NCG080143_MONITORING INFO_20191216

m
STORMWATER DIVISION CODING SHEET
NCG PERMITS
PERMIT NO.
DOC TYPE
❑ HISTORICAL FILE
❑"MONITORING REPORTS
DOC DATE
❑ a J L
YYYYMMDD

a
APEX
December 10, 2019
NC DEQ/Division of Water Resources
Attention: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
RE: Discharge Monitoring Report —July-December 2019
Pilot #56
2825 Lane Street
Kannapolis, North Carolina
Permit NCG080143
Dear Sir/Madam:
RECEIVFCI
DEC 16 2019
CENTRAL FILES
DVVR SECTION
Attached is the July -December 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
WATER RESOURCES • ENVIRONMENTAL SERVICES • INDUSTRIAL HYGIENE • SAFETY • AIR QUALITY • SUSTAINABILITY AND CLIMATE CHANGE
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 Energy, Mineral and Land Resources General Permit No. NCG080000
Date submitted 12I10119
CERTIFICATE OF COVERAGE NO. NCG08 0 1 4 3
FACILITY NAME Pilot Travel Centers LLC #56
COUNTY Cabarrus
PERSON COLLECTING SAMPLES John McGuire
LABORATORY Pace National
Lab Cert. # 375
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR 2019
SAMPLE PERIOD ❑ Jan -June Q July -Dec
or ❑ Monthly' (month)
p�
_DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
RECE FU ❑zero -flow ❑Water Supply [_]SA
DEC 16 2019 *Other
CENTRAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE
DWR SECTION
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new oil per month? ❑ yes X no (ifyes, complete Part A)
Part A: Vehicle & Equipment Maintenance Areas Monitoring Requirements (If applicable) ❑ No discharge this period
Outfall No.
Date Sample Collected'
(mo/dd/yr)
24-hour rainfall amount,
Inches3
Non -Polar Oil & Grease
mg/L
Total Suspended Solids,
mg/L
New Motor or Hydraulic Oil Usage,
gal/mon
Benchmarks
_
-
15
100 or SW
Parameter Code
-
46529
00552
C0530
NCOIL
' Monthly sampling (instead of semi-annual) must begin with the second consecutive benchmark exceedance for the same parameter at the same outran.
z For sampling periods with no discharge at any single outtall, you must still submit this discharge monitoring report with a checkmark here.
'The total precipitation must be recorded using data from an on -site rain gauge. Unattended sites may be eligible for a waiver of the rain gauge requirement.
' See General Permit text, Table 1, identifying the especially sensitive receiving water classifications where the more protective benchmark applies.
Note: Results must be reported in numerical format. For example, do not report Below Detection Limit, BDL, <PQL, Non -detect, ND, or other similar non -
numerical format. When results are below the applicable limits, they must be reported in the format, "<XX me/L", where XX is the numerical value of the
detection limit, reporting limit, etc. in mg/L. Conversely, where fecal coliform results exceed the dilution upper limit, report the result as ">XX".
Permit Date: 11/1/2018-5/31/2021 SWU-248, last revised 11/1/2018
Page 1 of 2

Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable) No discharge this period1
Outfall
No.
Date Sample
Collected'
(mo/dd/yr)
24-hour rainfall
amount,
Inches
Sample Collected'
mo/dd/yr
Total Suspended
Solids,
mg/L
pH,
Standard units
Non -Polar Oil &
Grease,
mg/L
Permit Limit
_
-
-
100 or 504
6.0 — 9.0
15
Parameter Code -
-
46529
-
- C0530
00400
00552
001
11112/19
0.61
11112/19
23.8
7.9
c5.75
Footnotes from Part A also apply to this Part B
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 Q
IF YES, HAVE YOU CONTACTED THE DEMUR REGIONAL OFFICE? YES ❑ NO ❑
REGIONAL OFFICE CONTACT NAME:
Mail an original copv 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."
Permittee
Date
Permit Date: 11/1/2018-5/31/2021 SWU-248, last revised 11/1/2018
Page 2 of 2

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

aceAnaiyticai• ANALYTICAL REPORT
rveuo.wtcnrcaro. resilrgd Innovation November 19, 2019
Pilot Apex Environmental
Sample Delivery Group: L1160100
Samples Received: 11/13/2019
Project Number: 768490-043
Description: Pilot 56
Site: 56
Report To: Robert Wagner
7724 Garland Circle
Roanoke, VA 24019
Entire Report Reviewed By
Jason Romer
Project Manager
Results relate only to the Items tested or callbrated and are reported as rounded values. This test report shall not be
reproduced. except in full, without written approval of the laboratory. Where applicable, sampling conducted by Pace
Analytical National Is performed per guidance provided In laboratory standard operating procedures ENWSOP-MTJL-0067 and
ENV-SOP-MTJL-0066. Where sampling conducted by the customer, results relate to the accuracy of the Information provided,
and as the samples are received.
il
ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE:
n Pilot Apex Environmental 768490-043 L1160100 11M91911:27 1 of 10

TABLE OF CONTENTS
ONE LAB, NATIONWIDE,
Cp: Cover Page
1
RP
Tc: Table of Contents
2
Ss: Sample Summary
3
Cn: Case Narrative
4
Sr: Sample Results
5
3SS
KUNNOPOLRS L1160100-01
5
4
Cn
Qc: Quality Control Summary
6
Gravimetric Analysis by Method 2540 D-2011
6
5Sr
Wet Chemistry by Method 1664E
7
GI: Glossary of Terms
8
fiQC
Al: Accreditations & Locations
9
GI
Sc: Sample Chain of Custody
10
rAI
9Sc
1
ACCOUNT:
Pilot Apex Environmentnl
it
PROJECT:
768490-043
SDG:
L1160100
DATETIME:
11p9/ 91127
PAGE:
2 of 10

SAMPLE SUMMARY ONE LAB. NATIONWIDE.
KUNNOPOLRS L1160100-01 GW
Collected by Collected eateltime Received date/time
John M. 11/12/1912:00 11/13/19 08.40
Method
Batch Dilution Preparation
Analysis
Analyst
Location
date/time
date/time
Gravimetric Analysis by Method 2540 D-2011
WG1380216 1 11/14/19 01:20
11/14/19 02:25
MMF
Mt. Juliet, TN
Wet Chemistry by Method 1664E
WG1382689 1 11/18/19 08:07
11/18/19 20:00
MBP
Mt. Juliet, TN
ACCOUNT: PROJECT: SDG: DATERIME: PAGE:
Pilot Apex Environmental 768490-043 L1160100 11/19/1911'.27 3 of 10

CASE NARRATIVE ONE LAB. NATIONWIDE.
sample aliquots were received at the correct temperature, in the proper containers, with the
RPAll
appropriate preservatives, and within method specified holding times, unless qualified or notated within
the report. Where applicable. all MDL (LOD) and RDL (LOO) values reported for environmental samples
Tc
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
Ss
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.
Fri
6QC
7G1
Jason Romer
aAl
Project Manager
9Sc
ACCOUNT: PROJECT: SDG: DATEITIME: PAGE:
Pilot Apex Environmental 768490-043 L1160100 11A9/1911127 4 of 10

KUNNOPOLRS
SAMPLE RESULTS - 01
ONE LAB. NATIONWIDE.
Collected date/time: 11112/19 12:00
L1160100
Additional Information
'i Result
Units
C P
Analyze
2
PH (On Site) 7.9
su
FTC
Temperature (on -site) 9.7
Deg C
Flow Measure 0.5
gpm
e
Ss
Gravimetric Analysis by Method 2540 D-2011
,
Result
Oualifier
RDL
Dilution Analysis
Batch
Cn
Analyze mgA
mgA
date/time
Suspended Solids 23.8
500
M4/2
1 11/14I201902:25
WG1380216
Wet Chemistry by Method 1664B
apc
Result
Oualifer
RDL
Dilution Analysis
Batch
Analyte mgA
mg/I
date/time
7GI
TPH -Oil&Grease ND
5.75
1 11118/201920:00
WG1382689
aAl
9Sc
ACCOUNT: PROJECT: SDG: DATEMME: PAGE:
Pilot Apex Environmental 768490-043 L1160100 1109/1911127 5 of 10

WG1380216
QUALITY CONTROL SUMMARY
ONE LAB. NATIONWIDE. "-
- _ ----Gravlmetric- Analysis- by Method 2540`D-2011 - - -- -
- "-
- - - - - - - L116010O.01
Method Blank (MB)
Pp
(MB) R3472369-1 1V14119 02:25
2
MB Result MB Qualifier MB MDL MB RDL
Anatyte mg4 mg4
mg4
Tc
Suspended Solids U 0.350
2.50
35s
4Cn
L1160025-01 Original Sample (OS) • Duplicate (DUP)
(OS) L1160025-01 11/14/19 02:25 • (DUP) R3472369-3 1V14/19 02:25
Original Result DUP Result Dilution DUP RPD
DUP Qualifier DUP RPD
LimitsSr
s
Analyte mg4 mg4 %
%
Suspended Solids 35.2 37.2 1 5.52
P1 5
L1160125-01 Original Sample (OS) • Duplicate (DUP)
GI
(OS) L1160125-01 11/14/19 02:25 • (DUP) R3472369-3 11/14/19 02:25
OUR RPDLimits
a
Original Result DUP Result Dilution DUP RPD
DUP Qualifier
'41
Analyze mg4 mg4 %
%
Suspended Solids 14.0 16.8 1 IV
P1 5
9SC
Laboratory Control Sample (LCS)
(LCS) R3472369-2 11/14/19 02:25
Spike Amount LCS Result LCS Rea
Rec. Limits LCS Qualifier
Analyze mg4 mg4 %
%
Suspended Solids 773 812 105
85.0-115
ACCOUNT:
PROJECT: SDG:
DATE/DME: PAGE:
Pilot Apex Environmental
768490-043 L1160100
11/19p911:27 6 of 10

WG1382689_ ______ _ _ _ QUALITY CONTROL SUMMARY __ ONE LAB. NAnorIwDE.
_- -
Wet Chemistry by Met hod 166413 11160100-01
Method Blank (MB)
C
(MB) R3473405-1 1V18/19 20:00
MB Result
TPH -Oil&Grease U
MB Qualifier MB MOIL MB ROL
mgA mgA
0.725 SOO
Laboratory Control Sample (LCS) • Laboratory Control Sample Duplicate (LCSD)
(LCS) R3473405-2 11/18/19 20:00 • (LCSD) R3473405-3 1V18/19 20:00
Spike Amount LCS Result LCSD Result LCS Rec. LCSD Rec. Rec. Limits LCS Qualifier LCSD Qualifier RPD RPD Limits
Analyte mg4 mgA mgA % % % % %
TPH -Oil&Grease 20.0 14.2 14.5 71.0 74.0 64.0-132 4.14 34
ACCOUNT: PAGE:
7 of 10
PROJECT:
SDG:
DATE/rlME:
Pilot Apex Environmental
768490-043
L1160100
11l19/1911:27

GLOSSARY OF TERMS ONE LAB. NATIONWIDE.
Guide to Reading and Understanding Your Laboratory Report
Cp
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.
Results Disclaimer- Information that may be provided by the customer, and contained within this report, include Permit Limits, Project Name,
FTCSample
ID, Sample Matrix, Sample Preservation, Field Blanks, Field Spikes, Field Duplicates, On -Site Data, Sampling Collection Dates/Times, and
Sampling Location. Results relate to the accuracy ofthis information provided, and as the samples are received.
Abbreviations and Definitions
aSs
MDL Method Detection Limit.
ND Not detected at the Reporting Limit (or MDL where applicable).
4
Cn
RDL Reported Detection Limit.
Rec. Recovery.
a$r
RPD Relative Percent Difference.
SDG Sample Delivery Group.
6
U Not detected at the Reporting Limit (or MDL where applicable).
QC
❑
Analy[e 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 thatthe
laboratory can accurately report, the sample may be diluted for analysis. If a value different than 1 is used in this field, the
result reported has already been corrected for this factor.
6Al
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.
95C
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 analyte, the result in this column may state "ND" (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 analyte.
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 (Cc)
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
P1
RPD value not applicable for sample concentrations less than 5 times the reporting limit.
ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE:
Pilot Apex Environmental 768490-043 L1160100 11/19A911:27 8 of 10

ACCREDITATIONS & LOCATIONS ONE LAB. NATIONWIDE.
Pace National Is the only environmental Laboratory accredRed/cenified to Support your work nationwide from one location. One phone call, one paint 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 CanectNer totals of the network
laboratories in our Industry. The most Significant benefit to our one locatlon design is the design of our laboratory campus. The model is conducive to accelerated product". decreasing
turnaround time, and preventing cross contamination, thus protecting sample Integrity. Ou r 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 leg methods specified on each Scope of accreditation held by Pace National.
State Accreditations
Alabama
40660
Alaska
17-026
Arizona
AZ0612
Arkansas
88-0469
California
2932
Colorado
TN00003
Connecticut
PH-0197
Florida
E87487
Georgia
NELAP
Georgla
923
Idaho
TN00003
Indiana
C-TN-01
Iowa
364
Kansas
E-102T7
j1 Kentucky1°
90010
Kentucky °
16
Louisiana
A130792
Louisiana`
LA180010
Maine
TN0002
.1 Maryland
324
Massachusetts
M-TNO03
Michigan
9958
Minnesota
047-999-395
MISSISSIPPI
TN00003
Third Party
Federal Accreditations
�i A2LA—ISO 17025
/461.01
A2LA—ISO 17025°
1461.02
Canada
1461.01
EPA—Crypto
TN00003
Nebraska
NEOS-15-05
Nevada
TN-03-2002.34
New Hampshire
2975
New Jersey—NELAP
7NO02
New Mexico'
n/a
New York
11742
North Carolina
Env375
North Carolina'
DW21704
North Carolina °
41
North Dakota
R-140
Ohlo—VAP
CLOO69
Oklahoma
9915
Oregon
TN200002
Pennsylvania
68-02979
Rhode Island
LA000356
South Cmollna
84004
South Dakota
n/a
Tennessee "
2006
Texas
T104704245-18-15
Texas'
LAS0152
Utah
TN00003
Vermont
VT2006
Washington C847
Wisconsin 9980939910
Wyoming A21A
AIHA-AP,LLC EMIAP 100789
DOD 1461.01
USDA P330-15A0234
Drinking Water ° Underground Storage Tanks `Aquatic Toxiciy'Chemlcal/Mlcroblological 'Mold 'Wastewater n/a 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 main office. Pace National performs all testing at our central laboratory.
WA
MT NO
OR MN
T ID so T WI NY
WY 1,41 T
T T T NE IA T T PA
NV UT
Tco' T � • IL 'It
GN
VAT
CA K3 MO T �,
N
• TAZ NM Olt AIR T T Y
• M$ A� GA
T TX LA SST
T
AKFIL
T T
,xD
C. T
—e NI
ACCOUNT: PROJECT: SDG: DATE/TIME:
Pilot Apex Environmental 768490-043 L1160100 11AS1191127
fAE
PAGE:
9 of 10

fi
F �7oo
Rifling Information:
e
chxu, of C
Pilot Apex ex Environmental
Gary Douglas Pres
5508 Lonas Road
7724 Garland Circle
Knoxville, TN 37993
Roanoke, VA 24019•
tNoes
Dart rN aA11 Eli
Report to:
Email :rwagnerilitapexcpscom
Robert Wagner
Phase:
F. 61YA45859
Project
City/State
Description: Pilot 56
Cofiected:
4
LO JJ(/O
ClientProject 0
Lab Project 0
Phone; 540-563-4920
1&fj4!o7(? 43-
PILOTAPEXENV-PILS6
41
1084
Fax:
3:
T
1
Ar`,tF.ffi-PlLOTAPEXE?CV—
Collected by (print):
Site/Facillry, to #
P.o;#
A
GA
I
7emplate:T144422
Prelogin: P707872
Cot
Rush? (Lab MUST Be Notified) Quote It.
�, -; J
-'a
_Same Day Five DayU
Next Day 5 Day Bud 0-10 Date Results Needed
TSR: 633 -Pa m Langford
Immediately
7. Day 10 D-Y Rad OmM No.
X
X
PB:
Packed on Ice N Y V
Three (My of
t
0
0
X:
o.
%6
Shipped via: FedEX Ground
Sample lD
Comp/Grab
Matrix•
Depth
Date
Time
ut;
t-
5-
eVO
GW
a
12
X
1-X
ea
;Matrix: Remarks' Cl
Temp
Coc,Seal Present/Intact: NPyY
SS -Soil AIR -Air F - Filter pit
CDC signed/Accurate. /Y 11
71 —11
8 - assay
GIN , -Ground B10
4"!Other
Bottle$ arrive int-at:
-
WVV - wast.zt.er,
Flow
Correct hOLUQX Used j
zy
DW - Drinking Water Samples returned via:
;Courier Tracking AV(
sufficient volume sent: L 23
If AP,ligalal,
07 - Other— UPS Fed Ex z9 Y
VOA rots tlaa,13POCe: —Y _,V
re) Date: Time: ieceived y: (Sigr�kture Trip Blank Received: Yes/%
......vation Cc�r�eCL$hecked: —Y —N
Relinquished .
I- ? fell
li hill, 4 17W "014 1 T
I OR
If preservation required.. V Login: Dateflime
ee�— — . - 1, or itattles Received:
OV: (Sig re) Date! Time: Received by: (Signature) Temp:
ed
AS
RelinquishedTime: by: (Signature)
Date:
me:
Receive
- d for tab by: (Sign2iw*-;so""
Date: Time;
O
aV
Hold; Condition:
NCF?r0 P5,