NCG080166_2022 DMR_20230127

NCDEQ Division f Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG080000
Tr$nsit and Transportation
Click here for instructions
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Complete, sign, scan and submit the DMR via the }tormwater_NPDFS Permit Data Monitoring ReportIDMR) Upload 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 following areas that have been specifically designated by the
Division as subject to the requirements 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 stOrrnwater discharges associated with vehicle maintenance areas at
categorically captured facilities under NCG080000, please use the standard NCG080000 DMR form.
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Certificate of Coverage No. NCGO8 0166 Person Collecting Samples: Ben Kelly
Facility Name: Colonial Pipeline Company Apex Facility Laboratory Name: PACE Analytical
Facility County: Wake Laboratory Cert. No.: ENV375
Discharge during this period: 0 Yes El No (if no, skip to signature and date)
Has your facility implemented mandatory tier response actions this sample period for any benchmark exceedances?QYes Q No
If so, which Tier (I, II, or III)?
A copy of this DMR has been uploaded electronically via https://edocs.deq.nc.Rov/Forms/SW-DMR 111 Yes II No
Date Uploaded: 1/27/2023
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
Parameter 1 utfall 001 Outfall Outfall Outfall Outfall
Code
N/A Receiving Stream Class W
N/A Date Sample Collected MM/DD/YYYY 1 /3/2022
46529 24-Hour Rainfall in inches .03
CO530 TSS in mg/L (100 or 50�`) 3
00552 Non-Polar Oil & Grease in mg/L (15) .8
pH in standard units (6.0 — 9.0 FW,
00400
6.8 — 8.5) 83
' Outfalls to Outstanding Resource Waters (ORW), High uality Waters (HOW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS limit of 50 mg/L. All other water classifications have a benchmark of 100 mg/L
FW (Freshwater) SW (Saltwater)
Notes (optional): Sample collected 10/3/2022
"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, br 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 imp is ment for knowing violations."
SiI '— ' ) 1 2 i / 3
• at of Permittee or Delegated Authorized Ind 'vidual Date
[e-mail] 703-517-3051
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