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HomeMy WebLinkAboutNCG080716_MONITORING INFO_20180713STORMWATER DIVISION CODING•SHEET NCG PERMITS PERMIT N0. /V DOC TYPE. ❑HISTORICAL FILE "ONITORING REPORTS DDC DATE ❑ oli�� � 0 3 YYYYMMDD I APEX July 5, 2018 Division of Water Quality Attention: DWQ Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 RE: Discharge Monitoring Report —.January to .June 2018 Pilot 96978 801 NC Hwy 211 E Candor, North Carolina Permit NCG080716 Dear Sir/Madam: RECEIVED JUL 13 2018 CENTH,AL FILES DVVR SECTION Attached is the January - .June 2018 Discharge Monitoring Report (DMR) prepared for the above referenced site. The laboratory analytical data for this round of sampling is also attached. If you have any questions, please feel free to contact me at (540) 563-4920. Sincerely, Robert S. Wagner Program Manager Attachments cc: Melody Mayville, Pilot Flying J Apex Companies, LLC • 7724 Garland Circle • Roanoke, VA 24019 T 540.563.4920 • F 540.563,4921 • apexcos.com Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 CERTIFICATE OF COVERAGE NO. NCG080716 FACILITY NAME _Pilot 6978 COUNTY Montgomery PERSON COLLECTING SAMPLES RSW LABORATORY_SGS Date submitted Lab Cert. # _346 Comments on sample collection or analysis: 7/5/18 SAMPLE COLLECTION YEAR 2018 SAMPLE PERIOD ® Jan -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 Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? (if yes, report your analytical results in the table immediately below) Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable) yes _no No discharge this period' Outfall No. Date Sample Collected, mo/dd/yr 00530 00400 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 100 see permit Within 6.0 — 9.0 15 - Part B: Oil/water Separators and Secondary Containment Areas at Petroleum Bulk Stations and Terminals (If applicable) O utfa I I No. Date Sample Collected, mo/dd/yr 00556 00530 00400 Non -Polar Oil and Grease/TPH EPA Method 1664 (SGT-HEM), mg/L Total Suspended Solids, mg/L pH, Standard units Permit Limit - 15 50 or 100 see permit 6.0 -- 9.0 001 6/22/18 <5.4 53.8 6.91 I 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 Page I of 2 STORM EVENT CHARACTERISTICS: Date _6/22/18 (first event sampled) Total Event Precipitation (inches): x0.1_ 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. r 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 oriainal and one copy of this DMR,_including all "No Discharge" reports _within 30 days of receipt of the lab 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 penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." (Signature of 7-S /,? (Date) Additional copies of this form may be downloaded at: http:lll2ortal.ncdenr.org/weblwqlws/su/npdesswlltab-4 S WU-250 last revised April 11. 2013 Page 2 ot'2 fed 4 � � � if �f3 � S Dayton, NJ 6129118 The results set forth herein are provided by SGS North America hic. a-Htir copy 2.0 Automated Report Technical Report for ` Pilot Travel Centers LLC ACVAR: #6978, 801 North Carolina Highway 211, East Candor, NC SGS Job Number: JC68733 Sampling Date: 06/22/18 Report to: Apex Companies, LLC 7724 Garland Circle Roanoke, VA 24019 RWagner@apexcos.com ATTN: Robert Wagner Total number of pages in report: 14 Test results contained within this data package meet the requirements Nancy Cole of the National Environmental Laboratory Accreditation Program Laboratory Director and/or state specific certification programs as applicable. Client Service contact: Tammy McCloskey 732-329-0200 Certifications: NJ(12129), NY(10983), CA, CT, FL, IL, IN, KS, KY, LA, MA, MD, ME, MN, NC, Oil VAP (CL0056), AK (UST-103), AZ (AZ0786), PA, RI, SC, Tx, UT, VA, WV, DoD FLAP (ANAB L2248) This report shall not be reproduced, except in Its entirety, without the written approval of SGS. Test results relate only to samples analyzed. SGS North America Inc, • 2235 Route 130 • Dayton, NJ 08810 • tel: 732-329-0200 • fax: 732-329-3499 SCIS i} the sole authority 1-61 authorizuts edits ur ntrdiftruions to this document. Please share your ideas about ^ Unauthnrizrd moditicatinn of ihi; report is strictly prohibited, how%%e c;ut sme you better at: Su Review standard terms aC 1aIS.US.Cn;tomeiCarcgsgs,com 1 of 14 JC68733 Sections: Table of Contents Section 1: Sample Summary................................................................................................... 3 Section2: Case Narrative/Conformance Summary.............................................................. 4 Section 3: Summan, of Hits ...................................................... ......... Section4: Sample Results........................................................................................................ 6 4.1: JC68733-1: OWS.......................................................................................................... 7 Section5: Misc. Forms............................................................................................................ 8 5.1: Chain of Custody........................................................................................................... 9 Section 6: General Chemistry - QC Data Summaries.......................................................... I I 6.1: Method Blank and Spike Results Summary 6.2: Duplicate Results Summary.......................................................................................... 13 6.3: Matrix Spike Results Summary..................................................................................... 14 ! 2of14 _SGS r JC68733 SGS North America Inc. Sample Summary Pilot Travel Centers LLC Job No: JC68733 ACVAR: #6978, 801 North Carolina Highway 211, East Candor, NC Sample ' Collected i Matrix Client Number Date Time By Received Code Type Sample ID JC68733-1 06122/l8 17:00 HC 06/26/18 AQ Water :OWS 3 of 14 JC68733 CASE NARRATIVE 1 CONFORMANCE SUMMARY Client: Pilot Travel Centers I.[.0 Job No JC68733 Site: ACVAR: 96978, 801 North Carolina Highway 211, East Candor, N Report Date 6/29/2018 9:09:59 AM On 06/26/2018, l Sample(s), 0 Trip Blank(s) and 0 Field Blank(s) were received at SGS North America Inc. at a maximum corrected temperature of2.1 C. Samples were intact and chemically preserved, unless noted below. A SGS North America Inc. Job Number of JC68733 was assigned to the project. laboratory sample ID, client sample ID and dates of sample collection are detailed in the report's Results Summary Section. Specified quality control criteria were achieved for this job except as noted below. For more information, please refer to the analytical results and QC summary pages. Compounds qualified as out of range in the continuing calibration summary report are acceptable as per method requirements when there is a high bias but the sample result is non -detect. General Chemistry By Method EPA 1664A Matrix: AQ Batch ID: GP14112 ■ All samples were prepared within the recommended method holding time. ■ All method blanks for this batch meet method specific criteria. ■ Sample(s) JC68733-1 MS, JC68739-1 DUP were used as the QC samples for HEM Oil and Grease. ■ RPD(s) for Duplicate for HEM Oil and Grease are outside control limits for sample GP14112-DI. High RPD due to possible nothomogeniety between sample bottles. j Matrix: AQ Batch ID: GP14121 ■ All samples were prepared within the recommended method holding time. ■ All method blanks for this batch meet method specific criteria. ■ Sample(s) JC68733-1 MS, JC68739-1 DUP were used as the QC samples for HEM Petroleum Hydrocarbons. ■ RPD(s) for Duplicate for HEM Petroleum Hydrocarbons are outside control limits for sample GP14121-DI. High RPD due to possible nonhomogeniety between sample bottles. General Chemistry By Method SM2540 D-11 Matrix: AQ Batch ID: GN82021 ■ All samples were analyzed within the recommended method holding time. ■ All method blanks for this batch meet method specific criteria. ■ Sample(s) JC68703-2DUP were used as the QC samples for Solids, Total Suspended. General Chemistry By Method SM4500H+ B-11 Matrix: AQ Batch ID: R170848 ■ The data for SM45001i+ B-1 I meets quality control requirements. ■ JC68733-1 for pli: Sample received out of holding time for phI analysis. SGS North America Inc. certifies that data reported for samples received, listed on the associated custody chain or analytical task order, were produced to specifications meeting the Quality System precision, accuracy and completeness objectives except as noted. Estimated non-standard method measurement uncertainty data is available on request, based on quality control bias and implicit for standard methods. Acceptable uncertainty requires tested parameter quality control data to meet method criteria. SGS North America Inc. is not responsible for data quality assumptions if partial reports are used and recommends that this report be used in its entirety. Data release is authorized by SGS North America Inc indicated via signature on the report cover Friday, June 29, 2018 Page I of 1 cc 4of14 JC68733 Summary of Hits Page I of t Job Number: JC68733 Account: Pilot Travel Centers LLC Project: ACVAR: #6978, 801 North Carolina Highway 211, East Candor, NC Collected: 06/22/18 .ab Sample ID Client Sample 10 Result/ ,nalyte Qual RL MDL Units Method JC68733-1 OWS Solids, Total Suspended ' 53.8 ! 4.0 mg/l SM2540 D-11 pH a (5_97 _ su SM450011+ B-11 (a) Sample received out of holding time for pH analysis. -SG9r 5 of 14 JC68733 SGS �L Vol Sample Results Report of Analysis Section 4 G�r 6 °f 14 _S JC68733 SGS North America Inc. Report of Analysis ;lient Sample ID: OWS ,ab Sample ID: JC68733-1 Date Sampled: 06/22/18 Ratrix: AQ - Water Date Received: 06/26/18 Percent Solids: n/a 'roject: ACVAR: #6978, 801 North Carolina Highway 211, East Candor, NC General Chemistry Analyte Result RL Units HEM Oil and Grease < 5.4 ? 5.4 mg/I HEM Petroleum Hydrocarbons < 5.4 14.0 5.4 mg/I Solids, Total Suspended ;53.8 mg/I PH a 5.97 ! su (a) Sample received out of holding time for pH analysis. RL = Reporting Limit Page 1 of 1 DF Analyzed By Method 1 06/28/ 18 16:00 TM EPA 1664A 1 06/28/ 18 17:00 TM EPA 1664A 1 06/27/18 10:55 RC SM2540 D-1 l l 06/26/18 13:54 SUB SM4500H+ &1I SGgr 7 of 14 JC68733 d gyeE 1 . Misc. Forms..- — - - - _---- 4 Custody Documents and Other Forms Includes the following where applicable: • Chain of Custody Section 5 CGS t 8of14 _V JC68733 cr. W� CHAIN OF CUSTODY SOS Aeci W-DyMn PAGE _1,_ OF -L ' nL 1' IA0wig . . "3 t34" at•a r _ ._ � wy�.:A�tV t ..r :�.. '-, r,�.:F.:et'+ iXL'i ra:{Af�w.'a:: ���:^+',',jSR'�i1-Kayt{.li�s�iyJ:AfA�".1F��w���'1,y f, : �L. �'-:`, 1 / �/ , �►I� "'lkti:7A :.:.al.�•c.�Rv:i+YFY n.•.:..!:;:AW 1 ■ F SUOU4,CRMr.Cw W3n4 JC68733: Chain of. Custody Page 1 of 2 9of14 JC66733 SGS Sample Receipt Summary Job Number: JC68733 Client: APEX COMPANIES, LLC Date 1 Time Received: 6126/2018 9:20:00 AM Delivery Method: Cooler Temps (Raw Measured) °C: Cooler 1: (2.1); Cooler Temps (Corrected) °C: Cooler 1: (2.1); Project: ACVAR: #6978, 801 NORTH CAROLINA HIGHW Alrblll We: Cooler Security Y 1. Custody Seals Present: Rd or N ❑ Y or N 3. COC Present: %1 ❑ Sample Integrity --Documentation 1. Sample labels present on bottles: 2. CustodySeals Intact: IJ ❑ 4. Smpl Dateslrime OK Fe] ❑ 2. Container labeling complete: Cooler Temperature Y or N 3. Sample container label I COC agree: 1. Temp criteria achieved: R ❑ Sample Intearity - Condition 2. Cooler lamp varificatlon: IR Gun 1. Sample raced within HT: 3. Cooler media: Ice (Bag) 2. All containers accounted for, 4. No. Coolers: Quality Control erftgervatlon Y 1 or N NIA 3. Condition of sample: 1. Trip Blank present 1 cooler: ❑ , 2 ❑ Santpill_1Dttt9rlty -Instructions 1. Analysis requested is dear: 2. Trip Blank listed on COC; ❑ 5J ❑ 2. Bottles received for unspecified tests 3. Samples preserved property: R ❑ 3. Sufficient volume recvd for analysis: 4. VOCs headspace free: ❑ ❑ R 4. Compositing instructions dear: 5. Filtering instructions clear: Test Strip Lot #s: pH 1.12: 216017 Comments SM089-03 Rev. 0ete 12r7117 pH 12+: 208717 Other. (Specify) _Y or N ® © Ch ® ❑ 3 Y or N ® ❑ W ❑ Intact Y or N N/A R ❑ ❑ W Sd ❑ ❑ ❑ ❑ ❑ JC68733: Chain of Custody Page 2 of 2 CC i 10 of 14 _..SUS JCfi8733 SGSr Dr General Chemistry QC Data Summaries Includes the following where applicable: • Method Blank and Blank Spike Summaries • Duplicate Summaries • Matrix Spike Summaries Section 6 _���r 11 of 14 JC63733 METHOD BLANK AND SPIKE RESULTS SUMMARY GENERAL CHEMISTRY Login Number: JC68733 Account: PILOTSS - Pilot Travel Centers LLC Project: ACVAR: #6978, B01 North Carolina Highway 211, East Candor, NC MB Spike BSP BSP QC Analyte Batch ID RL Result Units Amount Result %Recov Limits HEM Oil and Grease GP14112/GN62117 5.0 HEM Petroleum Hydrocarbons GP14121/GN82119 5.0 Solids, Total Suspended GN82021 4.0 Associated Samples: Batch GN82021: JC68733-1 Batch GP141127 7C68733-1 Batch GP14121: JC68733-1 I') Outside of QC limits D.0 — mg/l 40.3 32.1 79.7 76-114% 0.0 I mg/1 20.13 14.6 172.5 64-132% 0_0 --- mg/1 Page 1 1 12of14 SG JC68733 DUPLICATE RESULTS SUMMARY GENERAL CHEMISTRY Login Number: JC68733 Account: PILOTSS - Pilot Travel Centers LLC Project: ACVAR: 06978, 801 North Carolina Highway 211, East Candor, NC QC Original DUP QC Analyte Batch ID Sample Units Result Result RPD Limits HEM Oil and Grease GP14112/GN82117 JC68739-1 mg/1 HEM Petroleum Hydrocarbons GP14121/GN82119 JC68739-1 mg/1 Solids, Total Suspended GN82021 JC68703-2 mg/1 Associated Samples: Batch GN82421: JC68733-1 Batch GP14112: JC68733-1 Batch GP14121: JC68733-1 (-) Outside of QC limits (a) High RPD due to possible nonhomogeniety between sample bottles. Page 1 8.8 15.3 ' S3.9'(a) 0-188 8.5 14.0 48.9'(a) 0-34% 0.57 U 0.0 0.0 0-17% _..SGS 1 13af34 JC68733 MATRIX SPIKE RESULTS SUMMARY GENERAL CHEMISTRY Login Number: JC68733 Account: PILOTSS - Pilot Travel Centers LLC Pro}ect: ACVAR: #6978, 801 North Carolina Highway 211, East Candor, NC QC Original Spike M5 QC Analyte Batch ID Sample Units Result Amount Result %Rec Limits HEM Oil and Grease GP14112/GN82117 JC68733-1 mg/1 0.0 40.3 34.5 85.6 78-114% HEM Petroleum Hydrocarbons GP14121/GN82119 JC66733-1 mg/1 0.0 20.13 15.6 77.5 64-132% Associated Samples: Batch GP14112: JC68733-1 Batch GP14121: JC68733-1 (1) Outside of QC limits (N) Matrix Spike Rec. outside of QC limits Page 1 1 14of14 _SGS , JC68733 0 Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG080000 � CERTIFICATE OF COVERAGE NO. rNC_G080716 FACILITY NAME A.T. Williams Oil Co. Pilot Travel Center - Store 6978 COUNTY Montgomery County PERSON COLLECTING SAMPLES NA LABORATORY ESC Lab Cert. 4 3 Comments on sample collection or analysis: � SAMPLE COLLECTION YEAR 2016 SAMPLE PERIOD ❑ Jan -June ® July -Dec or El Monthly' month DISCHARGING TO CLASS ❑ORW ❑HQW [:]Trout❑PNA ❑Zero -flow ❑Water Supply ❑SA ®Other Class C: NSW iCFp PLEASE REMEMBER TO SIGN ON THE REVERSE -7 Did this facility perform Vehicle Maintenance Activities usin 55 gallons of new motor oil per month? _ yes X no (if yes, report your analytical results in the table immediatel'FCTF�<<ESON Part A: Vehicle Maintenance Areas Monitoring Requirements (If applicable) ❑ No discharge this period' Outfall No. Date Sample Collected, mo/dd/yr 00530 00400 00556 Total Suspended Solids, mg/L pH, Stand.ard units Rion -Polar Oil and Grease/TPH EPA Method.1664 (SGT-HEM), mg/L New Motor Oil Usage, Annual average gal/mo Benchmark - 50 or 100 see permit Within 60-9.0 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 00530 00400 Non -Polar Oil and Grease/TPH EPA Method 1664 (SGT-HEM), mg/L Total Suspended Solids, mg/L pH, Standard units Permit Limit 15 50 or 100 see permit 6.0 - 9.0 Outfall No. 1 12/31/2016 No Sample No Sample No Sample 1 For sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. 5WU-250 last revised April 11, 201 j Page I of 2 STORM EVENT CHARACTERISTICS: Date NA (first event sampled) Total Event Precipitation (inchesj: NA 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 Z 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 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 of this OMR, including all "No Discharge" resorts, within 30 days of receipt of the lab results (or at end of monitoring period in the case o "No Dischar e" 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 ar significant penalties for submitting false information, including the possibility of fines and imprisonment for knowing violations." of Permitteej 2h=tt I 1-� (Date) Additional copies of this form may be downloaded at: htt�://portal.ncdenr.org/web/wq/ws/su/npdessw#tab-4 SWU-250 last revised April 11. 2013 Page 2 of 2 AIV Semi-annual Stormwater Discharge Monitoring Report xr,00At, 40 for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted 05/12/16 4 rid 0 CERTIFICATE OF COVERAGE NO. NCG080716 SAMPLE COLLECTION YEAR _2016 0,0 FACILITY NAME Speedway Travel Plaza #6978 Candor SAMPLE PERIOD x Jan -June July -Dec COUNTY Montgomery or Monthly'-- (month) PERSON COLLECTING SAMPLES Lynne Hays DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA LABORATORY R&A Lab Cert #34 Comments on sample collection or ❑Zero -flow ❑Water Supply [:]SA analysis: []Other Part A: Vehicle Maintenance Areas Monitoring Requirements PLEASE REMEMBER TO SIGN ON THE REVERSE 4 ❑ No discharge this period' Outfall ' No {tDate Sample Collected £ ;,_�mo/dd/,yr 0_ 0530 ' s 00400 . 00S56 R 'Total Suspended' . `'' ;_. Solitls, mg/L pH, ' .-„` Standardunits Non -Polar Oil and Grease/TPH EPA ,Method_ 1664 (SGT-HEM), mg/iL _ New Motor Oil Usage Annual average gal/mo Benchmark `- 50or00rse_`e `ermitWithin 50 - Did this facility perform Vehicle Maintenance Activities using more than SS gallons of new motor oil per month? yes no x (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 CENTRAL FILES D1NR SEC7'!4N Outfall No �.:;. Date00556% ;Sample Collected,n ma//,Yr r 00530 A ..:� 00400,E ;No- nPolar Oi,l and Grea/TP EPA Methotl ;„� 1664:(SGS iT�HM}. mgl�L :. T to aESuspFgi ceed 5'olids, �.-... = pH, 6� .: ,Standard units lPe�rmit Limit 15 `4 50 or 100 see,pe 71. SDO #1 04/12/16 <5 118 7.1 ' Far sampling periods with no discharge at any single outfall, you must still submit this discharge monitoring report with a checkmark here. SWU-250 Iasi revised October 25, 2012 Page 1 of 2 STORM EVENT CHARACTERISTICS: Date 04/12/16 (first event sampled) Total Event Precipitation (inches):.23 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 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 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 oil "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." A4— Lynne Hays For Speedway LLC 05 12 16 (Signature of Permittee) (Date) Additional copies of this form may be downloaded at: ht�t _//portal.ncdenr.org/web wq/ws/su/npdessw#tab-4 SWU-250 last rcviscd October 25, 2012 Paae2of2 EnviroLinc Environmental Compliance Solutions May 12, 2016 Division of Water Quality Attn: Central Files 1617 Mail Service Center Raleigh, North Carolina 27699-1617 Subject: Stormwater Discharge Outfall Monitoring Report Speedway LLC General Permit Number NCGO80000 Please find enclosed the Stormwater Discharge Outfall Monitoring Report for Speedway LLC site located at 801 State Hwy 211, Candor, North Carolina Store 46978, if you have any questions please contact us at (336) 687-2256. Yours truly, b6rkL�- S Lynne Hays 109 Gentle Pond Court 0 Winston Salem, NC 27107 • Phone: (336) 687-2256 0 Fax: (336) 505-4794 Semi-annual Stormwater Discharge Monitoring Report �� F . for North Carolina Division of Water Quality General Permit No. NCG080000t 6 Date submitted 07/30/15 ed .40ML CERTIFICATE OF COVERAGE NO. NCG080716 FACILITY NAME WilcoHess Travel Plaza #205 Candor MIM104eft VM COUNTY Montgomery AUG 0 3 2015 PERSON COLLECTING SAMPLES Lynne Hays LABORATORY R&A Lab Cert #34 Comments on sample collection @ENTRAL FILES analysis: DWR SECTION Part A: Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR 2015 SAMPLE PERIOD an- - SAM O J June x July Dec or Monthly' _ (Month) DISCHARGING TO CLASS ❑ORW ❑HQW ❑Trout MPNA ❑Zero -flow ❑Water Supply ❑SA [:]Other___ PLEASE REMEMBER TO SIGN ON THE REVERSE 4 El No discharge this period' Outfal_I No. _ Date Sample Collected, mo/dd/yr 00530 00400 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 100 see permit Within 6.6 — 9.0 Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? yes no x (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 No. Date Sample Collected, mo/dd/yr 00556 00530 00400 Non -Polar Oil and Grease/TPH EPA Method 1664 (SGT-HEM), mg/L Total Suspended Solids, mg/L . pH, Standard units Permit Limit - 15 50 or 100 see permit 6.0 — 9.0 SDO #1 07/14/15 41.1 1350 7.4 ' 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 rcvised Oclobcr 25, 2012 Page I of 2 STORM EVENT CHARACTERISTICS: 19 "Date 07/14/15 (first event sampled) Total Event Precipitation (inches):.10 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 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 ANYONE 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 3D 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 07 30 15 (Signature of Permittee) (Date) Additional copies of this form may be downloaded at: h_ttp://portal.ncdenr.org/wLtb/­�w_q/­ws/su/npdessw#tab-4 SWU-250 last revised October 25.2012 Pa -Cc 2 of 2 Semi-annual Stormwater Discharge Monitoring Report • for North Carolina Division of Water Quality General Permit No. NCGO80000 Date submitted 03/23/15 + CERTIFICATE OF COVERAGE NO. NCGO80716 SAMPLE COLLECTION YEAR 14 FACILITY NAME WilcoHess Travel Plaza #205 Candor SAMPLE PERIOD xJan-June July -Dec COUNTY _Montgomery or Monthly' _ (month) PERSON COLLECTING SAMPLES Lynne Hays � C y Di5CHARGING TO CLASS ❑ORW ❑HQW ❑Trout ❑PNA LABORATORY R&A Lab Cert#34 Comments on sample collection or ❑Zero -flow ❑Water Supply ❑SA analysis: ❑Other Part A: Vehicle Maintenance Areas Monitoring Requirements PLEASE REMEMBER TO SIGN ON THE REVERSE 4 Ej No discharge this period' - Noel F "d Date Sample Collected, <„ /�Yr _� n,��-0053d"� t} � OQ400 ' � �? �.s 0� p556 _ Total Suspended. Solids, mg/.� . _ pH Standard unit's a �� ��Non-Polar Qil and Grease/TPH EPANUNN Method 1664 5GT HEM m L i �L.�x), g/�.� New Motor Oil Llsage, Annual a�era a al mo g g_/ Benchmark •., - ' 50 oe 10Q ermtt W ithinif0 -�'9�0 �,_ .F • ?"`�= ,�15 ,�; �,`u Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? yes no x (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 = b= I]ate `: - 00556 � sue.. t► 00530 I= ' _` 00-400 T ".; Sampleoi ected 'No PolaOil and Grease/%PW_EPA M ho ; ' Total Sus�pe ded Solids ;,L pH, - mo/dd/,�yr y : . ?i64 [SGT-HEM)g/L�,� a mg/L� r" s' Standard units Permit Limit: '�` +15 N - = s� 5D or 100 see ermtt sue.. : �. �K , _� :7' P- 1 ..� z SDO #1 02/09/15 <5 34 8.5 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 rc+,iscd October 25, 2012 Palc I of 2 STORM EVENT CHARACTERISTICS: Date 02/09/15 (first event sampled) Total Event Precipitation (inches):.22 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 IN A ROW FOR THE SAME PARAMETER AT THE 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 ANYONE 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 _ 03 23 15 (Signature of Permittee) (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/we /wws/su/npdessw#tab-4 SWU-250 last revised October 25. 2012 Page 2 of 2 �1 et� Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCGO80000 J Date submitted 03 23 15 �. CERTIFICATE OF COVERAGE NO. NCG080716 FACILITY NAME WilcoHess Travel Plaza #205 Candor COUNTY Montgomery PERSON COLLECTING SAMPLES Lynne Hays LABORATORY R&A Lab Cert #34 Comments on sample collection or analysis: Part A: Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR SAMPLE PERfOD 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' Outfall r r No Date` SampleYCollected_, dd/�y �:;� 00530a 00400 �.. ; Total Suspended __: Solid ,;.mg/L '; pH, - Standard units Nan -Polar oil and Grease/TPH EPANevr Method.1564 (SGT ,HEM), mg/L....:: Motor Oil Usage; Annual average gai/.mo a A' chmarkLL = 50,0 100 see permit IfVitFiin 6Y0 �9 0 Al 15 ; Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? yes no x (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 0. . , sDate <� .. Sample Collected,` ., / Xr a` .. v .,Non -Polar Qil and`Grease/aTFH EPAMethod A .serif : ,+ ,: -.}�S r ° � 1'664 SGT H M m L Total Suspend`e,d Solids, Ed- 1? 't: m %Ls ': �._ . pH,`; i _ Standard unniit"s Y' P.ecmitimit ''1.^AF�J9'. e 50 or 10 s0 eel e� rmi ` i SDO #1 02/09/15 <5 34 8.5 ' 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 Page I of 2 STORM EVENT_ fCHARACTERISTICS: Date 02/09/15 (first event sampled) Total Event Precipitation (inches):.22 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 IN A ROW FOR THE SAME PARAMETER AT THE SAME OUTFALL TRIGGER TIER 2 REQUIREMENTS. SEE PERMIT PART it 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 OMR, including all "No Discharge" reports, within 30 days of receipt of the lab 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 U 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 (Signature of Permittee) 03 23 15 (Date) Additional copies of this form may be downloaded at: http//portal.ncdenr.org/web/wq/ws/su/­npdessw#tab-4 S W U-250 last revised October 25, 2012 Paae 2 of 2 f Semi-annual Stormwater Discharge Monitoring Report for North Carolina Division of Water Quality General Permit No. NCG080000 Date submitted 10/27/14 CERTIFICATE OF COVERAGE NO. NCGO80716 FACILITY NAME WilcoHess Travel Plaza #205 Candor COUNTY Mantgomery PERSON COLLECTING SAMPLES Lynne Hays LABORATORY R&A Lab Cert #34 Comments on sample collection or analysis: Part A: Vehicle Maintenance Areas Monitoring Requirements SAMPLE COLLECTION YEAR _2014 SAMPLE PERIOD Jan -June xJuly-Dec or Monthly' (month) DISCHARGING TO CLASS ❑ORW ❑HQW []Trout ❑PNA ❑Zero -flow ❑Water supply ❑SA RECEIVED ❑Other NOV 0 4 2014 PLEASE REMEMBER TO SIGN ON THE REVERSE --> CENTRAL FILES ❑ No discharge this period DWR SECTION Outfall� pates Y0053(}' F i r' 004o0 00556 j' No Nam.. xi 'Sam Ie,C61lected, T6tal;5us ended , 'li, ,, Non Polar Oi! an re PH' EPA New'Motof.OilrUsa 'e r;` r /yr �.,,_ =_3ol�ds; mg/L ° Standard units Method 1664 (SGT FEEMjY; mg/L Anrtual:aVerage Benchmark,;. ,.. ;,;.: �0 00 p'ermit 5 h_ - or1see_,-�ry- r,.<: Did this facility perform Vehicle Maintenance Activities using more than 55 gallons of new motor oil per month? yes no x (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 ul x.IMRV t _ yQ_U55r 0053U :,,00400. -^s�a.-Qyrsrx.^.x.---•�a.SF'�( �;•:. �- _ rw� o " Sam le Collected, olar Oi.l and Grease TPH EP'A�fVlethod3 r H� p _ Non P / 4. Total�Susp�enedalads, p ., 1664 (SG.T�HEM), mg/L Standard units — [P rm tiLimit _.:' {.,. 15•y _. _ l 50 or 100 see permit " 6:0 9.0 SDO #1 09/29/14 <5.0 15.0 7.8 ' 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 Page 1 of 2 STORM EVENT CHARACTERISTICS: Date 9/29/14 (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 Genera! 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 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 ANYONE OUTFALL? YES ❑ NO x IF YES, HAVE YOU CONTACTED THE DWQ REGIONAL OFFICE? YES ❑ NO ❑ REGIONAL OFFICE CONTACT NAME: Mail an originat and one copy of this DMIi, 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." (Signature of Permittee) 10/27/14_ (Date) Additional copies of this form may be downloaded at: http://portal.ncdenr.org/web/wg/ws/su/npdessw#tab-4 S W U-250 last revised October 25, 2012 Page 2 of 2