NCG060429_Application_20220203

FOR AGENCY USE ONLY
NCG06Q02g
Assigned to:
ARO FRO MRO RO WARD WIRO WSRO
Division of Energy, Mineral, and Land Resources Land Quality Section
National Pollutant Discharge Elimination System
NCGO60000 Notice of Intent
This General Permit covers STORMWATER DISCHARGES associated with activities under the following Standard
Industrial Classifications: SIC20 [Food and Kindred Products], SIC21 [Tobacco Products], SIC283 [Drugs], SIC284
[Soaps, Detergents, & Cleaning Preparations, Perfumes, Cosmetics, & Other Toilet Preparations], SIC 422 [Public
Warehousing and Storage —except for 4226]. You can find information on the DEMLR Stormwater Program at
deq.nc.gov/SW.
Directions: Print or type all entries on this application. Send the original, signed application with all required
items listed in Item (6) below to: NCDEMLR Stormwater Program, 1612 MSC, Raleigh, NC 27699-1612. The
submission of this application does not guarantee coverage under the General Permit. Prior to coverage under
this General Permit a site inspection will be conducted.
1. Owner/Operator (to whom all permit correspondence will be mailed):
Name of legal organizational entity:
Legally responsible person as signed in Item (7) below:
Amazon.com Services LLC - NA Environmental Department
Paul Wilson
Street address:
City:
State:
Zip Code:
PO Box 80842
Seattle
WA
98108
Telephone number:
Email address:
951445-T785
[e-mail]
Type of Ownership:
Government
[I County ❑Federal dNunicipal ❑State
Non-govemment
(]Business (If ownership is business, a copy of NCSOS report must be included with this application)
[]Individual
2. Industrial Facility (facility being permitted):
Facility name:
Facility environmental contact:
Amazon.com Services LLC - HRD2
James Mills
Street address:
City:
State:
Zip Code:
805 South Briggs Avenue
Durham
NC
27703
Parcel Identification Number (PIN):
County:
205-18-11
Durham
Telephone number:
Email address:
860-778-5274
'[e-mail]
4-digit SIC code:
Facility is: I
1
Date operation is to begin or began:
4225
Il New ❑ Proposed ❑ Existing 1
December 17, 2021
Latitude of entrance:
Longitude of entrance:
35.972222
-78.874122
Brief description of the types of industrial activities and products manufactured at this facility:
General warehousing facility engaged in the handling, storage, and transportation of merchandise.
This facility processes meat: ❑ Yes No
If the stormwater discharges to a municipal separate storm sewer system (MS4), name the operator of the MS4:
❑ N/A
Page 1 of 5

3. Consukant (if applicable):
Name of consultant
Canmulting firm:
Street address:
CKT-
State:
Zip code:
Telephone number:
Email address:
4. Outfall(s)_At least one outfall is required to be eligible for coverage.
3-4 digit identifier:
Name of receiving water:
Classification:
—Roil
This water is impaired.
MP001
Third frock Creek
WSN
is watershed has a TMDL
Latitude of outfall:
Longitude of outfall:
35.972022
-78.8734
Brief description of the industrial activities that drain to this outfall:
Material loading, unloading, shipping and receiving
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? ❑ Yes ❑+ No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
3-4 digit identifier.
Name of receiving water.
Classification:
❑ This water is impaired.
❑ This watershed has a TMDL.
Latitude of outfall:
Longitude of outfall:
Brief description of the industrial activities dud drain to this outfall:
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? ❑ Yes Il No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
3-4 digit identifier.
Name of receiving water.
Classification:
❑ This water is impaired.
❑ This watershed has a TMDL
Latitude of outfall:
Longitude of outfall:
Brief description of the industrial activities that drain to this outfall:
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? ❑ Yes ❑ No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
3-4 digit identifier:
Name of receiving water.
Classification:
❑ This water is impaired.
❑ This watershed has a TMDL
Latitude of outfall:
Longitude of outfall:
Brief description of the industrial activities that drain to this outfall:
Do Vehicle Maintenance Activities occur in the drainage area of this outfall? ❑ Yes ❑ No
If yes, how many gallons of new motor oil are used each month when averaged over the calendar year?
All outfalls must be listed and at least one outfall is required. Additional outfalls may be added in the section
"Additional Outfalls" found on the last page of this NOL
Page 2 of 5

S. Other facility Conditions (check all that apply and explain accordingly):
❑ This facility has other NPDES permits.
If checked, list the permit numbers for all current NPDES permits:
❑ This facility has Non4)ischarge permits (eg. recycle permit).
If checked, list the permit numbers for all current Non -Discharge permits:
❑+ This facility uses best management practices or structural stormwater control measures.
If checked, briefly describe the practices/measures and show on site diagram:
Ctlfske detention ponds, indoor storage, covered dumpsters, inspections, housekeeping, training, and preventative maintenance
l This facility has a Stormwater Pollution Prevention Plan (SWPPP).
If checked, please list the date the SWPPP was implemented:
01/21/2022
❑ This facility stares hazardous waste in the 100-year floociplain.
If checked, describe how the area is protected from flooding:
❑ This facility is a (mark all that apply)
❑ Hazardous Waste Generation Facility
❑ Hazardous Waste Treatment Facility
❑ Hazardous Waste Storage Facility
❑ Hazardous Waste Disposal Facility
If checked, indicate:
Kilograms of waste generated each month:
Type(s) of waste:
How material is stored:
Where material is stored:
Number of waste shipments per year.
Name of transport/disposal vendor.
Transport/disposal vendor EPA ID:
Vendor address:
❑ This facility is located on a Brownfield or Superfund site
If checked, briefly describe the site conditions
6. Required Items (Application will be returned unless all of the following items have been included):
O Check for $100 made payable to NCDEQ
l Copy of most recent Annual Report to the NC Secretary of State
+❑ This completed application and any supporting documentation
l A site diagram showing, at a minimum, epsting and proposed:
a) outline of drainage areas
b) surface waters
c) stormwater management structures
d) location of stormwater outfalls corresponding to the drainage areas
e) runoff conveyance features
f) areas where industrial process materials are stored
g) impervious areas
h) site propertylines
O Copy of county map or USGS quad sheet with the location of the facility dearly marked
Page 3 of 5

7. Applicant 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 ... shall be guilty of a Class 2 misdemeanor which may include a fine not
to exceed ten thousand dollars ($10,000).
Under penalty of law, I certify that:
El I am the person responsible for the permitted industrial activity, for satisfying the requirements of this permit, and for any
civil or criminal penalties incurred due to violations of this permit.
O The information submitted in this NOI is, to the best of my knowledge and belief, true, accurate, and complete based on
my inquiry of the person or persons who manage the system, or those persons directly responsible for gathering the
information.
O I will abide by all conditions of the NCG060000 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 hereby request coverage under the NCG060000 General Permit.
Printed Name of Applicant: Paul Wilson
Title: North America Environmental Leader
4A(aihm 47h, 2,,
(Signature of Applicant) (Date Signe )
Mail the entire package to: DE MLR —Stormwater Program
Department of Environmental Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
Page 4 of 5

,: A LIMITED LIABILITY COMPANY ANNUAL REPORT
■
NAME OF LIMITED LIABILITY COMPANY: Arnazon.com Services LLC
�, fMea ttseo*
SECRETARY OF STATE ID NUMBER 1938649 STATE OF FORMATION: DE E - Filed Annual
REPORT FOR THE CALENDAR YEAR 2021 Report
_ 1938649
SECTION A REGISTERED AGENTS INFORMATION
1. NAME OF REGISTERED AGENT: Corporation Service Company
2. SIGNATURE OF THE NEW REGISTERED AGENT:
SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT
3. REGISTERED AGENT OFFICE STREET ADDRESS & COUNTY 4. REGISTERED AGENT OFFICE MAILING ADDRESS
2626 Glenwood Ave Ste 550 2626 Glenwood Ave Ste 550
Raleigh, NC 27608 Wake County Raleigh, NC 27608
SECTION B: PRINCIPAL OFFICE INFORMATION
1. DESCRIPTION OF NATURE OF BUSINESS: Fulfillment center and customer Service holding Company
2. PRINCIPAL OFFICE PHONE NUMBER: [phone] 3. PRINCIPAL OFFICE EMAIL: Privacy Redaction
4. PRINCIPAL OFFICE STREET ADDRESS 5. PRINCIPAL OFFICE MAILING ADDRESS
410 Terry Ave N
410 Terry Ave N
Seattle, WA 98109 Seattle, WA 98109
6. Select one of the following If applicable. (Optional see instructions)
❑ 'The company is a veteran -owned small business
❑ The company Is a servicerdisabled veteran -owned small business
SECTION C: COMPANY OFFICIALS (Enter additional company officials in Section E.)
NAME: MICHAEL D. DEAL NAME:
NAME:
TITLE: Manager TITLE: TITLE:
ADDRESS: ADDRESS: ADDRESS:
410 TERRY AVE N
SEATTLE, WA 98109
SECTION D: CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a personibusiness entity.
MICHAEL D. DEAL
SIGNATURE
Form must be signed by a Company Official listed under Section C of This tone.
4/2/2021
DATE
MICHAEL D. DEAL Manager
Print or Type Name of Company Official Print or Type Title of company Official
This Annual Report has been filed electronically.
MAIL TO: Secretary of State, Business Registration Division, Post Office Box 29525, Raleigh, NC 27626-0525

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Legend
QFacility Boundary (approximately 3 acres)
Dur
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Source: USGS Topo Maps N
Datum: TMN Download (V2.0) A
bst Location:
35058'20.00" IN
78°52'26.84" W
1187 Main Avenue, Surte 2B
Clifton, Nev, Jersey 07011
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Amazon.com Services LLC - HRD2
$05 South Briggs Avenue
Durham, North Carolina 27703
Figure 1 - General Location Map
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January 2022

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