310292_Permit (Tracking Slip)_20210304

Docu
• SECURED
Certificate Of Completion
Envelope Id: 9FA211 A2B27C4732B5500CB818C57372
Subject: Please DocuSign: AWS310292P20200917.docx
Source Envelope:
Document Pages: 2
Certificate Pages: 1
AutoNav: Enabled
Envelopeld Stamping: Enabled
Time Zone: (UTC-05:00) Eastern Time (US & Canada)
Signatures: 1
Initials: 0
Status: Completed
Envelope Originator:
Bill Dunlap
217 W. Jones Street
Raleigh, NC 27699
[e-mail]
IP Address: 149.168.204.10
Record Tracking
Status: Original
3/3/2021 3:30:01 PM
Security Appliance Status: Connected
Storage Appliance Status: Connected
Holder: Bill Dunlap
[e-mail]
Pool: StateLocal
Pool: North Carolina Department of Environmental
Quality
Location: DocuSign
Location: DocuSign
Signer Events
Signature
Timestamp
Ramesh Ravella
[e-mail]
1-DocuSigned by:
ramt,S(t, ravaLL.
�E3415E2C05B24CD...
North Carolina Department of Environmental Quality
Security Level: Email, Account Authentication
(None)
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
Signature Adoption: Pre -selected Style
Using IP Address: 149.168.204.10
Sent: 3/3/2021 3:31:30 PM
Viewed: 3/4/2021 11:25:42 AM
Signed: 3/4/2021 11:25:54 AM
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Envelope Sent
Certified Delivered
Signing Complete
Completed
Hashed/Encrypted
Security Checked
Security Checked
Security Checked
3/3/2021 3:31:30 PM
3/4/2021 11:25:42 AM
3/4/2021 11:25:54 AM
3/4/2021 11:25:54 AM
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