NC0061492_NOV-2023-MV-0049 GC_20230324

N IL-U U W I LV-1`1� - A 73 TNUNJ -,�gU'1-0 - INAN -
'1. 1
• Corn;Aete fterri� � 2
• PrLnt your name and address on the
so that We can return the card to yot
• Attach this card to the back of the maflpkx)% -
or on the front If space permIts.
1. Aitcle Abdressed to:
la'w rdmc-e�k M 6r�Fj r
Maury SarV.Aary Land District
PO Box'984�
Maury, N42"8554-0098,
9590 9402 7626 2122 6856 38
2- A! �cte NLLi - f M-1-W-
70n r56% 0 6 4
M ' MIA,
D. Is d*my a&km ffwent fran ftern 1?' 13 Yes
If YE% order d*� adcIrm below No
. I MAR 2 7 Z023
Water Quality
��ns Section
PRgior" op'___�—.l rwe
3. SerA�e Type
0 Pftfty ma
WHIftm
=
0 n4dwed �­'-
0
;0 S4naftm BmbtctDd Dd"
certmed Man
0
El CwUW Mal Pmtttod Ddveiy
TiimmT,
0 Colect on DeRmy
0 Signatum Cm�
O-Colect an DeDmy ReshkAed
6 ULU
Pmtdded DWvwy

USPS TP-ACMG #
FIrst-Oass MaU
Postage & Fees Paid
USPS
Permit No. G-10
9590 9402 7626 2122 6856 38
United StatDs
Postal Service
0 Sender Please prInt your name, address, and ZJP+4* In thIs box*
��9
Division of Water Resources
943 Washington Square MaU
Wasbington, NC 27889
11111 1111 1JI I 1111111 1) 111111