090146_Enforcement_20220915

RETURN OF SERVICE
I certify that this NOTICE OF SERVICE was received on the day of 2022, and together
with the document(s) was served as follows:
Date Served:
Designated Recipient: Chad Wayne Hazelwood
Place of Service:
(fill in address)
By:
11474 Old Mintz Hwy
Garland, NC 28441
(Served Officer)
Check one of the following:
By personally delivering copies to the named individual;
By leaving copies of the Notice and original letter at the named individual's dwelling, house or place
of business with a person of suitable age and discretion then residing therein. Name of the person
who the copies were left:
If not served to the named individual, please state the reason why:
Sampson County Sheriff
(Sheriff Signature) (Date)
Please return this form to:
Miressa D. Garoma
Division of Water Resources
1636 Mail Service Center
Raleigh, NC 27699-1636