NCG060406_Application_20200316

Nccr-o(004-06
FOR AGENCY USE ONLY
Division of Energy,Mineral and Land Resources Date ReceivedYear Month Day
Land Quality Section toga o3 t�
National Pollutant Discharge Elimination System Certificate of Covera e
NI lGl01 1 I I I_ V�-�
N
Check# Amount
Environmental NCG060000 Itet t *'GO
Quality Permit Ass vaned to
9.9+-rtcI t aw•/t
NOTICE OF INTENT
National Pollutant Discharge Elimination System application for coverage under General Permit
NCG060000:
STORMWATER DISCHARGES associated with activities classified as: RECEIVED
SIC (Standard Industrial Classification)20 Food and Kindred Products
SIC 21 Tobacco Products MAR 15 2020
SIC 283 Drugs
SIC 284 Soaps, Detergents, &Cleaning Preparations; Perfumes, Cosmetics, & E
SIC 422 Public Warehousing and Storage(except 4226) STORMWATER P RTTbNG
- For questions,please contact the DEMLR Regional Office for your area. See page 4.
Do Not use this NOI for renewals.
(Please print or type)
1) Mailing address of owner/operator(address to which all permit correspondence will be mailed):
Name Amazon.com Services,Inc.
Street Address PO Box 80842
City Seattle State WA ZIP Code 98108
Telephone No. 206- 266-1000 Fax: NA
2) Location of facility producing discharge:
Facility Name HCL1
Facility Contact Aaron Quintern
Facility Address 4525 Statesville,Rd _
Facility City Charlotte State NC ZIP Code 28269
Facility County Mecklenburg
Telephone No. 304- 409-0001 Fax: NA
Email [e-mail]
3) Physical Location Information:
Please provide a narrative description of how to get to the facility(use street names, state road numbers, and
distance and direction from a roadway intersection). The facility is located northeast of the intersection between Hwy 77
and Hwy 85 in Charlotte,NC.Statesville Rd.(which travels north and south,parallel to Hwy 77)intersects with Hwy 85.The facility is located approximately 0.58 miles
north from Hwy 85 along Statesville Rd,where the road intersects with Hutchinson McDonald Rd.The facility is on the northwest corner of this intersection.
(A copy of a county map or USGS quad sheet with the facility clearly located must be submitted with this application.)
4) Latitude 35°16'56.17"N Longitude 80°50'8.16"W _ (deg, min,sec)
5) This NPDES Permit Application applies to which of the following:
❑ New or Proposed Facility Date operation is to begin
❑✓ Existing
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NCG060000 N.O.I.
6) Standard Industrial Classification:
Provide the 4-digit Standard Industrial Classification code (SIC code) that describes the primary industrial
activity at this facility.
SIC code: 4 2 2 5
7) Activities
a) Provide a brief narrative description of the types of industrial activities and products manufactured
at this facility: Loading/unloading of packaged goods,outdoor equipment and materials(dumpsters/generator),and potential fueling of trucks
and generator.
b) Check all activities occurring at this facility:
❑ use or process meats ❑ use or process animal fats/byproducts
8) Discharge points/ Receiving waters:
How many discharge points (ditches, pipes, channels, etc.) convey stormwater from the property? 6
What is the name of the body or bodies of water(creek, stream, river, lake, etc.) that the facility stormwater
discharges end up in? Irwin Creek
Receiving water classification: c
Is this a 303(d) listed stream? Yes Has a TMDL been approved for this watershed? Yes
If the site stormwater discharges to a separate storm sewer system, name the operator of the separate storm
sewer system (e.g. City of Raleigh municipal storm sewer). Charlotte-Mecklenburg MS4
List discharge points (outfalls)that convey discharge from the site (both on-site and off-site) and location
coordinates. Attach additional sheets if necessary, or note that this information is specified on the site plan.
Stormwater Outfall No. Moo,
Latitude (degrees/minutes/seconds): In SWPPP-Facility Map N
Longitude (degrees/minutes/seconds): In SWPPP-Facility Map W
Stormwater Outfall No. M002
Latitude (degrees/minutes/seconds): In SWPPP-Facility Map N
Longitude (degrees/minutes/seconds): In SWPPP-Facility Map W
Stormwater Outfall No. M003
Latitude (degrees/minutes/seconds): In SWPPP-Facility Map N
Longitude (degrees/minutes/seconds): In SWPPP-Facility Map W
Stormwater Outfall No. MOOS
Latitude (degrees/minutes/seconds): In SWPPP-Facility Map N
Longitude (degrees/minutes/seconds): In SWPPP-Facility Map W
Stormwater Outfall No. M006
Latitude (degrees/minutes/seconds): In SWPPP-Facility Map N
Longitude (degrees/minutes/seconds): In SWPPP-Facility Map
Stormwater Outfall No. Moog only
Latitude (degrees/minutes/seconds): In SWPPP-Facility Map N
Longitude (degrees/minutes/seconds): In SWPPP-Facility Map W
Stormwater Outfall No. only
Latitude (degrees/minutes/seconds): N
Longitude (degrees/minutes/seconds): W
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NCG060000 N.O.I.
9) Does this facility have any other NPDES permits?
I No
❑ Yes
If yes, list the permit numbers for all current NPDES permits for this facility:
10) Does this facility have any Non-Discharge permits (ex: recycle permit)?
I No
❑ Yes
If yes, list the permit numbers for all current Non-Discharge permits for this facility:
11) Does this facility employ any best management practices for stormwater control?
❑ No
Pi Yes (Show any structural BMPs on the site diagram.)
If yes, please briefly describe: BMPs onsite include:curbing,stored materials properly enclosed and covered,routine pick-up of trash
and debris,routine inspections and observations(regarding stored materials,loading/unloading processes,conditions of outfalls),and
stabilization of areas where erosion may occur.
12) Does this facility have a Stormwater Pollution Prevention Plan?
❑ No
I Yes
If yes, when was it implemented? 2/13/2020
13)Are vehicle maintenance activities occurring at this facility?
I No ❑ Yes
14) Hazardous Waste:
a) Is this facility a Hazardous Waste Treatment, Storage, or Disposal Facility?
No ❑ Yes
b) Is this facility a Small Quantity Generator(less than 1000 kg. of hazardous waste generated per month)of
hazardous waste?
I No ❑ Yes
c) Is this facility a Large Quantity Generator(1000 kg. or more of hazardous waste generated per month)of
hazardous waste?
I No ❑ Yes
d) Is hazardous waste stored in the 100-year flood plain?
I No ❑ Yes If yes, include information to demonstrate protection from flooding.
e) If you answered yes to questions b. or c., please provide the following information:
Type(s) of waste:
How is material stored:
Where is material stored:
How many disposal shipments per year:
Name of transport/disposal vendor:
Vendor address:
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NCG060000 N.O.I.
15) Certification:
North Carolina General Statute 143-215.6E (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; or who
knowingly makes a false statement of a material fact in a rulemaking proceeding or contested case under this Article; or
who falsifies, tampers with, or knowingly renders inaccurate any recording or monitoring device or method required to be
operated or maintained under this Article or rules of the Commission 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 coverage under the referenced General Permit. I understand that coverage under this permit
will constitute the permit requirements for the discharge(s) and is enforceable in the same manner as an
individual permit.
I certify that I am familiar with the information contained in this application and that to the best of my
knowledge and belief such information is true, complete, and accurate.
Printed Name of Person Signing: Kevin Winston
Title: Global Environmental Field Leader
(Signature of Applicant) ( ate Signed)
This Notice of Intent must be accompanied by a check or money order for$100.00, made payable
to: NCDEQ. Do not send the check or money order separately.
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SWU-221 Last revised 6/24/14

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A 4525 Statesville Road, Charlotte,NC 28269
Figure 1 -General Location Map
Property Boundary Datum: WGS 1984
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Location: 1 inch = 3,500 feet
St35°16'56• .15"N
80°50'8.22"W
February 2020
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/000 N.Mopac Expiry.Suite 200
Austin,TX 78731

M001: 35°16'55.73"N 80°50'10.36"W
M002: 35°16'56.49"N 80°50'10.69"W M006 :,
M003: 35°16'57.29"N 80°50'11.02"W X
M005: 35°16'58.36"N 80°50'10.16"W M005
M006: 35°16'58.79"N 80°50'8.53"W (92%impervious) `. µ M007: 35°16'58.21"N 80°50'6.96"W Moo?
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Legend Source: ESRI World Imagery N Amazon-HCL1
A4525 Statesville Road, Charlotte,NC 28269
QProperly Boundary - Monitored Outfall Figure 2-Site Drainage Map
_._1 HCL1 Property Boundary 0 Outfall Datum: WGS 1984
i t Industrial Activity Area A Diesel Generator
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L .j Drainage Areas —►. Drainage Flow • Location: 1 inch = 125 feet
Employee Parking — Underground Drainage Flow bst•
35°16'56.15"N
80°50'8.22"W
February 2020
7000 N.Mopac Expwy,Suite 200
Austin,TX 78731

NCG060000 N.O.I.
Final Checklist
This application will be returned as incomplete unless all of the following items have been included:
Check for$100 made payable to NCDEQ. Must be included with this application (not sent separately).
❑ This completed application and all supporting documents.
❑ A site diagram showing, at a minimum, (existing or proposed):
(a) outline of drainage areas, (b) stormwater management structures, (c) location of stormwater outfalls
corresponding to the drainage areas, (d) runoff conveyance features, (e) areas where materials are stored,
loaded, and unloaded, (f) impervious areas, (g) site property lines.
❑ Copy of county map or USGS quad sheet with the location of the facility clearly marked on the map.
Mail the entire package to:
DEMLR-Stormwater Program
Dept. of Environmental Quality
1612 Mail Service Center
Raleigh, North Carolina 27699-1612
Note
The submission of this document does not guarantee coverage under the General Permit.
For questions,please contact the DEMLR Regional Office for your area.
DEMLR Regional Office Contact Information:
Asheville Office [phone] --,win =111111 <'
Fayetteville Office [phone] -IRaI `g}r"�4
Mooresville Office [phone]
Raleigh Office [phone] ° lima
Washington Office ...[phone] -�---`-- in ,
Wilmington Office [phone] � : °,o'er
Winston-Salem [phone]n�
Central Office [phone]
\ rrnngtan
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