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Of course I don't use streaming and my downloads are pretty much restricted to PDF's. Even those wouldn't be considered downloads due to deep linking prevention.
The only problems I experience are related to mails and log times not being the same.
There are a few major hubs in NA which all things are go though.
West Coast, Chicago and NY. There may be a couple more.
In routing your site from CA to NC your going to catch all three both ways.
If your site is commercial I might consider a local host. However be WARNED even some local host cross country. You'll need to verify that.
If it's a hobby site or your just beginning you'll be OK.
However, perhaps one thing to consider is how easy it is to get technical help. For example, I live in Sydney Australia, my host comapny is in Canberra Australia, almost a local phone call, but the servers are in the US. This seems to work well for me.