NCG080428 DMR SW

Semi-annual Stormwater Discharge Monitoring Resort
for North Carolina Division of Water Quality General Permit No. NCGO80000
Date submitted 4/17/15
CERTIFICATE OF COVERAGE NO. 1ME35804"28 RECEIVED FACILITY NAME WilcoHess Travel Plaza # 351
COUNTY Catawba APR 2 3 2015
PERSON COLLECTING SAMPLES Lynne Hays
LABORATORY R&A Lab Cert #34 Comments on sample collectioTRAL FILE a
analysis:
SWIR SECTION
Part A: Vehicle Maintenance Areas Monitoring Requirements
SAMPLE COLLECTION YEAR _2015
SAMPLE PERIOD xJan-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 4
❑ No discharge this period'
--b dif a I I" " `Date
No ,,'S amp�le,Collected,,
m'o/dd/yr, ,.`
00,556.
00530 e .
00556
Non=PQlar,61"an-d Grease/TPH EPA Method "'
_ 16.64 (SGT-HEM);-mg/L':-
,.,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:
BencFimark.� �' - _ -
50 or 100„see'-permit
Within 6:0'” 9.0
No Flow
No Flow
No Flow
SDO #2 3/19/15
11.8
186
7.6
Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? x yes _no
(if yes, report your analytical results in the table immediately below)
Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals
Outfall " '' = Date'
No:' , 6Sample Collected;_
-rrio/i!d/yr�
00,556.
00530 e .
-00400'', f
Non=PQlar,61"an-d Grease/TPH EPA Method "'
_ 16.64 (SGT-HEM);-mg/L':-
Total Suspended'Solids; �,
rng/L
_ pH, ,
Standard units
_Perm'i't°Limit -
15 -
50 or 100 see`per_mit`6.0
SDO #1 3/19/15
No Flow
No Flow
No Flow
SDO #2 3/19/15
11.8
186
7.6
' 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 October 25, 2012
Paae 1 of 2

STORM EVENT CHARACTERISTICS:
Date 3/19/15 (first event sampled)
Total Event Precipitation (inches): .16
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 INA 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 x
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 (or 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."
Lynne Hays For AT Williams Oil Company 4/17/15
(Signature of Permittee) (Date)
Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4
SWU-250 last revised October 25, 2012
Page 2 of 2

EnviroLinc
Environmental Compliance Solutions
April 15, 2015
Division of Water Quality
Attn: Central Files
1617 Mail Service Center
Raleigh, North Carolina 27699-1617
Subject: Stormwater Discharge Outfall Monitoring Report
A.T. Williams Oil Company
General Permit Number NCGO80000
Please find enclosed the Stormwater Discharge Outfall Monitoring Report for A.T.
Williams site located at 1343 Rock Barn Road, Conover, North Carolina. The sample
results are for the stormwater outfall discharge points. If you have any questions please
contact us at [phone].
Yours truly,
�"o'L4d�s
Lynne Hays
log Gentle Pond Court 0 Winston Salem, NC 27107 • Phone: [phone] • Fax: [phone]