520014_Returned Green Card NOV-2021-PC-0069_20210204

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USPS TRACKING #
IN
Inr58(-L
9590 9402 6321 0296 8917 19
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*
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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:
Billie Tither
1799 Hwy 258
Pink !-11t , NC 28572
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1
1
III
1111
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III
1
III
III
II
II I
9590 9402 6321 0296 8917 19
2. Article Number (Transfer from service label)
7019 2970 0001 3139 9975
COMPLETE THIS SECTION ON DELIVERY
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gent
❑ Addressee
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B ved Printed C. Date of Delivery
D. Is delivery address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Adult Signature
❑ Adult Signature Restricted Delivery
'Certified Mail®
❑ Certified Mail Restricted Delivery
❑ Collect on Delivery
❑ Collect on Delivery Restricted Delivery
Isured Mail
sured Mail Restricted Delivery
ver $500)
❑ Priority Mail Express®
❑ Registered MaiITM
❑ Registered Mail Restricted
Delivery
❑ Signature ConfirmationTM
❑ Signature Confirmation
Restricted Delivery
PS Form 3811, July 2020 PSN 7530-02-000-9053
Domestic Return Receipt