time/Date Permit Expiration Date Kings Mountain NC 28086 01:30PM 17/12/13 18/08/31 Name(s) of Onsite Representative(s)/Titles(s)/Phone and Fax Number(s) Other Facility Data Name, Address of Responsible Official/Title/Phone and Fax Number Contacted Ken Deaver,PO Box 63 Rutherfordton NC 281390063/ORC/828-657-1810/8286574664 No Section C: Areas Evaluated During Inspection (Check only those areas evaluated) Permit Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary) (See attachment summary) Name(s) and Signature(s) of Inspector(s) Agency/Office/Phone and Fax Numbers Date Ori A Tuvia DWR/MRO WQ/704-663-1699/ Signature of Management Q A Reviewer Agency/Office/Phone and Fax Numbers Date EPA Form 3560-3 (Rev 9-94) Previous editions are obsolete. Page# NPDES yr/mo/day Inspection Type NCO032867 I11 12I 17/12/13 117 18 IRI Section D: Summary of Finding/Comments (Attach additional sheets of narrative and checklists as necessary) Page# Permit: NCO032867 Owner -Facility: Kings Mountain Travel Plaza Inspection Date: 12/13/2017 Inspection Type: Reconnaissance Permit Yes No NA NE (If the present permit expires in 6 months or less). Has the permittee submitted a new ❑ ❑ ❑ application? Is the facility as described in the permit? ❑ 0 ❑ ❑ # Are there any special conditions for the permit? ❑ 0 ❑ ❑ Is access to the plant site restricted to the general public? M ❑ ❑ ❑ Is the inspector granted access to all areas for inspection? 0 ❑ ❑ ❑ Comment: No ORC or backup ORC has been designated for the subject facility. ORC has resigned December 1, 2017, since than the facillity has not designated an ORC. Page# 3