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NCGNE1479_Application_20210519
FOR AGENCY USE ONLY NCGNEL�7 Assigned to: IA Vie 1o`�( RECEIVED ARO FR MRO\ WARD `INIRO WSRO MAY 191021 DENR LAND QUALITY Division of Energy, Mineral, and Land ResourciVRMWATER PERMITTING National Pollutant Discharge Elimination System No Exposure Certification for Exclusion NCGNE0000 Submission of this No Exposure Certification constitutes notification that your facility does not require a permit for stormwater discharges associated with industrial activity in the State of North Carolina because it qualifies for a no exposure exclusion.A condition of no exposure at an industrial facility means all industrial materials and activities are protected by a storm resistant shelter (with some exceptions) to prevent exposure to rain, snow, snowmelt, and/or runoff. Industrial materials or activities include, but are not limited to: • material handling equipment or activities, • by-products, • industrial machinery, • final products,or • raw materials, • waste products. • intermediate products, Material handling activities include the storage, loading and unloading, transportation, or conveyance of any raw material, intermediate product,final product,or waste product. A storm resistant shelter is not required for industrial materials stored in the following container types, provided the containers are not deteriorated and do not leak: • drums, • tanks,and • barrels, • similar containers. For permitted facilities in North Carolina, DEMLR must approve your application for No Exposure Certification before this exclusion is effective. Until you are issued a No Exposure Certification and your NPDES permit is rescinded,your facility must continue to abide by the terms and conditions of the current permit. A No Exposure Certification must be provided for each facility qualifying for the no exposure exclusion.Additionally, the exclusion from NPDES permitting is available on a facility-wide basis only— not for individual outfalls. If any industrial activities or materials are,or will be,exposed to precipitation,the facility is not eligible for the no exposure exclusion.By signing and submitting this No Exposure Certification form,you certify that a condition of no exposure exists at this facility or site and are obligated to comply with the terms and conditions of 40 CFR 122.26(g). If approved, your conditional No Exposure Certification has no expiration date but must be self-recertified at least annually. Please look for information about recertification under the No Exposure section on this page: https://deq.nc.gov/about/divisions/energy-mineral-lard-resources/npdes-no-exposure. Directions: Print or type all entries on this application form. Send the original,signed application to: NCDEMLR Stormwater Program, 1612 MSC, Raleigh, NC 27699-1612. The submission of this form does not guarantee exclusion from NPDES stormwater permitting. Prior to exclusion from NPDES stormwater permitting a site inspection will be conducted. Page 1 of 5 1. Owner/Operator(to whom all permit correspondence will be mailed): Name of legal organizational entity: Legally responsible person(as signed in Item 7 below): Amazon.com Services LLC Debora Sanches Street address: City: State Zip Code PO Box 80842 Seattle WA 98108 Telephone number: Email address: 510-541-5774 amazon-eap-northamerica@amazon.com Type of Ownership: Government ['County ❑Federal ❑Municipal ❑State Non-government Business(If ownership is business,a copy of NCSOS report must be included with this application) ❑Individual 2. Industrial Facility(facility requesting exclusion): Facility name: Facility environmental contact: Amazon.com Services LLC-SNC2 Deidre Kruckenberg Street address: Telephone number: 10622 Bryton Corporate Center Drive 630-689-7601 Email address: drdre@amazon.com City County State Zip Code Huntserville Mecklenburg NC 28078 Latitude of entrance: 35°22'23.29"N Longitude of entrance: 80°49'24.49"W Parcel Identification Number(PIN): 01913192 Date operation began: Standard Industrial Classification(SIC)Code: 6/16/2021 4225 Brief description of the types of industrial activities and products produced at this facility: Facility serves as a distribution warehouse. 3. Consultant(if applicable): Name of consultant: Consulting firm: Parker Cliatt ERM Street address: City: State and zip code: 300 West Summit Avenue,Suite 330 Charlotte NC 28203 Telephone number: Email address: 980-297-7273 parker.cliatt@erm.com 4. Exposure Checklists Are any of the following materials or activities exposed to precipitation, now or in the foreseeable future?If you answer"Yes"to any of these items, you are not eligible for the no exposure exclusion. Using,storing,or cleaning industrial machinery or equipment,and areas where residuals from using,storing,or cleaning industrial machinery or equipment remain and are exposed to ❑Yes 0 No❑N/A stormwate r Materials or residuals on the ground or in stormwater inlets from spills/leaks ❑Yes In No ON/A Materials or products from past industrial activity ❑yes D No❑N/A Material handling equipment(except adequately maintained vehicles) ❑Yes El No in N/A Page 2 of 5 Materials or products during loading/unloading or transporting activities ❑Yes El No❑N/A Materials or products stored outdoors(except final products intended for outside use[e.g., new ❑Yes El No❑N/A cars]where exposure to stormwater does not result in the discharge of pollutants) Materials contained in open,deteriorated, non-sealed',or leaking storage drums barrels,tanks, and similar containers El Yes❑No In N/A Materials or products handled/stored on roads or railways owned or maintained by the discharger ❑Yes❑No In N/A Final products that would be mobilized in stormwater discharges(e.g.,rock salt) ❑Yes El No El N/A Waste material(except waste in covered, non-leaking containers[e.g.,dumpsters]) in Yes El No El N/A Application or disposal of process wastewater(unless otherwise permitted) Dyes El No El N/A Particulate matter or visible deposits of residuals from roof stacks and/or vents not otherwise regulated(i.e. under an air quality control permit)and evident in the stormwater outflow El Yes No El N/A Empty containers that previously contained materials that are not properly stored(i.e.,not closed ID Yes El No El N/A and stored upside down to prevent precipitation accumulation) For any exterior ASTs,as well as drums,barrels,tanks and similar containers stored outside,has El Yes CI No In N/A the facility had any releases in the past three(3)years? 'Sealed means banded or otherwise secured and with locked or non-operational taps or valves. Above Ground Storage Tanks(ASTs)and Secondary Containment If you answer"No"to any of the following items,you are not eligible for the no exposure exclusion. Are exterior ASTs or piping free of rust,damaged or weathered coating, pits,or deterioration,or Elves❑No❑N/A evidence of leaks? Is secondary containment provided for all exterior ASTs?If so,is it free of any cracks,holes,or evidence of leaks,and are drain valves maintained locked shut? Yes❑No El N/A Is secondary containment provided for single above ground storage containers(including drums, Elves El No❑N/A barrels,etc.)with a capacity of more than 660-gallons? Is secondary containment provided for above ground storage containers stored in close proximity to each other with a combined capacity of more than 1,320 gallons? ❑Yes El No El N/A Is secondary containment provided for Title III Section 313 Superfund Amendments and Reauthorization Act(SARA)water priority chemicals? Yes El No El N/A Is secondary containment provided for hazardous substances designated in 40 CFR§116? In Yes❑No El N/A Are release valves on all secondary containment structures locked? Oyes❑No El N/A Other information If you answer"Yes"to any of the following items, you might not be eligible for the no exposure exclusion.A more in-depth evaluation of the site circumstances may be required. Are vehicles used in material handling in disrepair and/or leaking fluid? In Yes El No El N/A Does this facility store used, recycled,or otherwise reclaimed pallets outside? Dyes El No❑N/A Does this facility have coal piles on site? ❑Yes In No❑N/A Does this facility store other fuel sources outside in piles,such as wood chips,sawdust,etc.? Elves 0 No❑N/A Page 3 of 5 Does this facility have air emissions associated with industrial activity(e.g.,degreasing operations, 0 Yes®No 0 N/A plating,painting,or metal finishing)? If yes: Describe the industrial activity: The emergency generator will create air emissions. Are those emissions permitted by an Air Quality Permit? ©yes No Please specify: The emergency generator is exempt from air permitting. 5. Other Facility Conditions (check all that apply and explain accordingly): ❑This facility has other NPDES permits. If checked,list the permit numbers for all current NPDES permits: ❑This facility has Non-Discharge permits(e.g.recycle permit). If checked, list the permit numbers for all current Non-Discharge permits: ❑ This facility stores hazardous waste in the 100-year floodplain. If checked, describe how the area is protected from flooding: l]This facility is a(mark all that apply) l7 Hazardous Waste Generation Facility ❑ Hazardous Waste Treatment Facility ❑ Hazardous Waste Storage Facility ❑ Hazardous Waste Disposal Facility If checked,indicate: • Kilograms of waste generated each month: 450 kg • Type(s)of waste:Source of waste is spilled or broken consumer product packaged for retail sale.Waste classifications vary.Most commonly are flammables and corrosives. • How material is stored: 55 gallon poly drums or 55 gallon steel drums depending on the waste • Where material is stored: A secured hazardous waste storage area on spill containment pallets inside the warehouse • Number of waste shipments per year:Varies and is based entirely on the receiving of damaged products • Name of transport/disposal vendor: US Ecology • Transport/disposal vendor EPA ID: MIK435642742 • Vendor address: 101 S.Capitol Blvd,Suite 1000,Boise,Idaho 83702 ❑ This facility is located on a Brownfield or SUPERFUND site. If checked,briefly describe the site conditions: ❑This facility is located on Native American Lands. 6. Required Items (Application will be returned unless all of the following items have been included): O Copy of most recent Annual Report to the NC Secretary of State(if applicable) 0 This completed application and any supporting documentation O Copy of county map or USGS quad sheet with the location of the facility clearly marked Page 4 of 5 7. Applicant Certification North Carolina General Statute 143-215.66(i)provides that: Any person who knowingly makes any false statement, representation, or certification in any application,record, report,plan,or other document filed or required to be maintained under this Article or a rule implementing this Article. . .shall be guilty of a Class 2 misdemeanor which may include a fine not to exceed ten thousand dollars($10,000). I hereby request exclusion from NPDES stormwater permitting. Under penalty of law, I certify that: 0 I am the person responsible for the industrial activity,for satisfying the requirements of this exclusion,and for any civil or criminal penalties incurred due to violations of this exclusion. O I have read and understand the eligibility requirements for claiming a condition of"no exposure"and obtaining an exclusion from NPDES stormwater permitting. O There are no discharges of stormwater contaminated by exposure to industrial activities or materials from the industrial facility or site identified in this document(except as allowed under 40 CFR 122.26(g)(2)). O I understand that I am obligated to maintain no exposure conditions and complete a Self-Recertification form at least once each year and, if requested,provide this certification to the operator of the local municipal separate storm sewer system (MS4) into which the facility discharges(where applicable).I understand that I must allow the North Carolina Division of Energy,Mineral,and Land Resources,or MS4 operator where applicable,to perform inspections to confirm the condition of no exposure and to make such inspection reports publicly available upon request.I understand I must keep a copy of annual recertifications on file at the facility. O I understand that in the event that the site no longer qualifies for a No Exposure Exclusion that I must obtain coverage under an NPDES permit prior to any point source discharge of stormwater from the facility. O The information submitted in this NOI is,to the best of my knowledge and belief,true,accurate,and complete based on my inquiry of the person or persons who manage the system,or those persons directly responsible for gathering the information. Printed Name of Person Signing: Debora Sanches Title: Business Environmental Leader ciiwk 0 /ft1 zoz1 Signature of Appli ant Date Signed Mail the entire package to: DEMLR—Stormwater Program Department of Environmental Quality 1612 Mail Service Center Raleigh, NC 27699-1612 Page 5 of 5 A > n. I: „ ...,. • MEMO �+ - „II SNC2 tIIIIMO Onw L• R g Legend E tier +e y r.1nrSite Boundary i 1 § - . E g 1 - J 4, - 6 Si.,„,' i 4107 a Jopirn t s . x s ,. 8 . A . 0 2.000 4.000 Feel f . 4 Figure 1 General Location Map Site SNC2 M� _ 9\ 10622 Bryton Corporate Center Drive tilOio Huntersville,NC 28078 L 1M S LLSou,co Fan-World TopopWhR Map YWEurxca,VMS 1984 VVerc494 hal,5ph.,• : `��t LIMITED LIABILITY COMPANY ANNUAL REPORT 10/2017 NAME OF LIMITED LIABILITY COMPANY: Amazon.com Services LLC Fling Office Use Only SECRETARY OF STATE ID NUMBER: 1938649 STATE OF FORMATION: DE E - Filed Annual REPORT FOR THE CALENDAR YEAR: 2021 Report 1938649 SECTION A: REGISTERED AGENT'S INFORMATION Changes 1. NAME OF REGISTERED AGENT: Corporation Service Company 2. SIGNATURE OF THE NEW REGISTERED AGENT: SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT 3. REGISTERED AGENT OFFICE STREET ADDRESS&COUNTY 4.REGISTERED AGENT OFFICE MAILING ADDRESS 2626 Glenwood Ave Ste 550 2626 Glenwood Ave Ste 550 Raleigh, NC 27608 Wake County Raleigh, NC 27608 SECTION B: PRINCIPAL OFFICE INFORMATION 1. DESCRIPTION OF NATURE OF BUSINESS: Fulfillment center and customer service holding company 2. PRINCIPAL OFFICE PHONE NUMBER: (206) 266-1000 3.PRINCIPAL OFFICE EMAIL: Privacy Redaction 4.PRINCIPAL OFFICE STREET ADDRESS 5.PRINCIPAL OFFICE MAILING ADDRESS 410 Terry Ave N 410 Terry Ave N Seattle,WA 98109 Seattle,WA 98109 6. Select one of the following if applicable. (Optional see instructions) The company is a veteran-owned small business n I ' The company is a service-disabled veteran-owned small business SECTION C: COMPANY OFFICIALS(Enter additional company officials in Section E.) NAME: MICHAEL D. DEAL NAME: NAME: TITLE: Manager TITLE: TITLE: ADDRESS: ADDRESS: ADDRESS: 410 TERRY AVE N SEATTLE,WA 98109 SECTION D:CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business entity. MICHAEL D.DEAL 4/2/2021 SIGNATURE DATE Form must be signed by a Company Official listed under Section C of This form. MICHAEL D. DEAL Manager Print or Type Name of Company Official Print or Type Title of Company Official This Annual Report has been filed electronically. MAIL TO:Secretary of State, Business Registration Division,Post Office Box 29525,Raleigh.NC 27626-0525