NCG060454_Application_20240917

FOR AGENCY USE ONLY RECEIVED
NCG06 Q V tJ SEP 1 7G ZD�
Assigned to:
ARO FRO R RRO WARO WIRO WSRO
Division of Energy, Mineral, and Land Resources Land Quality Section
National Pollutant Discharge Elimination System
NCG060000 Notice of Intent
This General Permit covers STORMWATER DISCHARGES associated with activities under the following Standard
Industrial Classifications: SIC 20[Food and Kindred Products],SIC21[Tobacco Products), SIC 283[Drugs], SIC284
[Soaps, Detergents, &Cleaning Preparations;Perfumes, Cosmetics, & Other Toilet Preparations], SIC422[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 assigned in Item(7) below:
Amazon.com Services LLC Paul Wilson
Street address: City: State: Zip Code:
PO Box 80842,Seattle,WA 98108 Seattle WA 98108
Telephone number: Email address:
1 800 575-0171 [e-mail]
Type of Ownership:
Government
❑County ❑Federal ❑ Municipal ❑State
Non-government
® 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-SNC6 Kendris Cabral
Street address: City: State: Zip Code:
6255 Shumard Street Concord NC 28027
Parcel Identification Number(PIN): County:
46918794320000 Cabarrus
Telephone number: Email address:
1 800 575-0171 [e-mail]
4-digit SIC code: Facility is: Date operation is to begin or began:
4225 1 IN New ❑ Proposed ❑ Existing 1 11 27 2024
Latitude of entrance: Longitude of entrance:
35.435419 1 -80.6814700
Brief description of the types of industrial activities and products manufactured at this facility: Delivery Station used to ship
food,grocery items,and other products with the goal of getting orders to customers in less than 4 hours.
This facility processes meat: ❑Yes® No
If the stormwater discharges to a municipal separate storm sewer system(MS4),name the operator of the M54:
W N/A
Page 1 of 5

3. Consultant(if applicable):
Name of consultant: Consulting firm:
Street address: City: 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: ®This water is impaired.
001 CoddleCreek
C El This watershed has a TMDL.
Latitude of outfall: Longitude of outfall:
35.43327 -80.68269
Brief description of the industrial activities that drain to this outfall:
Loadin un loading of eoods for warehousing,equipment fueling and waste store e.
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?
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 NOI.
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 Non-Discharge permits(e.g.recycle permit).
If checked,list the permit numbers for all current Non-Discharge permits:
Rl This facility uses best management practices or structural stormwater control measures.
If checked, briefly describe the practices/measures and show on site diagram:
Indoor storage,covered waste containers inspections,housekeeping,training, preventative maintenance
R)This facility has a Stormwater Pollution Prevention Plan(SWPPP).
If checked,please list the date the SWPPP was implemented:
to be implemented upon anticipated launch of 11 27 2024
❑This facility stores hazardous waste in the 100-year floodplain.
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: Typperrs)of waste:Sourc of waste is spilled o brok n consuf�er
Less than 1000 roducl packaged for retail sale.Most commonly are 1�lammables and
How material is stored: Where material is stored: A secured hazardous waste storage a ea
on spill containment pallets inside the warehouse.
Number of waste shipments per year:55-gallon poly drums or Name of transport/disposal vendor:
55- allon steel drums depending on the waste US Ecology
Transport/disposal vendor EPA ID: Vendor address:
NCTF00000067 01 S.Capitol I Suite 1000 Boise Idaho 8,3702
❑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):
In Check for$120 made payable to NCDEQ
® Copy of most recent Annual Report to the NC Secretary of State
®This completed application and any supporting documentation
® A site diagram showing,at a minimum,existing 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 property lines
IN Copy of county map or USGS quad sheet with the location of the facility clearly marked
Page 3 of 5

7. Applicant Certification:
North Carolina General Statute 143-215.68(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($50,000).
Under penalty of law,I certify that:
® 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.
®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.
Ii 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: NA Environmental Leader-Last Mile
/2 4
(Signature of Applicant) (Date Signed)
Mail the entire package to: DEMLR—Stormwater Program
Department of Environmental Quality
1612 Mail Service Center
Raleigh, NC 27699-1612
Page 4 of 5

Additional Outfalls
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 oP 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 calendaryear?
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 arc used each month when averaged over the calendar year?
Page 5 of 5

OSNCS
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euvvmr Coddle Creek act o
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re rr,v far benthoa and turbidity)
a" Legend
qq. _ C.%v Property Boundary
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Figure 1
,. Site Location Map
Sim SCN6
- - 6255 Shunnard Street
Concord,NC 28027
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Gram
q 03WN ktloale N o A
W for 35,43327 4%6820
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Charlotte
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Legend
Shipping Dock Area Employee parking Area Dunpstar(s)-General LooOon
O Hydraulic Auger
Hydraulic Compactor
OUPell
• Sampie Location
Y Amazon SNC6 Ej 5ymavater lMec
Su loSame Day Facility A
® Stomrwater Outlet
G Emergency Generator(Diesel)
EJ Roof Draln
—> Surface Row Direction
Drainage Area i
Underground Stormwabe Piping
Q Building/Co red Structure
Detention Basin
Drainage Area
Impervious Area
Mobile Fueling Area
ey �.�• Property Boundary
�. .^ Notes:
"ee f 1.Sae Ares k apprm.21.81 acres.
g 2.Impervious Area of Delnage Area 1 is arm..
e f - 10.36 acres(47.50%of the s0e)
3.Availabla topographic iMmmation c not
..to aner s4e devebprrenl.
4.Spill kits are boated near areas of industrial
5 aciivRes.
5.See Plan for detaik on authorized NSVVTs.
Figure 2
0u1teU 007 Drainage Area Site Map
t. Site SCN6
Sampk Point Ot 6255 Shumard Street
imcewiaus raralArea Concord,NC 28027
e to 3M o.amasc ara., senate cres) I.. %impewbus
a
r,a r r0.35 z1.er 4zs -
ERM

LIMITED LIABILITY COMPANY ANNUAL REPORT
NAME OF LIMITED LIABILITY COMPANY: AInazon.corn Services LLC
Hing Office Um Only
SECRETARY OF STATE ID NUMBER: 1938649 STATE OF FORMATION: DE E-Filed Annual Report
1938649
CA202304102650
REPORT FOR THE CALENDAR YEAR: 2022 2/1012023 03:33
SECTION A: REGISTERED AGENT'S INFORMATION Changes
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: 2062661000 3.PRINCIPAL OFFICE EMAIL: Privacy Redaction
4. PRINCIPAL OFFICE STREET ADDRESS 5.PRINCIPAL OFFICE MAILING ADDRESS
410 Terry Avenue North 410 Terry Avenue North
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: Michael Deal NAME: NAME:
TITLE: Manager TITLE: TITLE:
ADDRESS: ADDRESS: ADDRESS:
410 Terry Avenue North
Seattle,WA 98109
SECTION D:CERTIFICATION OF ANNUAL REPORT. Section D must be completed in its entirety by a person/business entity.
Michael Deal 2/10/2023
SIGNATURE DATE
Form must be signed by a Company Official listed under Section C of This form.
Michael 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 Box29525,Raleigh,NC27626-0525