NCG080134_MONITORING INFO_20190717

Pu
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
lv C 0�u 13�
DOC TYPE
❑ HISTORICAL FILE
MONITORING REPORTS
DOC DATE
❑ `b� .� p 71 7
YYYYMMDD

APEX
July 9, 2019
Division of Water Quality
Attention: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
RE: Discharge Monitoring Report — January -June 2019
Pilot #58
2032 Highway 48
Pleasant Hill, North Carolina
Permit NCG080134
Dear Sir/Madam:
RECEIVED
JUL 17 2019
CENTRAL FILES
DNR SECTION
Attached is the January -June 2019 Discharge Monitoring Report (DMR) prepared for the above
referenced site. The laboratory analytical data for this round of sampling is also attached. If you have
any questions, please feel free to contact me at [phone].
Sincerely,
Robert S. Wagner
Program Manager
Attachments
cc: Melody Mayville. Pilot Flying J
Apex Companies, LLC • 7724 Garland Circle • Roanoke, VA 24019
T 540.563.4920 • F 540.563.4921 • apexcos.com

Semi-annual Stormwater Discharge Monitoring Report
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted 07/09/19
CERTIFICATE OF COVERAGE NO. NCGO80134
FACILITY NAME _Pilot 58
COUNTY Northampton
PERSON COLLECTING SAMPLES CR
LABORATORY —Pace National Lab Cert. # _375
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR 2019
SAMPLE PERIOD ® Jan -June ❑ July -Dec
or ❑ Monthly' (monthl
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
❑Other
PLEASE REMEMBER TO SIGN ON THE REVERSE 4
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? _yes x_no
(if yes, report your analytical results in the table immediately below)
Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable)
No discharge this period'
Outfall
No.
Date
Sample Collected,
mo/dd/yr
OOS30
00400
00556
Total Suspended
Solids, mg/L
pH,
Standard units
Non -Polar Oil and Grease/TPH EPA
Method 1664 (SGT-HEM), mg/L
New Motor Oil Usage,
Annual average gal/mo
Benchmark
50 or 100 see permit
Within 6.0 — 9.0
15
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable)
Outfall
No.
Date
Sample Collected,
mo/dd/yr
00556
00530
00400
Non -Polar Oil and Grease/TPH EPA Method
1664 (SGT-HEM), mg/L
Total Suspended Solids,
mg/L
pH,
Standard units
Permit Limit
15
50 or 100 see permit
6.0 — 9.0
001
05/06/19
<5.56
11.7
7.82
1 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here.
SWU-250 last revised April 11, 2013
Page 1 of 2

STORM EVENT CHARACTERISTICS:
Date _05/06/19_ (first event sampled)
Total Event Precipitation (inches): _>0.1
Date (list each additional event sampled this reporting period, and rainfall amount)
Total Event Precipitation (inches):
Note: If you report a sample value in excess of the benchmark, you must implement Tier 1, Tier 2, or Tier 3 responses. See General Permit text.
FOR PART A AND PART B MONITORING RESULTS:
• A BENCHMARK EXCEEDANCE TRIGGERS TIER 1 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART II SECTION B.
• TIER 3: HAS YOUR FACILITY HAD 4 OR MORE BENCHMARK EXCEEDENCES FOR THE SAME PARAMETER AT ANY ONE OUTFALL? YES ❑ NO
IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an oriainal and one copy of this DMR, including all "No Discharge" reports within 30 days of receipt of the lab results for at end of monitoring period in
the case of "No Discharge" reports) to:
Division of Water Quality
Attn: DWQ Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
YOU MUST SIGN THIS CERTIFICATION FOR ANY INFORMATION REPORTED:
"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."
7-9-/
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/­`ws/su/npdessw#tab-4
SWU-250 last revised April 11, 2013
Page 2 of 2

ATTACHMENT II
Laboratory Certificates of Analysis
and Chain -of -Custody Documentation

aceAnt/tical` ANALYTICAL REPORT
Mectnel conre. m. r�d�gaInawdon May 16, 2019
Pilot Apex Environmental
Sample Delivery Group:
L1097383
Samples Received:
05/09/2019
Project Number:
768490-047
Description:
Pilot 58
Report To: Robert Wagner
7724 Garland Circle
Roanoke, VA 24019
Entire Report Reviewed By:
Pam Langford
Project Manager
Results relate ony to the items tested or calibrated and are reposed as rounded values. This lest report shall not be
reproduced, except In full, without written approval of the laboratory. Where applicable, sampling conducted by Pace National s
` Is performed per guidance provided in laboratory standard operating procedures: 060302, 060303. and 060304,
y,
ACCOUNT: PROJECT: SDG: DATEMME: PAGE:
Pilot Apex Environmental 768490-047 L1097383 OV6/1916:08 1 of 10

TABLE OF CONTENTS
ONE LAB. NATIONWIDE.
Cp: Cover Page
1
C
Tc: Table of Contents
2
P
Ss: Sample Summary
3
Cn: Case Narrative
Sr: Sample Results
4
5
3S5
OLITFALL 001 L1097383-01
5
4
Cn
Qc: Quality Control Summary
6
Gravimetric Analysis by Method 2540 D-2011
6
SSr
Wet Chemistry by Method 1664A
GI: Glossary of Terms
7
8
6QO
Al: Accreditations & Locations
9
�GI
Sc: Sample Chain of Custody
10
aAl
9Sc
ACCOUNT: PROJECT: SDG: DATEMME: PAGE:
Pilot Apex Environmental 768490-047 L1097383 05/16/1916'.08 2 of 10

SAMPLE SUMMARY ONE LAB. NATIONWIDE.
OUTFALL 001 L1097383-01 GW
Collected by Collected date/time Received date/time
Craig Richardson 05/06/1913:15 05/09/19 08:45
Method Batch Dilution Preparation Analysis Analyst Location
date/time date/time
Gravimetric Analysis by Method 2540 D-2011 WG127T748 1 05/10/19 20:48 05/10/19 23:17 MMF
Wet Chemistry by Method 1664A WG1281708 1 05/15/1911*19 05/1611908:21 MSJ
Mt. Juliet, TN
Mt. Juliet, TN
ACCOUNT: PROJECT: SDG: DATEITIME:
Pilot Apex Environmental 768490-047 L1097383 05/16/1916:08
PAGE:
3 o110

CASE NARRATIVE ONE LAB. NATIONWIDE.
All sample aliquots were received at the correct temperature, in the proper containers, with the
appropriate preservatives, and within method specified holding times, unless qualified or notated within
the report. Where applicable, all MDL (LOD) and RDL (LOQ) values reported for environmental samples
have been corrected for the dilution factor used in the analysis. All Method and Batch Quality Control
are within established criteria except where addressed in this case narrative, a non-conformance form
or properly qualified within the sample results. By my digital signature below, I affirm to the best of my
knowledge, all problems/anomalies observed by the laboratory as having the potential to affect the
quality of the data have been identified by the laboratory, and no information or data have been
knowingly withheld that would affect the quality of the data.
fa�u' .;r
Pam Langford
Project Manager
1Cp
rTc
3Ss
Fri
6QC
7G1
6AI
9Sc
ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE:
Pilot Apex Environmental 768490-047 L1097383 05161916:08 4 of 10

OUTFALL 001
SAMPLE RESULTS - 01
ONE LAB, NATIONWIDE.
Collected date/time: 05/06/19 13:15
L1097383
Additional Information
Result
Units
CP
Analyte
z
pH (On Site) 7.82
su
TC
Temperature (on -site) 21.22
Deg. C
Flow Measure 1
Pre
o
SS
Gravimetric Analysis by Method 2540 D-2011
,
Result
Qualifier
ROL
Dilution Analysis
Batch
Cn
Anatyle mgA
2.5A
date/time
Suspended Solids 11.7
Suspended
2.50
1 05/10/2019 23:17
WG1277748
Wet Chemistry by Method 1664A
6Oc
Result
Qualifier
RDL
Dilution Analysis
Batch
Analyte mgA
mgA
date/time
7Gl
TPH - Oil 8 Grease NO
5.56
1 05P6/2019 08:21
WG1281708
aAl
eSc
ACCOUNT:
PROJECT:
SDG:
DATEITIME:
PAGE:
Pilot Apex Environmental
768490-047
L1097383
05A61916:08
5 of 10

WG1277748 QUALITY CONTROL SUMMARY ONE LAB. NATIONWIDE.
Gravimetrlc Analysis by Method 2540 D-2011 L1097383-01
Method Blank (MB)
(MB) R3410593-1 05/10/19 23:17
MB Result
MB Qualifier MB MDL
MB RDL
Analyte mg/I
mgA
mgA
Suspended Solids U
0.350
2.50
L1094905-01 Original Sample (OS) • Duplicate (DUP)
(OS) L1094905-01 05/10/19 23:17 • (DUP) R3410593-3 05/10/19 23:17
Original Result DUP Result Dilution DUP RPD DUP Qualifier DUP RPD
Limits
Analyte mgA mgA % %
Suspended Solids 920 895 1 2.75 5
Laboratory Control Sample (LCS)
(LCS) R3410593-2 05/10/19 23:17
Spike Amount
LCS Result
LCS Rec.
Rat. Limits LCS Qualifier
Analyte mgA
mgA
%
%
Suspended Solids T73
776
100
85.0-115
ACCOUNT: PROJECT: SDG: DATEITIME: PAGE:
Pilot Apex Environmental 768490-047 L1097383 05/16/19 16:08 6 of 10

WG1281708 QUALITY CONTROL SUMMARY ONE LAB. NATIONWIDE.
Wet Chemistry by Method 1664A L1097383-01
Method Blank (MB) FT7
(MB) P3411751-1 05/16/19 08:21
MB Result
TPH - Oil 8 Grease U
MB Qualifier MB MDL MB RDL
mgA mgA
0.725 5.00
Laboratory Control Sample (LCS) • Laboratory Control Sample Duplicate (LCSD)
(LCS) R3411751-2 05/16/19 08:21 - (LCSD) R3411751-3 05/16/19 08:21
Spike Amount LCS Result LCSD Result
LCS Rec.
LCSD Rec.
Rec. Limits
LCS Qualifier LCSD Qualifier RPD
RPD Limits
Anatyte mgA mgA mgA
%
%
%
%
%
TPH - Oil B Grease 20.0 17.6 16.9
88.0
94.5
64.0-132
4.06
34
IS
ACCOUNT:
PROJECT:
SDG:
DATE/TIME:
PAGE:
Pilot Apex Environmental
768490-047
L1097383
05116A91608
7 of 10

GLOSSARY OF TERMS ONE LAB. NATIONWIDE.
Guide to Reading and Understanding Your Laboratory Report
The information below is designed to better explain the various terms used in your report of analytical results from the Laboratory. This is not
intended as a comprehensive explanation, and if you have additional questions please contact your project representative.
Abbreviations and Definitions
MDL
Method Detection Limit.
ND
Not detected at the Reporting Limit (or MDL where applicable).
RDL
Reported Detection Limit.
Red.
Recovery.
RPD
Relative Percent Difference,
SDG
Sample Delivery Group.
U
Not detected at the Reporting Limit (or MDL where applicable).
Analyte
The name of the particular compound or analysis performed. Some Analyses and Methods will have multiple analytes
reported.
If the sample matrix contains an interfering material, the sample preparation volume or weight values differ from the
Dilution
standard, or if concentrations of analytes in the sample are higher than the highest limit of concentration that the
laboratory can accurately report, the sample may be diluted for analysis. If a value different than I is used in this field, the
result reported has already been corrected for this factor.
These are the target % recovery ranges or % difference value that the laboratory has historically determined as normal
Limits
for the method and analyte being reported. Successful OC Sample analysis will target all analytes recovered or
duplicated within these ranges.
Original Sample
The non -spiked sample in the prep batch used to determine the Relative Percent Difference (RPD) from a quality control
sample. The Original Sample may not be included within the reported SDG.
This column provides a letter and/or number designation that corresponds to additional information concerning the result
Qualifier
reported. If a Qualifier is present, a definition per Qualifier is provided within the Glossary and Definitions page and
potentially a discussion of possible implications of the Qualifier in the Case Narrative if applicable.
The actual analytical final result (corrected for any sample specific characteristics) reported for your sample. If there was
no measurable result returned for a specific analyze, the result in this column may state 'No" (Not Detected) or'BDL'
Result
(Below Detectable Levels(. The information in the results column should always be accompanied by either an MDL
(Method Detection Limit) or RDL (Reporting Detection Limit) that defines the lowest value that the laboratory could detect
or report for this analytic.
Uncertainty
(Radiochemistry)
Confidence level of 2 sigma.
A brief discussion about the included sample results, including a discussion of any non -conformances to protocol
Case Narrative (Cn)
observed either at sample receipt by the laboratory from the field or during the analytical process. If present, there will
be a section in the Case Narrative to discuss the meaning of any data qualifiers used in the report.
Quality Control
This section of the report includes the results of the laboratory quality control analyses required by procedure or
Summary (Qc)
analytical methods to assist in evaluating the validity of the results reported for your samples. These analyses are not
being performed on your samples typically, but on laboratory generated material.
This is the document created in the field when your samples were initially collected. This is used to verify the time and
Sample Chain of
date of collection, the person collecting the samples, and the analyses that the laboratory is requested to perform. This
Custody (Sc)
chain of custody also documents all persons (excluding commercial shippers) that have had control or possession of the
samples from the time of collection until delivery to the laboratory for analysis.
This section of your report will provide the results of all testing performed on your samples. These results are provided
Sample Results (Sr)
by sample ID and are separated by the analyses performed on each sample. The header line of each analysis section for
each sample will provide the name and method number for the analysis reported.
Sample Summary (Ss)
This section of the Analytical Report defines the specific analyses performed for each sample ID, including the dates and
times of preparation and/or analysis.
Qualifier
Description
The remainder of this page intentionally left blank, there are no qualifiers applied to this SDG
ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE:
Pilot Apex Environmental 768490-047 L1097383 05/16A9 16:08 8 of 10

ACCREDITATIONS & LOCATIONS ONE LAB, NATIONWIDE.
Pace National Is the only environmental laboratory accredited/cenified to support your work nationwide from one location. One phone call, one point of contact, one laboratory. No other lab Is as
accessible or prepared to handle your needs throughout the country. Our capacity and capability from our single location laboratory is comparable to the collectme totals of the network
laboratories In our Industry. The most significant benefit to our one location design is the design of our laboratory campus. The model is conducive to accelerated produethty, decreasing
turnaround time, and preventing cross contamination, thus protecting sample Integrity. Our focus on premium quality and prompt service allows us to be YOUR LAB OF CHOICE.
Not all certifications held by the laboratory are applicable to the results reported in the attached report.
Accreditation is only applicable to the test methods specified on each scope of accreditation held by Pace National,
State Accreditations
Alabama
40660
Alaska
17-026
Arlxana
AZ0612
Arkansas
88-0469
Connecticut
PH-0197
Florida
EB7487
Georgia
NELAP
Georgia
923
Illinois 200008
Iowa
364
Kansas
E-102P
Kentucky'°
90010
Kentucky'
16
Louisiana
A130792
Louisiana'
LA180010
Maine
TN0002
Maryland
324
Massachusetts
M-TNO03
Michigan
9958
Minnesota
047-999-395
Mississippi
iN00003
Missouri
340
Montana
CERT0086
Third Party Federal Accreditations
Nebraska
NEOS-15-05
Nevada
TN-03-2002-34
New Hampshire
2975
New Jersey—NELAP
TNO02
New Mexico'
n/a
New York
11742
North Carolina
Env375
North Carolina'
OW21704
North Carolina'
41
North Dakota
R-140
Ohio—VAP
CL0069
Oklahoma
9915
Oregon
TN200002
Pennsylvania
68-02979
Rhode Island
LA000356
South Carolina
84004
South Dakota
n/a
Tennessee "
2006
Texas
T104704245-18-15
Texas'
LABO152
Utah
TN00003
Vermont
VT2006
Virginia
460132
Washington
C847
West Vi into
233
Wisconsin
9980939910
AZLA — ISO 17025
1461.01
AIHA-LAP,LLC EMLAP
100789
A2LA—ISO 17025'
1461.02
DOD
1461.01
Canada
1461.01
USDA
P330-15-00234
EPA—Crypto
TN00003
'Drinking Water 2 Underground Storage Tanks 'Aquatic Toxicity'ChemlcaYMicroblological °Mold "Wastewater Na Accreditation not applicable
Our Locations
Pace National has sixty-four client support centers that provide sample pickup and/or the delivery of sampling supplies. If you would like assistance from one of our support offices, please contact
our maln office, Pace National performs a8 testing at our central laboratory.
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HI
NY
ME
ACCOUNT: PROJECT: SDG: DATE/rIME: PAGE:
Pilot Apex Environmental 768490-047 L1097383 05/16/19 16:08 9 of 10

Billing Information:
i�-
Avolysts
Coritairier/Preservative
Chain of Custody. Page, -L- Of -IL
Pilot Apex Environment6l
Payable/ Gmlo'oui
L7
Acc6unts 11
k"I
5508 Lonas Road is fP
F
7724 Garland Circle.
Knoliville, TN 37993
Roanoke, VA 240.19
Reponto:
Email Twrenagner0spexcP.S.00171
Robert Wagner e
J.
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Project li•. r
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Client
Lab Project I
Phone:54D-5 3-4920
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VOA Zero Feadspace: _Y __N
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Refinqu&d.bY. by:
Date:
Time:
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preservation required by Login: Date/Time
Relinquished by: (Signature)
Date:
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