NCGNE1537_Application_20220503

FOR AGENCY USE ONLY
NCGNE 1
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Dwism of Energy, Mmera4 and Land ResourcesMAYPollutant Discharge Elimination System MAY U.j 427
No Exposure Certification for Exclusion D -SbntntlaterPmM
NCGNE0000
Submission of this No Exposure Certification constitutes notification thatyouur facility, does no' .requirea,permit_for
stormwater discharges associated with industrial activity in the State of North Carolina because it qualifies for a no
exposure exclusion. A condition of no exposure at an industrial facility means all industrial materials and activities
arc . p1.Jti`mc eXiaptivisj iv PI$rent cxpv5ui2 v iairry Srwr, ai iri2iyvcd by aTwlep
and/or runoff. Industrial materials or activities include, but are not limited to:
• material handling equipment or activities, • by-products,
• industrial machinery, • final products, or
• raw materials, • waste products.
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Iviatenal nanaung actiwues Incwae ine storage, loaamg ana unloaaing, transportauon, or conveyance or any raw
material, intermediate product, final product, or waste product.
A storm resistant shelter is not required for industrial materials stored in the following container types, provided
the containers are not deteriorated and do not leak:
• drums,
• oarreis,
• tanks, and
• sunuar comaurers.
For new facilities, applicants should apply no earlier than 60 days before the start of operation. This will allow
DEMLR staff to verify conditions during active operation. For facilities that alreadv have an industrial stormwater
permit in North Carolina, DEMLR must approve your application for No Exposure Certification before this exclusion
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continue to abide by the terms and conditions of the current permit.
A No Exposure Certification must be provided for each facility qualifying for the no exposure exclusion. Additionally,
the exclusion trom NPULb permitting is available on a tacility-Wloe basis only — not for moiV10ual outtalls. it any
industrial activities or materials are, orwill be, exposed to precipitation, the facility is not eligible forthe no exposure
exclusion. By signing and submitting this No Exposure Certification form, you certify that a condition of no exposure
pvigtg At this farility nr gitp and arp nhliaatprl to rmmnly with tha tprmg and rnnditinng of &n rFR 177 ?rfal
For new facilities, applicants should not apply more than 60 days before the start of operation date. This
If approved, your conditional No Exposure Certification has no expiration date but must be self -recertified at least
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https / deci.nc.gov/about/divisions/energy-mineral-Iand-resources/nPdes-no-exposure.
Directions: Print or type all entries on this application form. Send the original, signed application to: NCDEMLR
btormwater. Program, 1b1Z MSc, Kalelgn, Nc Z/bw-1biz I ne submission of this Corm does not guarantee
exclusion from NPDES stormwater permitting. Prior to exclusion from NPDES stormwater permitting a site
inspection will be conducted.
Page 1 of 6

Page 2 of 6

• ,- •, • • •- • ee •- •-u. -•
Name of legal organizational entity:
Legally responsible person (as signed in Item 7 below):
Amazon.com Services LLC
Belinda McDowell
Street address:
City:
State
Zip Code
PO Box 80842
Seattle
WA
98108
Telephone number:
Email address:
206-839-6033
[e-mail]
Type of Ownership:
i3overnment
❑ County ❑ Federal ❑ Municipal ❑ State
® Business (If ownership is business, a copy of NCSOS report
must be included with this application)
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2. Industrial Facility (facility requesting exclusion):
Facility name:
Facility environmental contact:
Amazon.com Services LLC - DRT3
Leslie Hams
Street address:
Telephone number:
4524 New Bem Avenue
941-962-1049
Email adrlrper
[e-mail]
Raleigh I Wake
INC I27610 I
35'47'40.79"
N, 78°33'36.08" W
Longitude'ofentrance:
Parcel Identification Number (PINj:
1734-054088; 1734-04-0982; 1734-044376; 1734-05-9036;
1734-04-9744; 1734-14.3715; 1734-04-9541; 1734-14-3511; 1734-04-9216; 1734-14-3205I
Date operation began:
I Standard Industrial Classification (SIC) Code:
1/24/2022
4225
Brief description of the types of industrial
activities and products produced at this facility:
Facility serves as a distribution warehouse of consumer goods.
I Name of consultant: I Consulting firm:
Parker Cliatt I ERM
I Strppt addrpsc I city- I Statp and Tin rndp-
300 W. Summit Avenue,#330 Charlotte 128203
Telephone number: Email address:
706-541-8345 1 oarker.cliatt0amazon.com
4. Exposure Checklists
Are any of the following materials or activities exposed to precipitation, now or in the foreseeable future? If you
answer "Yes" to any of these items, you are not eligible for the no exposure exclusion.
Using, storing, or cleaning industrial machinery or equipment, and areas where residuals from
using, storing, or cleaning industrial machineryorequipment remain and are exposed to
stormwater
I❑'yes Fm No El N/A
Materials or residuals on the ground or in stormwater inlets from spills/leaks
❑ Yes © No ❑ N/A
Materials or products from past industrial activity
❑ Yes IN No ❑ N/A
Material handling equipment (except adequately maintained vehicles)
❑ Yes W No ❑ N/A
regc .; ui 6

Materials or products during lbading/unloading ortransporting activities
❑ Yes ®1Vo ❑-ti/A
Materials or products stored outdoors (except final products intended for outside use [e.g., new
❑ Yes ® No ❑ N/A
cars] where exposure to stormwater does not result in the discharge of pollutants)
Materials contained in open, deteriorated, non -sealed', or leaking storage drums barrels, tanks,
El Yes ®No ❑NIA
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Materials or products handled/stored on roads or railways owned or maintained by the discharger
❑ Yes ® No ❑ N/A
Final products that would be mobilized in stormwater discharges (e.g., rock salt)
❑ Yes ® No ❑ N/A
L Waste material (except waste in covered, non -leaking containers [e.g., dumpstersT)
I ❑ Yes A No LJ N/A
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'Particulate matter or visible deposits of residuals from roof stacks and/or vents not otherwise
❑Yes 0 No ❑ N/A
regulated (i.e. under an air quality control permit) and evident in the stormwater outflow
Empty containers that previously contained materials that are not properly stored (i.e., not closed
r _ „_ ,,,,
and stored upside down to prevent precipitation accumulation)
Yes
urea m No U N/A
Dui e.. cnic. iv. n3ia, as w�ii as ui wna, vm iota, ienna auu aimiiat wuiaine+a aiu�eu uuiaiue, i,aa
❑Yes NO ❑ N/A
the facility had any releases in the past three (3) years?
'Sealed means banded or otherwise secured and with locked or non -operational taps or valves.
Above Ground Storaee Tanks IASTSI and Secondary Containment
If you answer "No" to any of the following items, you are not eligible for the no exposure exclusion
Are exterior ASTs or piping free of rust, damaged or weathered coating, pits, or deterioration, or I ❑ yes 0 No ❑ N/A
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Is secondarycontainment provided for all exterior ASTs? If so, is it free of any cracks, holes, or
evidence of leaks, and are drain valves maintained locked shut?
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barrels, etc.) with a capacity of more than 660-gallons? I ❑ Yes R No ❑ N/A
Is secondary containment provided for above ground storage containers stored in close proximity I ❑ Yes No ❑ N/A
to each other with a combined capacity of more than 1,320 gallons?
Is sendary containment provided for Title III section 313 Superfund Amendments and
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Is secondarycontainment provided for hazardous substances designated in 40 CFR §116? ❑ Yes IW No ❑ N/A
Are release valves on all secondary containment structures locked? ❑ Yes ® No ❑ N/A
Other information
Ifyou answer "Yes" to any of the following items, you might not be eligible for the no exposure exclusion. A more
in-depth evaluation of the site circumstances may be required.
Are vehicles used in material handling in disrepair and/or leaking fluid?
Does this facility, store used, recycled,. or otherwise reciaimed_pallets outside?
❑ Yes X No ❑ N/A
❑ Yes ® No ❑ N/A
Does this facility have coal piles on site?
❑ Yes W No ❑ N/A
Does this facility store other fuel sources outside in piles, such as wood chips, sawdust, etc.?
❑ Yes ® No ❑ N/A
Page 4 (if 6

iDoes this facility have air emissions associated withindustrialactivity (e.g., degreasing operations, ❑'Yes B No ❑ NIA
plating, painting, or metal finishing)?
if yes:
Describe the industrial activity:
Are those emissions permitted by an Air Quality Permit? LJ Yes LJ No
Please specify:
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 Non -Discharge permits (e.g. recycle permit).
If checked, list the permit numbers for all current Non -Discharge permits:
❑ This facility stores hazardous waste in the 100-year
w�wc.i, �w�i i uc uvry a is a� ca a M� „ic�ic� n vu i i iwmi ig.
❑ This facility is a (mark all that apply)
Cl Hazardous Waste Generation €acuity
❑ Hazardous Waste Treatment Facility
Li Hazardous waste storage I-acmty
❑ Hazardous Waste Disposal Facility
If checked, indicate:
Type(s) of waste:..
• How material is stored:
• Number of waste shipments per year:
• Name of transport/disposal vendor:
• Vendor address:
❑ This facility is located on a Brownfield or SUPERFUND site.
If checked, briefly describe the site conditions:
❑ This facility is located on Native American Lands.
6. Required Items (Application will be returned unless all of the following items have been included):
®Copy of most recent Annual Report to the NC Secretary of State (if applicable)
B This completed application and any supporting documentation
B Copy of county map or USGS quad sheet with the location of the facility clearly marked
Pages of 6

7_ Applicant Certification
NorthCarolina General Statute 143-215.613 (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 ... shallbeguilty of a Class 2 misdemeanor which may include a fine not
to exceed ten thousand dollars ($10,000).1 hereby request exclusion from NPDES stormwater permitting.
Under penalty of law, l certify, that:
B7 1 am the person responsible for the industrial activity, for satisfying the requirements of this exclusion, and for any civil
or criminal penalties incurred due to violations of this exclusion.
® I have read and understand the eligibility requirements for claiming a condition of "no exposure' and obtaining an
® There are no discharges of stormwater contaminated by exposure to industrial activities or materials from the industrial
facility or site identified in this document (except as allowed under 40 CFR 122.26(g)(2)).
�J I understand that I am obligated to maintain no exposure conditions and complete a Self -Recertification form at least
once each year and, If requested, provide this certification to the operator of the local municipal separate storm sewer
system (MS4) into which the facility discharges (where applicable). I understand that I must allow the North Carolina
Division of Energy, Mineral, and Land Resources, or MS4 operator where applicable, to perform inspections to confirm
the condition of no exposure and to make such inspection reports publicly available upon request I understand I must
keep a copy of annual recertifiications on file at the facility.
bt1 I understand that in the event that the site no longer qualifies for a No Exposure Exclusion that I must obtain coverage
under an NPDES permit prior to any point source discharge of stormwater from the facility.
® The information submitted in this NOI is, to the best of my knowledge and belief, true, accurate, and complete based on
n y niyun y of iiic ycu ii h' Nc wiia rriiu iiaucgc u4c ayoicui, v G we yci avua unc iry oNuna u c iu gaincn g inc
information.
Printed Name of Person Signing: Belinda McDowell
Title:
4 — U
Sign re of App scant Date signed
Mail the entire oackaee to: DEMLR — Stormwater Proeram
Department of Environmental Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
Page 6 of 6

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:11 Glananllacatl leI
0.500 Bullock Farm Rnad
Raleigh, NC21610

LIMITED LIABILITY COMPANY ANNUAL REPORT In
NAME OF LIMITED LIABILITY COMPANY: ArriaZon.COf11 Services LLC
SECRETARY DFaTATE1D,NUMRFR:.1,938649. STATE OF FORMATION: DE
REPORT FOR THE CALENDAR YEAR: 2021
SECTION A:
1. NAME OF REGISTERED AGENT: Corporation Service Company
2. SIGNATURE OF THE NEW REGISTERED AGENT:
- filed' Annual'
Report
1938649
SIGNATURE CONSTITUTES CONSENT TO THE APPOINTMENT
3. REGISTERED AGENT OFFICE STREET ADDRESS & COUNTY 4. REGISTERED AGENT OFFICE MAILING ADDRESS
2626-GIenwood,AvP ttP SSD.
2625 Genw_ood.Ave5te550.
Raleigh, NC 27608 Wake County Raleigh, NC 27608
SECTION B: PRINCIPAL OFFICE INFORMATION
1. DESCRIPTION OF NATURE OF BUSINESS:,FUlfillment_6eriter.and,custon:ler-senFlCe-holding-Company
2. PRINCIPAL OFFICE PHONE NUMBER: [phone] 3. PRINCIPAL OFFICE EMAIL: Privacy Redaction
4. PRINCIPAL OFFICE STREET ADDRESS
5. PRINCIPAL OFFICE MAILING ADDRESS
41,0 Terry.Av,e,N. 41 O TerryAve 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 service -disabled veteran -owned small business
SECTION C: COMPANY OFFICIALS (Enter additional company officials in Section E.)
NAME: M]CHAFJ-D-DEAL. NAME:
TITLE: Manager TITLE:
ADDRESS:
410 TERRY AVE N
SFA'ffCE,'111IA�3S1`09
F bbRESS:
NAME:
TITLE:
ADDRESS:
SECTION D: CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a personlbusiness entity.
MICHAEL D. DEAL
.Sr3NA7.URE
Fonn must be signed by a Company Official fisted under Section C of This form.
4/2/2021
DATE
MICHAEL D. DEAL Manager
Print or Type Name of Company Official Print or Type Title of Company Official
This Annual-Repor -has"been-filed eiectronicaliv.
MAIL TO: Secretary of State, Business Registration Division, Post Office Box 29525, Raleigh, NC 27626-0525

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The undersigned, Desmond Eppel, hereby certifii the following as of the date of this Certificate:
1. I am a Senior Corporate counsel responsible for overseeing corporate governance matters
relating to the global subsidiaries (collectively, the "Subsidiaries') of Amazon.com, !nc. In such
capacity, I have access to the original books and records of the Subsidiaries and I have the
requisite knowledge and information to make and deliver this Certificate.
2. The persons listed below are duly appointed and qualified by a power of attorney to act on
behalf of Amazon.com Services LLC (the "Comoam") and hold the titles specified opposite
such persons' name below
Name
Tide
Date Appointed
Michael Boese
Power of Attorney
09/1012020
BeSnda McDowell
Power of Attorney
03/11/2022
Amber Nickens
Power of Attorney
09/10,12020
Cedric Robinson
Power of Attorney
03/11/2022
Mark Tanner
Power of Attorney
O5/17/2021
V'xnal Vijaykumar Power of Attorney 09/10/2020
Paul Wilson Power of Attorney 09/10/2020
3. All necessary corporate action having been taken in respect thereof, the persons listed above
are duly authorized for and on behalf of the Company to execute and file environmental and
permitting applications, and related documents with government authorities.
IN WITNESS WHEREOF, the undersigned has executed this Certificate on wrC' 14, 2022
Name: Desmond Eppel
Title: Senior Corporate Counsel,
Global Subsidiaries