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Home My WebLink AboutNCG080143_MONITORING INFO_20141208M zlo STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. /V CCU � � LI DOC TYPE ❑HISTORICAL FILE MONITORING REPORTS DOC DATE ❑ a b 1 y J a a �' YYYYMMDD F 7� 0 1) t) � C-�A' V-t, STORMWATER DIVISION CODING SHEET NCG PERMITS PERMIT NO. DOC TYPE HISTORICAL FILE ❑ MONITORING REPORTS DOC DATE ❑ c)pIy U7 �7 YYYYMMDD Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quali General Permit No. NCGO80000 Date submitted I Z CERTIFICATE OF COVERAGE NO. N�,CG08L J_ � � FACILITY NAME _ lAd irlwd chl[QrI/ 409P COUNTY . rAbgr({) PERSON COLLECTING SAMPLES S%f)ly. 51 "I)MI& LABORATORY&L Comments on sam Lab Cert. # or analysis: SAMPLE COLLECTION YEAR Mt(A SAMPLE PERIOD ❑ Jan -June [� July -Dec or ❑ Montq0RW 1 month R C q1DISCHARGING TO CLASS ❑HQW [—]Trout❑PNA {{ VV Zero -flow ❑Water Supply ❑SA DEC W8 2014 ❑Other CENTRAL FILES PLEASE REMEMBER TO SIGN ON THE REVERSE 4 DWR SECTION Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month?— yes -"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' ' : Out#all - ° Date -00530x ram:. Q0� �; � 00 } No ;� :Sam�I Collected '= Total Sus endedr <. pH '* ` �_ � : "NonpP(i Oil arid.Gre a TPFI EPA NeW)Motor Oil Usa "e` Solids;:mg/LG;z'°_+Standartl _ . :. units, _:.:: Method1664.(SGT=HEM),mg/L�,, _'Annualkayerageigal/rno ; Benc€imark sb- : ':50 o`r 100'see permit. 'i':lAlithin 6.0,"9.0 15 Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (if applicable) 06tfal4- fi No ':`:Date - Sample`Collected, Imo%dd%yr- - - _ " ' 00556 _ ' ; ` 1= _ _ + _ 00530 : a Y _`• 4 „s 00400 ;Non-Polar.0il and Grease/TPH•EPA Method 1664 (S_GT=NEM), mg/L_ Total Suspended Solids, rrtg/L' u r pH, Standard units' : Per-mit Liin�t :;° .�'15 =- "� rd 50'or 100 see permit '6 0 = 9.0 . 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 1], 2013 Page] of 2 STORM EVENT CHARACTERISTICS: Date (first event sampled) Total Event Precipitation (inches): . V5 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 11 SECTION B. • 2 EXCEEDANCES IN A ROW FOR THE SAME PARAMETER AT TH£ SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS, SEE PERMIT PART 11 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 a recei t of the lab results or at end of monitoring period in the case of "No Discharge" reports) to: Division of Water Quality Attn: DWQCentral 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 fobsubmitting false information, including the possibility of fines and imprisonment for knowing violations." re #2 2 (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr_org/web/wg/ws/su/npdessw#tab-4 S WU-250 last revised April 11, 2013 Page 2 of 2 i a r' r 'Y • J F F Stormwater Discharge OutfalI (SDO) Qualitative Monitoring Report E ' Permit No.: or Certificate of Coverake No.: NIGGi s Facility N e: ` r County: Inspector: e j Date of Inspection: By this signature, I certify that this report a_"_-j 1. Outfall Description 4e* (P Phone No. + ps'o-" . and complete to the crest of my knowledge: Ouutfall No. -QQ I_ -- Structure (pipe, ditch, etc.) Receiving Stream: Describe the industrial activities that occur within the outfall drainage area: " t" 2. Color Describe the color of the disch ge using basic colors (red, brown, blue, etc.) and tint (light, medium, dark) as descriptors, G j^ 3. Odor Describe any distinct odors that the discharge may have (i.e., srneiIs strongly of oil. weak chlorine odor, etc.) P 4. Clarity Choose the number which best describes the clarity of the discharge where I is clear and 10 is very cloudy: 1 0 3 4 5 6 7 8 9 10 S W U-242-020705 Page l „ 5 � 5. Floating Solids Choose the number which best describes the amount of floating solids in the stormwater discharge where l is no solids and 10 is the surface covered with floating solids: 1 3 4 5 6 7 8 9 10 d. Suspended ,Solids Choose the number which best describes the amount of suspended solids in the starrnwater discharge where I is no solids and 10 is extremely muddy; 1 3 4 5 6 7 8 9 10 7. Foam Is there any foam in the stormwater discharge? Yes No I 9. Oil Sheen Is there an oil sheen in the stormwater discharge? Yes rNo) i 9. - Depositiou at Outfall Is there deposition of material (sediment, etc,) at or immediately below the outfall? Yes 10. Erosion at Outfall Is there erosion at or immediately below the outfall? Yes No 11. Other Obvious Indlcators of Stormwater Pollution List and describe Note: Low clarity, high solids, and/or the presence of foam:, oil sheen, deposition or erosion may be indicative of conditions that warrant further investigation and corrective action. • Page 2 SWU-242-0207U5 4 lDynamls,Inc. P.O. Box 50636, Knoxville, TN 37950 Phone: (865) 588-5422 Fax: (865) 588-6857 �1a\\jeD 9 o Q Iva Gt; S Q June 24, 2014 ATTN: Central Files Division of Water Quality NC DENR 1617 Mail Service Center Raleigh, NC 27699-1617 Certified Mail #: 7013 3020 0001 4408 2878 'I1h 01 V, CENTRAL HIE ' DWDIAf`r- RE: Discharge Monitoring Report (DMR) — Semi -Annual #1 2014 NPDES #NCG080143 Pilot Travel Center, Store #056 Dear Sir or Madam: I have enclosed a copy of the semi-annual DMR for the first half of 2014. If you have any questions concerning this report, or if I can be of assistance in any way please feel free to contact me at 865-588-5422 ext. 205. Sincerely, &�kqmjwK Emily J. Wilson Dynamis, Inc. Enclosure: One original and one copy of the semi-annual #1 2014 DMR. cc: Joey Cupp, Pilot Travel Centers, file CERTIFICATE OF FACILITY NAME COUNTY Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Qualit General Permit No. NCG080000 Date submitted IP NO. NCG08_ 1, .�_ 3 SAMPLE COLLECTION YEAR Z O iq SAMPLE PERIOD 'M Jan -June ❑ July -Dec IAc or Monthly' (month) PERSON COLLECTING SAMPLES LABORATORY Comments on sample collectioi DISCHARGING TO CLASS XORW ❑HQW ❑Trout ❑PNA 'bS Lab Cert. # Zero -flow ❑Water Supply []SA or analysis: ❑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 ✓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' butfall No. y ' Date Sample Collected, mo/dd/yr- 00s30. - 6040Q A • .. _ 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,106see 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 100530...: _ 00400 Non -Polar Oil and Grease/TPH EPA Method - 1664 (SGT=HEM), mg/L Total Suspended Solids, ' mg/L pH, Standard units..:,. Permit Limit - - _ �l. IS - ._15/kio 50 or 100 see permit _ - 6:0 - 9.0 5. iR lu. ci 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 Pagel of 2 STORM EVENT CHARACTERISTICS: Date (first event sampled) Total Event Precipitation (inches): 5 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 R LT : • 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 ot this DMR including all "No Discharge" reports, within 30 days oF receipt of the tab 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 penaltigA for submitting false information, including the possibility of fines and imprisonment for knowing violations." (D te) 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 a, Stormwater Discharge Outfall (SDO) Qualitative Monitoring Report Permit No.: N/CI I I PVDJ Facility N County: Inspector: 1C `"-- Date of hispebtion: S By this signature, I certify that is repon is accurate and complete.to the best of my knowledge: (Signature of Permittee or Desi6ee) X. Outfall Description Outfall No.� Structure (pipe, ditch, etc.) Receiving Stream: `--f Describe the industrial agGvitles that occur within the outfall drainage area:S 2, Color Describe the color of the dischajge usigg basic colors (red, brown, blue, etc,) and tint (light, medium, dark) as descriptors: C r ,qL r 3. Odor Describe any distinct odors that the discharge may have (i.e., smells strongly of oil, weak chlorine odor, etc.) JV O k { 4. Clarity Choose the number which best describes the clarity of the discharge where I is clear and 14 is very cloudy: 1 2 0 G' 5 6 7 8 9 10 Page I 0 SWU-242-020705 t. 5. floating Solids Choose*the number which best describes the amount of [coating solids in the stormwater discharge where I is no sodds and 10 is the surface covered with floating solids: 2 4 5 6 7 8 9 10 6. Suspended Solids Choose the number which best describes the amount of suspended solids in the stormwater discharge where I is no solids and 10 is extremely muddy, 1 2 (5) 4 S 6 7 8 9 10 7, Foam Is there any foam in the stormwater discharge? Yes IVo I 8. Oil Sheen Is there an oil sheen in the stormwater discharge? Yes No 9. Deposition at Outfall Is there deposition of material (sediment, etc.) at or immediately below the outfall? Yes No 4 10. Erosion at Outfall I Is there erosion at or immediately below the outfall? Yes No. 11. Other Obvious Indicators of Stormwater Pollution List and describe _ Note: Low clarity, high solids, and/or the presence of foam, oil sheen, deposition or erosion may be indicative of conditions that warrant further investigation and corrective action. Page 2 SWU•242.020705