540049_Returned Green Card NOV-2021-PC-0056_20210204

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9590 9402 5743 0003 1177 82
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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SENDER: COMPLETE THIS SECTION
• 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:
Martha Smith
2828 Billy Becton Road
Kinston, NC 28504
1111
III
111111
11111
II
II
II
9590 9402 5743 0003 1177 82
2. nrtl,-lA nn imhpr ITrancfer from service label)
r019 2970 0001 3140 0015
COMPLETE THIS SECTION ON DELIVERY
A.X SigrlaturL
A Agent
Addressee
Recved by (Printed l`
C'„Dam oofelivery
D. Is delivery address differenf 4to,ei item 1 . 0 es
If YES, enter delivery address btlfoph ❑ No
04.
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3. Service Type o a/4�ac_,
❑ Adult Signature 6 '0
❑ Adult Signature Restricted Delivery 0
"Certified Mail®
❑ Certified Mail Restricted Delivery 0
❑ Collect on Delivery
❑ Collect on Delivery Restricted Delivery 0
Insured Mail 0
Insured Mail Restricted Delivery
i (over $500)
Priority Mail Express®
Registered MaiFT""
Registered Mail Restricted i
Delivery
Return Receipt for
Merchandise
Signature Confirmation*.
Signature Confirmation
Restricted Delivery
PS Form 3811, July 2015 PSN 7530-02-000-9053
Domestic Return Receipt