NC0033111_Returned Green Card NOV-2021-LV-0794_20211105

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ENDER: COMPLETE THIS SECTION
• Complete items 1, 2 and 3. e„ VO35 1 I (
• 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:
Don'D ton
Carolina Water Service Inc of NC
4944 Pkwy Plz Blvd, Suite 375
Charlotte, NC 28217
111111111111111111111111111111111111111111111
2._arnc0i8 N� 9 10r2r� 050n122b; Oq$5,07
7021 0950 0001 1028 5357
‘VI E. 01
COMP.._TE THIS SECTION ON DELIVERY
atu
❑ Agent
.ressel
B. Received by (Printed Name)
D. Is daddress iiiiteelVE91
If YES, enter delivery address below: 0 No
0V 0 6 2021
Water Qualnty action
1 iC 4Ur rl Qtio S
3. Service Type g xxpfe s®
❑ Adult Signature Washingt o Registeredd��Maian"
0 Adult Signature Restricted Delivery 0 Registered Mail Restrict
0 Certified Mali® Delivery
❑ Certified Mail Restricted Delivery 0 Signature ConfirmatlonTi
❑ Collect on Delivery 0 Signature Confirmation
n-' "-;t on Delivery Restricted Delivery Restricted Delivery
id M
id Mailall Restricted Delivery
[—lover $500)
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USPS TRACKING #
9590 9402 7050 1225 0085 07
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•
,y,.,..
g �if Environmental al QuRTH ality
xccality
Division of Water Resources
943 Washington Square Mall
Washington, NC 27889
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