WQ0034102_Returned Green Card NOV-2021-LV-0143_20210311

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USPS TRACKING #
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111
1111
9590 9402L321 i296 8942 77
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.
COMPLETE THIS SECTION ON DELIVERY
A. Signature
Sr Received by fpLinted Name)
I � ❑` Agent
L 4. LtI Addressee
C. Date of Delivery
1 _ Article Addressed to:
Barbara Aycock, TownAciministi0ri4i(
Town. of Fremont
PO Box 4'
Fremont, NC 27830
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9590 9402 6321 0296 8942 77
2. Article Number (Transfer from service label)
7020 1810 0001 5981 1211
D. Is delivery address di
If YES, enter delivery addre
Item 1? ❑ Yes
1:1 No
'0<
3. Service Type ' h0 I) A
0 Priority Mail Express®
❑ Adult Signature `_ =.istered Malin,
❑ Adult Signature Restricted De117^ svo `, . ered Mail Restricted
yd't ertified Mail® • - very
❑ Certified Mall Restricted Delivery 0 Signature Confirmation^"
❑ Collect on Delivery 0 Signature Confirmation
❑ Collect on Delivery Restricted Delivery Restricted Delivery
'nsured Mail
nsured Mall Restricted Delivery
Dyer $500)
PS Form 3811, July 2020 PSN 7530-02-000-9053
Domestic Return Receipt