NCG060401_2021 DMR_20210422

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NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCGO6O0O0
Food and Kindred
Click here for instructions
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit Data Monitoring Report (DMR) Upload form within
30 days of receiving sampling results. Mail the original, signed hard copy of the DMR to the appropriate DEMLR Regional Office.
Certificate of Coverage No. NCG06 0401
Person Colk
Facility Name: Amazon.com Services LLC - CLT4
Laboratory
Facility County: Mecklenburg
Laboratory
Discharge during this period:❑✓ Yes ❑ No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample per
If so, which Tier (I, II, or III)? Tier I
A copy of this DMR has been uploaded electronically via https://edocs.deg.nc.g
Date Uploaded: L412__�O JV
acting Samples: Parker Cliatt
Name: Eurofins TestAmerica
Cert. No.: 269
iod for any benchmark exceedances? ✓❑ Yes ❑ No
ov Forms SW-DMR ✓❑ Yes ❑ No
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Parameter
Outfall001
Outfall002
Outfall003
Outfall004 Outfall
Code
C
C
N/A
Receiving Stream Class
C
C
3/31/2021
0.44
20
7.65
3.9
3/31/2021
0.44
22
7.28
3.1
3/31/2021
0.44
12
7.85
< 1.3
N/A
Date Sample Collected MM/DD/YYYY
3/31/2021
46529
24-Hour Rainfall in inches
0.44
CO530
TSS in mg/L (100 or 50*)
15
00400
pH in standard units (6.0-9.0)
7.54
00556
Oil & Grease in mg/L (30)
2.9
Fecal Coliform per 100 ml of
N/A
N/A
N/A
N/A
31616
freshwater (if required) (1000)
Enterococci per 100 ml of saltwater
N/A
N/A
N/A
N/A
61211
(if required) (500)
Chemical Oxygen Demand in mg/L
14
< 5
5.4
10
00340
(120)
Additional parameters for outfalls in drainage
areas that use
>55 gallons per
month of new hydraulic oil on average
Estimated New Motor/Hydraulic Oil
N/A
N/A
N/A
N/A
NCOIL
Usage ingal/month
00552
Non -Polar Oil & Grease in mg/L (15)
N/A
N/A
N/A
NIA
W IT ) nd or;—nm Nurcary Areas (PNA)
* Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout aters r a
have a benchmark TSS limit of 50 mg/L. All other water classifications have a benchmark of 100 mg/L
Notes (optional):
"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, 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
Authorized Individual
Date
Email Address v [e-mail] Phone Number [phone]