WQ0015052_Returned Green Card NOV-2021-LV-0824_20211115

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ENDER: COMPLETE THIS SECTION
ti 1 1 Cis
• Complete items 1, 2, and 3.1,
• Print your name and address on e revers
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
X
. eceive • i'•rinted Name)
ECEIVED/NCDEN
❑ Agent
❑ Addresser
C. Date of Deliver
/DWR
A.{: 1.._A-IJ
William Galen Freed
113 Duck Woods Drive
Kitty Hawk, NC 27949
IIIIIIIII IIIIIIIIIII II IIIIIIIIIIIIIIIIIIIIIIII
9590 9402 7050 1225 0086 13
7021 0950 0001 1028 5470
D. Is delivery address different from item 1? 0 Yes
If YES, enter delivery address below: ❑ No
NOV 152021
Water Quality
Regional,Operations Section
Washington ••!11,,:c•
3. Service Type
❑ Adult Signature
❑ Adult Signature Restricted Delivery
❑ Certified Mail®
❑ Certified Mail Restricted Delivery
❑ Collect on Delivery
lied on Delivery Restricted Delivery
ured Mail
.drred Mall Restricted Delivery
(over $500)
❑ Priority Mall Express®
❑ Registered MaIITM
❑ Registered Mail Restrict(
Delivery
❑ Signature Confirmation1'
❑ Signature Confirmation
Restricted Delivery

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9590 9402 7050 1225 0086 13
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•
NC DEPARTMENT OF ENVIRONMENTAL QUALITY
Division of Water Resources
943 Washington Square Mall
Washington, NC 27889
Earronmentor
Quality
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