NCG060413_2021 DMR_20211021

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCGO60000
Food and Kindred
ick 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 0413
Person Collecting Samples: Parker Cliatt
Facility Name: Amazon.com Cervices LLC - DLT3
Laboratory Name: Eurc ins TestAmenca
Facility County: Cabarrus
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? ✓RYes Q No
If so, which Tier (I, If, or III)? Tier I
A copy of this DMR has been uploaded electronically via https://edocs.deg.nc.gov/Forms/SW-DMR
Date Uploaded:
Yes FiNo
Analytical Monitoring Requirements for Outfalls with Industrial Activities — Benchmarks in (Red)
Parameter
Code
Parameter
Outfall001
Outfall002
Outfall003
Outfall
Outfall
N/A
Receiving Stream Class
C
C
C
N/A
Date Sample Collected MM/DD/YYYY
9/8/2021
9/812021
9/8/2021
46529
24-Hour Rainfall in inches
0.3
0.3
0.3
C0530
TSS in mg/L (100 or 50*)
12
7.8
11
0400
PH in standard units (6.0-9.0
'
7.29
7.14
6.54
�_O_
0556
Oil & Grease in mg/L `
< 1.4
< 1.4
< 1.4
31616
Fecal Coliform per 100 ml of
freshwater (if required)
N/A
N/A
N/A
61211
Enterococci per 100 ml of saltwater
(if required)
N/A
N/A
N/A
00340
Chemical Oxygen Demand in mg/L
13
6.3
13
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
N/A
00552
Non -Polar Oil & Grease in mg/ L
N/A
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 "
(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 tion, includin11Vg the ssibility of fines and imprisonment for knowing violations."
FrI
co I g 21
Signature of Perrnittee'ar Delegates! Authorized Individual Bate
[e-mail]
Email Address
[phone]
Phone Number