HomeMy WebLinkAboutWM0100490_Signature Documentation_20210603Certificate Of Completion
Envelope Id: F8E25159B4514415AEFFF8AB5E0D136E Status: Completed
Subject: Please DocuSign: Monitoring well permit shell.docx
Source Envelope:
Document Pages: 2 Signatures: 2 Envelope Originator:
Certificate Pages: 1 Initials: 0 Brett Laverty
AutoNav: Enabled
EnvelopeId Stamping: Enabled
Time Zone: (UTC-08:00) Pacific Time (US & Canada)
217 W. Jones Street
Raleigh, NC 27699
brett.laverty@ncdenr.gov
IP Address: 149.168.204.10
Record Tracking
Status: Original
6/3/2021 7:35:10 AM
Holder: Brett Laverty
brett.laverty@ncdenr.gov
Location: DocuSign
Security Appliance Status: Connected Pool: StateLocal
Storage Appliance Status: Connected Pool: North Carolina Department of Environmental
Quality
Location: DocuSign
Signer Events Signature Timestamp
Tim Heim
Tim.Heim@ncdenr.gov
DWR
DEQ
Security Level: Email, Account Authentication
(None)
Signature Adoption: Pre-selected Style
Using IP Address: 174.195.22.137
Signed using mobile
Sent: 6/3/2021 7:36:29 AM
Viewed: 6/3/2021 8:24:05 AM
Signed: 6/3/2021 8:24:13 AM
Electronic Record and Signature Disclosure:
Not Offered via DocuSign
In Person Signer Events Signature Timestamp
Editor Delivery Events Status Timestamp
Agent Delivery Events Status Timestamp
Intermediary Delivery Events Status Timestamp
Certified Delivery Events Status Timestamp
Carbon Copy Events Status Timestamp
Witness Events Signature Timestamp
Notary Events Signature Timestamp
Envelope Summary Events Status Timestamps
Envelope Sent Hashed/Encrypted 6/3/2021 7:36:29 AM
Certified Delivered Security Checked 6/3/2021 8:24:05 AM
Signing Complete Security Checked 6/3/2021 8:24:13 AM
Completed Security Checked 6/3/2021 8:24:13 AM
Payment Events Status Timestamps