WQ0022155_Response to 2019 ARR NOV_20200708

■ Complete items 1, 2, and 3.
■ Print your name and address on the reverse /
so that we can return the card to )
■ Attach this card to the back of the mallplece, B
or on the front If space
permits.
Ms. Cathy Howell, Town D.
Town of Jefferson Manager
P.O. BOX 67
Jefferson, NC 28640
IIIIIII'II'IIIIIIIIIIIIIIIIIIII IIIIIII IIIIIIII '" 9590 9402 4893 9032 6855 66
7018 1130 0'nIo Do]
0091612 7383
Form 3811, July 2015 PSN 7530-02-000-9053
0-pe--
C.
❑ Agent
❑ ANNmm.... I
,YES, enter tlelive� erenE qm item 79 ❑ yes 1
ry atltltQm below:
Mq y 1 67p?0
O No
oIN
s
o
Ice Type
.....
>Ignature
tlgrUnureMade Restrcted Delvery
li Meil®
O Priority Melt Express® `
❑ Registered MJll-
99 is erect Mail Restricted
d Mall Restricted Delivery
on Delivery r%'
D0livery (
❑ Return Receipt for i
on Delivery ReettotedD elivery
Merchandise
❑ Signature Confirmation- {.
Stdcted0
Delivery
17 Signature confirmation
Re.mm.N neu.—
Domestic Return Receipt

Jll I I
T�i�I
i
First -Class Mail I
Postage &Fees Paid
USPS
Permit No. G-10
9590 9402 489rsende�r:p-
032 6855 66
United States
lease print your name, address,and ZIP+4® in this box•
Postal Service f
WATER QUALITY REGIONAL OPERATIONS SECTION
N.C. DEPARTMENT OF ENVIRONMENTAL QUALITY
450 WEST HANES MILL ROAD, SUITE 300
W I NSTON- SALEM, NC 27105-7407
II�lI��I1,Illilln111l�l�lll�lluiilllil��il�llui�yl�ll�IliNu