Larry King & Associates RLS,PA - 2/20/2018 11:31:48 AM

WW "Arpplemental Information Upload Fon
Staff Review:
Updated ID#:
Updated Version:
Who needs a copy?*
SW6180201
1
V Central Office
r Regional Office
Select Reviewing Office*
Fayetteville Regional Office — 910-433-3300
Central Office Reviewer:
Robert Patterson - eads\rdpatterson
Select RO Reviewer:*
[e-mail]
SUBMITTED PROJECT INFORMATION
Existing Project Information:
ID# SW6180201
Version: 1
Facility Name: Larry King & Associates RLS,PA
County: Cumberland
Name: Penny Markle
Vft is subrritting the inforrration?
Email Address: [e-mail]
Describe the attachments:
Please upload all files that need to be submitted.
copy-submittal.pdf 2.6MB
C05-C13.pdf 3.72MB
C00-C04.pdf 1.34MB
Only pdf files are accepted.
V By checking the box and signing box below, I certify that
Water Resources
ENVIRONMENTAL QUALITY
• I have given true, accurate, and complete information on this form;
• I agree that submission of this Supplemental Information 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
o I intend to electronically sign and submit the Supplemental Information form.
Full Name: Penny Markle
Signature:
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