NCG060409_2021 DMR_20211015

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NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCGO60000
Food and Kindred
Click here for instructions
Uplo
within
Complete, sign, scan and submit the DMR via the Stormwater NPDES Permit
Dataof the MR nitorin Repothe appropriat(DMR)
R)MLR ad form.
30 days of receiving sampling Office.
lin results. Mail the original, signed hard copy
Person Collecting Samples: Parker Cliatt
Certificate of Coverage No. N(_'G06 0409 �Laborat�oryName: TestAmerica
Facility Name: Amazon.com Services LLC - GS01
Facility County: Guiltord 9
Discharge during this period: V Yes No (if no, skip to signature and date)
Has your facility implemented mandatoryTier response actions this sample period for any benchmark exceedances7
if so, �kfhirh Tior (1, 11 or 111)?
A copy of this DMR has been uploaded electronically via https //edocs deg nc sov/Forms/SW-DMR
Date Uploaded: 1()ILIIA92-1
for Outfalls with industrial Activities — Benchmarks in (Red)
Analytical Iv9onM-oring
Requirements
Parameter
Parameter
Outfa!! 001 outfal! Outfa!I Outfall
Code
N/A
Receiving Stream Class
WS-IV
N/A
Date Sample Collected MM/DD/YYYY
9/8/2021
46529
24-Hour Rainfall in inches
0.5
C0530
TSS in mg/L 11100 or 50*)
< 2.5
PH in standard units (6.0-9.0 I'M
7.76
00400
6.8 — 8.5 SW)
00556
Oil & Grease in mg/L (30)
N/A
Fecal Coliform per 100 ml of
N/A
31oio
freshwater (if required) (1000)
Enterococci per 100 ml of saltwater
N/A
11211
r ___..._ a� trnnt
Yes 1,11 No
Yes I 1 No
Outfall
Chemical Oxygen Demand in mg/L I5 9
00�40 I(120)
Additional parameters for outfalls in drainage areas that use >55 gallons per month of new hydraulic oil on average
NCOIL Estimated New Motor/Hydraulic Oil N/A
Usage in gal,/month
00552 Non -Polar Oil & Grease in mg/L (15) N/A
* Cattails to Outstanding Resource Waters (ORw), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS limit of Se mg/L. All other water classifications have a benchmark of
FW (Freshwater) SW (Saltwater)
1-1 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 Pelt
�' �1 i
[e-mail]
Email Address
Delegated Authorized Individual
i -DW3S
t.
[phone]
Phone