NCG060398_2021 DMR_20211021

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCGO60000
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 0398
Person Collecting Samples: Darrin Peine
Facility Name: Amazon.com Services LLC - DLT1
Laboratory Name: Eurofins TestAmerica
Facility County: Mecklenberg
Laboratory Cert. No.: 269
Discharge during this period:
✓
Yes
'
No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? E]Yes 0 No
If so, which Tier (I, II, or 111)?
A copy of this DMR has been uploaded electronically via https://edocs.deg.nc.gov/Forms/SW-DMR MYes No
Date Uploaded:
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Code
Parameter
Outfall001
Outfall002
Outfall
Outfall
Outfall
N/A
Receiving Stream Class
WS-IV
WS-IV
N/A
Date Sample Collected MM/DD/YYYY
9/16/2021
9/16/2021
46529
24-Hour Rainfall in inches
0.16
0.16
C0530
TSS in mg/L (100 or 501 •
23
83
00400
pH in standard units (6.0-9.0 F
6 6
7 0
6.8 — 8.5 SW)
00556
Oil & Grease in mg/L' )
2.1
2.1
Fecal Coliform per 100 ml of
31616
freshwater (if required) 7
N/A
N/A
61211
Enterococci per 100 ml of saltwater
(if required)
N/A
N/A
Chemical Oxygen Demand in mg/L
00340
41
83
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
Usage in gal/month
N/A
N/A
00552
Non -Polar Oil & Grease in mg/L *_
N/A
N/A
Outfalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS limit of All other water classifications have a benchmark of
',J (Freshwater) (Saltwater)
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 info mation, including the possibility of fines and imprisonment for knowing violations."
�[P2,'
ur Signate of Permittee De or legated Authorize! Individual Bate
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Email Address
[phone]
Phone Number