WSCO_RAND_WSWP Submittal Review_20230627

Action History (UTC-05:00)Eastern Time(US&Canada)
Submit by Anonymous User 6/21/2023 3:18:29 PM (Supplemental Submittal)
Approve by Paul.Clark 6/27/2023 2:35:35 PM (WSW Program Info Submittal Review)
0 Thank you for recompleting/resubmitting survey and uploading most recent docs as well as
calculations.
• The task was assigned to Paul.Clark.The due date is:July 5,2023 5:00 PM 6/21/2023 3:18:30 PM

Water Supply Watershed E-Submittal
s
NORTH CAROLINA
Environmental Quality
Submittal Dated: 6/21/2023
Water Supply Watershed Protection Program Info
Please supply the information below
.....................................................................................................................................................................................................................................................................................................................................................................................................
County:* Randolph
What Type of Municipality
Program?* County
Choose additional counties if applicable:
Additional County:
WSW Program WSCO_RAND
Identifier:* Auto-populated from choices above
Name of Submitter:* Tim Mangum
Who is submitting this information?
Title:* Planner
Email:* [e-mail]
Telephone:* 336 318-66552
Map: Click the upload button or drag and drop files here.
OfficialWatershed Map.pdf 6.5MB
Only pdf files are accepted.
The current version Click the upload button or drag and drop files here.
of your WSWP OfficialWatershedOrdinance.pdf 788.25KB
ordinance(s):
Only pdf files are accepted.
Other Information: Click the upload button or drag and drop files here.
WatershedSurveyCalculations2023.pdf 12.76KB
Only pdf files are accepted.
Describe the
attachments:
* By checking the box and signing box below, I certify that:
• I have given true,accurate,and complete information on this form;
• I agree that submission of this form is a"transaction"subject to Chapter 66,Article 40 of the NC General Statutes(the
"Uniform Electronic Transactions Act');

• I agree to conduct this transaction by electronic means pursuant to Chapter 66,Article 40 of the NC General Statutes
(the"Uniform Electronic Transactions Act');
• I understand that an electronic signature has the same legal effect and can be enforced in the same way as a written
signature;AND
• I intend to electronically sign and submit this form."
Full Name:* Timothy V. MAngum
Signature
TI'M07-*Y V. f&4AI6V*
Date Submitted 6/21/2023
Submittal Date 20230621
Formatted

Review
Program Entity: Randolph
Edit if necessary
Verify Primary Randolph
County* Update county if needed.
Verify WSW ID* Randolph Co(WSCO_RAND)
Update ID if needed.
Review Date 06/27/2023