NCG080231_2021 DMR_20211029 (2)

NCDEQ Division of Energy, Mineral and Land Resources
Storrmwater Discharge Monitoring Report (DMR,) Forst for NCG080000
Transit and Transportation
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitorin Report DIVIR U load form within
30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the appropriate DEMLR Regional Office.
This DMR form is only applicable to stormwater discharges from the followingareas that have been specifically designated by the
Division as subiect to the requirements of Bart F-1 and brought under NCG080000: (1) oil water separators (2) containment
structures at petroleum bulk stations and terminals with a total petroleum storage capacity of less than 1 million gallons (3) other
stormwater discharges specifically designated. For stormwater discharges associated with vehicle maintenance areas at
categorically captured facilities under NCG080000, please use the standard NCG080000 DMR form.
Certificate of Coverage No. NCG08 0231 Person Collecting Samples: David C. Moody
Facility Name: Carolina Travel Management Inc Laboratory Name: Not Applicable
Facility County: Randolph Laboratory Cert. No.: Not Applicable
Discharge during this period: Yes E]No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances?E]Yes ✓ No
If so, which Tier (I, II, or III)?
A copy of this DMR has been uploaded electronically via htt s: /edocs.deci.nc.ov/FormslSW DMR ✓ Yes No
Date Uploaded: 10/30/2021
Analytical Monitoring Requirements for Oil/Water Separators and Secondary Containments Areas at Bulk Stations & Terminals
(Those Designated and Brought Under NCG080000) — Effluent Limits in
Parameter
Code
Parameter
Outfall 001
Outfall
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
C
N/A
Date Sample Collected MM/DD/YYYY
See Notes
46529
24-Hour Rainfall in inches
See Notes
C0530
TSS in mg/L 11' ?W 1­-
See Notes
00552
Non -Polar Oil & Grease in mg/L (".i
See Notes
00400
' nnrf�llc rr.
pH in standard units ,-�. * - a,
a „)
n„rofA;
See Notes
,,,.b ,QLC„ %vnvvj, nigh Ltuallty waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS limit of Si st . p.. All other water classifications have a benchmark of 9'
<r=t' (Freshwater) mVV (Saltwater)
Notes (optional): No discharge this period.
"I certify by my signature below, 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
fa ormation, incl din the po"ility of fines and imprisonment for knowing violations."
atur� Permittee or Delegated Authorized Individual
[e-mail]
Email Address
/O- Z`_Zazt
Date
[phone]
Phone Number