NCG080716_MONITORING INFO_20190717

STORMWATER DIVISION CODING SHEET
NCG PERMITS
[PERMIT NO.
DOC TYPE
❑ HISTORICAL FILE
❑MONITORING REPORTS
DOC DATE
❑ a o t/ Z) 7 1 -7
YYYYMMDD

0011
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 #6978
801NCHwy 211E
Candor, North Carolina
Permit NCGO80716
Dear Sir/Madam:
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. NCG080000
Date submitted _07/09/19
CERTIFICATE OF COVERAGE NO. NCG080716
FACILITY NAME Pilot 6978
COUNTY Montgomery
PERSON COLLECTING SAMPLES HC
LABORATORY —Pace National Lab Cert.p 375
Comments on sample collection or analysis:
SAMPLE COLLECTION YEAR 2019
SAMPLE PERIOD ® Jan -June ❑ July -Dec
or ❑ Monthly' (month)
DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA
❑Zero -flow ❑Water Supply ❑SA
❑Other
PLEASE REMEMBER TO SIGN ON THE REVERSE -)
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
00530
00400
00SS6
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
06/12/19
14.3
5.70
8.97
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 _06/12/19_ (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 original 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."
�-
(Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.orp/web/wq/ws/su/npdes5w#tab-4
SWU-250 last revised April 1 1, 2013
Page 2 of 2

ATTACHMENT 11
Laboratory Certificates of Analysis
and Chain -of -Custody Documentation

aceAnalytical
Naflpbl cerrre. a resrxrg a I dndxe
eft
ANALYTICAL REPORT
June 28, 2019
Pilot Apex Environmental
Sample Delivery Group:
L1109112
Samples Received:
06/14/2019
Project Number:
Description:
Pilot 6978
Site:
CAMDOR
Report To: Robert Wagner
7724 Garland Circle
Roanoke. VA 24019
Entire Report Reviewed By: mDD,,
'4"
Pam Langford
Project Manager
Results relate only to the items tested or calibrated and are reported as rounded values. This test report shall not be
reproduced, except In full. without written approval of the laboratory. Where appiicable, sampling conducted by Pace National,
Is performed per guidance provided in laboratory standard operating procedures: 060302, 060303, and 060304.
ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE:
Pilot Apex Environmental L1109112 06/2M9 21:35 1 of 10

TABLE OF CONTENTS ONE LAB. NATIONWIDE. 0
Cp: Cover Page
1
Cp
Tc: Table of Contents
2
a
Ss: Sample Summary
3
Cn: Case Narrative
4
Sr: Sample Results
5
3SS
OWS-CAMDOR L1109112-01
5
,
Oc: Quality Control Summary
6
Cn
Gravimetric Analysis by Method 2540 D-2011
6
Sr
Wet Chemistry by Method 1664A
7
GI: Glossary of Terms
8
6
Qc
Al: Accreditations & Locations
9
Sc: Sample Chain of Custody
10
F
ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE:
Pilot Apex Environmental L1109112 06/28/19 21'.35 2 of 10

SAMPLE SUMMARY
ONE LAB. NATIONWIDE. 0
Collected by
OWS-CAMDOR L1109112-01 GW Harrison Carter
Collected date/time
06/1211914:15
Received date/time
06/1411908:45
1
C P
Method Batch Dilution Preparation
Analysis
Analyst Location
date/time
date/time
Tc
Giavimetric Analysis by Method 2540 D-2011 WG1297822 1 06/1911913:48
06119/1914:27
AEC Mt. Juliet, TN
Wet Chemistry by Method 1664A WG1303184 1 06/2711917:36
06/28/1918:13
MBP Mt. Juliet, TN
Fn
SSr
6QC
�GI
aAl
9Sc
ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE:
Pilot Apex Environmental L1109112 06/28/19 21:35 3 of 10

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 (LOO) 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.
Pam Langford
Project Manager
ACCOUNT: PROJECT: SDG: DATE/TIME: PAGE:
Pilot Apex Environmental L1109112 06/28/19 21:35 4 of 10

OWS-CAMDOR SAMPLE RESULTS - 01 ONE LAB, NATIONWIDE.
Collected dateltime: 06/12/19 14: 15 L 110 9112
Additional Information
CP
Result
Units
z
Analyte
pH (On Site) 8.96
su
TC
Temperature(on-site)76.6
Deg.F
Method 2540
D-2011
3Ss
Gravimetric Analysis by
Result
Qualifier
ROL
Dilution Analysis
Batch
4
Cn
Analyte mgll
mg/I
- date/time
Suspended Solids 5.70
2.50
1 06119/201914:27
WG1297822
Wet Chemistry by Method 1664A
6
Result
Qualifier
RDL
Dilution Analysis
Batch
QC
F
Analyte mgll
mg/I
date/time
TPH -Oil&Grease 14.3
6.02
1 06/28/201918:13
WG1303184
Fl_. I
ACCOUNT: PROJECT: SDG: DATEMME: PAGE:
Pilot Apex Environmental L1109112 06l28/19 21:35 5 of 10

WG1297822
Gravimetric Analysis by Method 2540 D-2011
Method Blank (MB)
QUALITY CONTROL SUMMARY
L1109112-01
ONE LAB. NATIONWIDE.
(MB) R3422726-1 06119/1914:27
MB Result
MB Oualifer MB MDL
MB ROL
Anayte mg/l
mg8
mg/I
Suspended Solids U
0.350
2.50
L11O8808-03 Original Sample (OS) • Duplicate (DUP)
(OS) L1108808-03 06/19/19 14:27 - (DUP) R3422726-3 06/19/1914:27
Original Result DUP Result Dilution DUP RPD OUR Ouali(er DUP RPD
Limits
Anayte mg4 mg4 % %
Suspended Solids 8.67 8.00 1 8,04 P1 5
Laboratory Control Sample (LCS)
(LCS) R3422726-2 06/1911914:27
Spike Amount LCS Result LCS Rec. Rec. Limits LCS Ouali6er
Analyte mg/I mgA % %
Suspended Solids 773 796 103 85.0-115
ACCOUNT:
PROJECT:
SDG:
DATE/TIME:
PAGE:
Pilot Apex Environmental
L1109112
0628/19 21:35
6 of 10

WG1303184
QUALITY
CONTROL SUMMARY
ONE LAB, NATIONWIDE.
Wet Chemistry by Method 1664A
L1109112-01
Method Blank (MB)
1 Cp
(MB) R3425937-1 06/28/191813
MB Result MB Qualifier MB MDL
MB RDL
z
Analyte mg/1 mg/I
mg/I
TC
TPH -Oil &Grease U 0.725
5A0
3Ss
Laboratory Control Sample (LCS) • Laboratory Control Sample Duplicate (LCSD)
4Cn
(LCS) R3425937-2 06/28/1918:13 • (LCSD) R3425937-3 06/28/1918:13
Spike Amount LCS Result LCSD Result
LCS Rec. LCSD Rec.
Rec. Limits LCS Qualifier LCSD Qualifier RPD RPD Limits
s$r
AnaMe mg/I mgn mgI
% %
% % %
TPH -Oil B Grease 20.0 19.2 16.9 -
96.0 84.5
64.0432 12.7 34
�GI
aAl
9Sc
ACCOUNT:
PROJECT:
SDG:
DATE/TIME:
PAGE:
Pilot Apex Environmental
L1109112
06/28/19 21:35
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
RP
as a comprehensive explanation, and if you have additional questions please contact your project representative.
Abbreviations and Definitions
FTC]
MOIL
Method Detection Limit.
RDL
Reported Detection Limit.
3
SS
Rec.
Recovery.
RPD
Relative Percent Difference.
u
SDG
Sample Delivery Group.
Cn
U
Not detected at the Reporting Limit (or MOIL where applicable).
Analyte
The name of the particular compound or analysis performed, Some Analyses and Methods will have multiple analyses
reported.
a$r
Dilution
If the sample matrix contains an interfering material, the sample preparation volume or weight values differ from the
standard, or if concentrations of analytes in the sample are higher than the highest limit of concentration that the
a
QC
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.
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 analyses 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.
AI
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
a
potentially a discussion of possible implications of the Qualifier in the Case Narrative if applicable.
SC
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 analyle, 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 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 (Oc)
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.
Sample Chain of
Custody (Sc)
Sample Results (Sr)
Sample Summary (Ss)
Qualifier
P1
This is the document created in the field when your samples were initially collected. This is used to verify the time and
date of collection, the person collecting the samples, and the analyses that the laboratory is requested to perform. This
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
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.
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.
Description
RPD value not applicable for sample concentrations less than 5 times the reporting limit.
ACCOUNT:
Pilot Apex Environmental
PROJECT: SDG: DATE/TIME: PAGE:
L1109112 06/28/19 2135 8 of 10

ACCREDITATIONS & LOCATIONS ONE LAB. NATIONWIDE. Jo
Pace National is the only environmental laboratory accrer itedlcerti0ed to support your work nationwide from one location. One phone call, one point of contara, one laboratory. No other lab Is as
accessible ar prepared to handle your needs throughout the country. Our capacity and capability from our single location laboratory is comparable to the collective 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 productivity, 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 B only applicable to the test methods specified on each scope of accreditation held by Pace National.
State Accreditations
Alabama 40660 Nebraska NEOS-15-05
Alaska 17-026 Nevada TN43-2002.34
Arkansas 88-0469
California 2932
Colorado TN00003
Connecticut
PWO197
Florida
E87487
Georgia
NELAP
Georgia
923
Idaho
TN00003
Illinois
200008
Indiana
C-TN-0l
Iowa
364
Kansas
E-102T7
Kentucky10
90010
Kentucky °
16
Louisiana
A130792
Louisiana'
LA180010
Maryland
324
Massachusetts
M-TNO03
Michigan
9958
Minnesota
047-999-395
Mississippi TN00003
Missouri 340
Montana CERT0086
Third Party Federal Accreditations
A21A — ISO 17025 1461.01
A2LA—ISO 17025' 1461.02
New Hampshire
2975
New Jersey—NELAP
TNO02
New Mexico'
Na
Newyork
11742
North Carolina
Env375
North Carolina'
DW217D4
North Carolina °
41
Nonh Dakota
R-140
Oho—VAP
CLOO69
Oklahoma
9915
Oregon
TN200002
Pennsylvania
68-02979
Rhode Island
LA000356
South Carolina
84004
South Dakota
run
Tennessee "
2006
Texas
T104704245-18-15
Texas`
LAS0152
Utah
TN00003
Vermont VT2006
Washington C847
West Virginia 233
Wisconsin 9980939910
Wvomma QLA
AIHA-AP,LLC EMLAP 100789
DOD 1461.01
Canada 1461.01 USDA P330-15-00234
EPA—Crypto TN00003
'Drinking Water' Underground Storage Tanks ° Aquatic Toxicity'Cnemlcal/Microbiological'Mold `Wastewater nla 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 Clout support offices, please contact
our main office. Pace National performs all testing at our central laboratory.
WA
W MT NO
OR MN
T 10 SO T Wl NY
WY MI T
T LN NE T T pA 1
lT T Nxx UT t T T IL Ir* oN wv
co KS MO T KY VAT
T y T TcT
• N
� NM OGK AR
TT 3C
T
MS • GA
T TX T LA —aT
T T
• , o Pl.
ME
ACCOUNT: PROJECT: SDG: DATEMME: PAGE:
Pilot Apex Environmental L1109112 06Y28/1921,35 9of 10

Billing Information:
AnalysiS/Container/Preservative
Chain of Custody Page _of_
Pilot'ApexEnvironmental
Accounts Payable/Gar/Douglas Pre,
5508 Lonas Road U'k
-@AnaMlc2(e
7724 Garland Circle
Knoxville, TN 37993*+ose.
aa.o.en
Roanoke, VA 24019
vorstae.O
Report to:
Emil To: [e-mail]
Robert Wagner
Mwm1= TmnNws7122
..
-
rnPn.: a15.25e6esa
P1nne:aep267-5as9
Project
City/State
Description: Pilot 6978
COIIKIld:
fa: 6IS1515359
ll�
Phone: [phone]
Client Project
lab Project
Fay:
PILOTAPEXENV-PIL678
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Acctnum: PILOTAPEXENV
7emplate:T144522
Coll y nature): l
_
Rush? (Lab MUST Be Notified) Quote q
_Same Day _Five Day
.J-1
W
Prelogin: P708026
_Neat Day _5 Day(Rad Ord,) Date Results Needed
w
�.°
TSR: 633-Pam Langford
Immediately
_T"Day _looaT(Rad"4 : No.
Packed on la N_ y_
Three Day ,. of
l=7
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m
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H
PBo TZ S-31-
Sample ID
Comp/Grab
"'Matra'
Depth
Date
Time
'•r
fps s
Shippedvia:FedEXGround
aemans
samokr Nh •ay1.
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•Matrix: `'
emarks: I
_ 5e_cnie Roce?oe cnec
SS'. Soil AIR - Air F•Filter
pH tea. (6 temp �6, G
CO[ See3 Proven;/Intact: uP _Y "N
GW•Groundwater e- Bioassay
CCC Signed/Accurate: /y N
. WaReWater
- v
Flow_ Other
Bottles arrive intact: -Y _H
DW- Drinkin Water
8
_
Samples rot nod via:
Correct bottlas Vaud: Y N
Bu `.fiolnn: valcoe aen-
OT•Other
_UPS _ edEa _Courier Tackingg i�
_t1
SLAeolicab+e
Q 1 '
VOA Zero Readspace: Y N
Preservation Correct/Checked: _Y _N
Re dby ign e)
Date- -
Time:
Received by:(Signatur
Trip Blank Received: Yes a
©
HQ/MeoH
V I
TBR
uished : (Signatur
Date:
Time-
Rttvved by: (Signature) s
br13 i
TemP: °� Bottles Received:
If reservation required by Login: Date/Time
P 9 B
I 1 I
2—
S+a:.j 52:aaav o
Relinquished by: (Signature)
D{I :
Ti(m��Je:
Received I hy: S' ature)
Date: Time:
Hold:
Conditi�
I7
ISO
y
NCF
Y
- \
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