NCG060419_2021 DMR_20220120

NCDEQ Division of Energy, Mineral and Land Resources
Stormwater Discharge Monitoring Report (DMR) Form for NCG060000
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 0419 Person Collecting Samples: N/A
Facility Name: Amazon.com Services LLC - DLT7 I Laboratory Name: Eurofins TestAmerica
Facility County: Guilford Laboratory Cert. No.: 269
Discharge during this period: 0 Yes [xj No (if no, skip to signature and date)
Has your facility implemented mandatory Tier response actions this sample period for any benchmark exceedances? ❑ Yes 0 No
If so, which Tier (I, 11, or 111)?
A copy of this DMR has been uploaded electronically via https://edocs.deg.nc.gov/Forms/SW-DMR ® Yes ❑ No
Date Uploaded: 1/20/2022
Analytical Monitoring Requirements for Outfaiis with industrial Activities — Benchmarks in Red)
Parameter
Code
Parameter
Outfail
Outfall
Outfall
Outfall
Outfan
N/A
Receiving Stream Class
I
N/A
Date Sample Collected MM/DD/YYYY
46529
24-Hour Rainfall in inches
C0530
TSS in mg/L (100 or 50*)
pH in standard units (6.0-79.0 FW,
00400
6.8 — 8.5 SW
31616
Fecal Coliform per 100 ml of
freshwater (if required) (1000)
61211
Enterococci per 100 ml of saltwater
(if required) (4b
Chemical Oxygen Demand in mg/L
00340
(120)
Additional parameters for outfalls in drainage areas that use >55 gallons per month of new hydraulic oil on average
NCOIL I Estimated New Motor/Hydraulic Oil I
Usage in gal/month
00552 Non -Polar Oit & Grease in mg/L I
I
Outtalls to Outstanding Resource Waters (ORW), High Quality Waters (HQW), Trout Waters (Tr) and Primary Nursery Areas (PNA)
have a benchmark TSS limit of !, 6 ;6 . 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
fats in rmagpn, inclRding the possibility of fines and imprisonment for knowing violations."
Signature,of Permittee or Delegated Authorized individual
[e-mail]
Email Address
Date
[phone]
Phone Number