NCG080231_2021 DMR_20220204

NCDEQ Division of Energy, Mineral and Land Resources
Transit a' Transportation
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report (DMR) Upload form within
30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the appropriate DEMLR Regional Office.
"i his DMR forms is only applicable to stormwater discharges a~om the f0lowing areas that have been specifically designated bythe
Division as subject to "he requirermnts of Part 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: SGS
Facility County: Randolph
Laboratory Cert. No.: NC(573)
Discharge during this period:
✓
Yes ; .No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? QYes ; ✓ No
If so, which Tier (I, II, or III)?
A copy of this DMR has been uploaded electronically via htt s; edocs.dr .nc.7ov Forms SW-DMR ®✓ Yes FINo
Date Uploaded:1/30/22
Analytical Monitoring Requirements for Oil/Water Separators and Secondary Containments Areas at Bulk Stations & Terminals
(Those Designated and Brought Under NCG080000) - Effluent Limits in (Red,"
Parameter
Code
Parameter
Outfall 001
Outfall
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
C
N/A
Date Sample Collected MM/DD/YYYY
12/19/21
46529
24-Hour Rainfall in inches
0.7
C0530
TSS in mg/L (100 or 50*)
5.9
00552
Non -Polar Oil & Grease in mg/L (15)
<5.4
00400
PH in standard units (6.0- 9.0 Fvlf,
>1.31.5,
7.04
"" Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS limit of ! 4) rng/L. All other water classifications have a benchmark of 10€; rr,,;/L
fW (Freshwater) S (Saltwater)
Notes (optional):
"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 th best of my knowledge and belief, true, accurate, and complete. I am aware that there are significant penalties for submitting
fa se ' ormation, (in\le
th ors bf fines and imprisonment for knowing violations."
1 /28/22
Permittee or Delegated Authorized Individual Date
[e-mail]
Email Address
[phone]
Phone Number