20040026 Ver 4_Certified Return Receipt_20070606

^ Complete items 1, 2, and 3. Also complete
item 4 if Restricted Delivery is desired.
^ 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:
Mr. Robert Polanco
8804 Albright Road
Raleigh,NC 27612
DWQ# 04-0026-v4-Wake
A Siq ur
X _
B. Recei ed by (Printed Name)
D. Is delivery Qf~ff
If YES, ~ delivery add
^ Insured Mail Q C.O.D.
^ Agent
J ^ Addressee
C. Date of Delivery
item 1? ^ Yes
glow: ^ No
JUN 0 6 2007 `~'
3.
Receipt for Merchandise
4. Restricted Delivery? (Extra Fee) ^ Y~
2. Article Number 7pp7 p71,0 X002 1579 1665
(lFansfer /rom service
_ -- -- _ --
PS Form 3811, February 2004 Domestic Return Receipt 102595-02-M-1540

UNITED STA~,~S~~f3~Tey{~'..SF~~E,,f~rl`'e:j~yEAF.. ~
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• Sender: Please print your name, address, and ZIP+4 n this box •
NC DENR Division of Water Quality
401 Oversight/Express Unit
2321 Crabtree Boulevard, Suite 250
Raleigh, NC 27604
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