960121_Returned Green Card NOV-2020-PC-0468_20201120

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United States
Postal Service
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
• Sender: Please print your name, address, and ZIP+4® in this box*
NCDEQ
DIVISION OF WATER RESOURCES
WATER QUALITY OPERATIONS SECTION
943 WASHINGTON SQUARE MALL
WASHINGTON, NC 27889

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■ Complete items 1, 2, and 3.
■ Print your name and address on the reverse
so that we can return the card to you.
■ Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
Williarn L. Jackson
756 Country Club Road
Mt dive; NC 28365
I I �II'I IIII I III I IIII I I I I IIII II I I I
9590 9402 5743 0003 1191 20
2. Article Number (Transfer from service label)
019 2970 0001 3139 9692
A. Nnature
X \ V / (� ❑ Agent
❑Addressee
B. Received by (Printed Name) Date of Delivery
D. Is deliver ��NN ss different from item 1? ❑ Yes
If YES, ente adCdress below: ❑ No
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3. S Op�,r 8!!�
p Priority Mail Expresso
O Adult Sign On pof�c7tiO,,s
❑ Adult Signature RestrlCCed DeliSgrO!
❑ Registered MailT"
O Registered Mail Restricted
l3Certified Mail® )7fln
Delivery
❑ Certified Mail Restricted Delivery
❑ Return Receipt for
❑ Collect on Delivery
Merchandise
❑ Collect on Delivery Restricted Delivery
El Signature ConfirmationT"
❑ Insured Mail
❑ Signature Confirmation
❑ Insured Mail Restricted Delivery
Restricted Delivery
I PS Form 3811, July 2015 PSN 7530-02-000-9053
Domestic Return Receipt