WQ0007283_Return_20191023

■ Complete items 1, 2, and 3.
j■ 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.
Article Addressed to:
Jay Bender
Town of Pollocksville
202 Hwy 41 W
Trenton, NC 28585-5421
III' 11 I 1111111111111111111111 1111
9590 9402 5158 9122 7692 21
I 2. Article Number (transfer from service label)
7018 1830 0000 9509 8706
I: PS Form 3811, July 2015 PSN 7530-02-000-9053
A.
X V — 11 Agent
t� c!/l. ❑Addressee
B. Received by (Pr' ted Name) C. Date of Delivery
7S i 10-7 C 1�
D. Is delivAry address different from item 17 ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑ Priority Mail Expresso
❑ Adult Signature
❑ Registered MaiITM
❑ dult Signature Restricted Delivery
❑ Registered Mail Restricted
Certified Mailo
Delivery
❑ Certified Mail Restricted Delivery
O Return Receipt for
❑ Collect on Delivery
Merchandise
❑ Collect on Delivery Restricted Delivery
O Signature ConfirmationTM
❑ Insured Mail
❑ Signature Confirmation
❑ Insured Mail Restricted Delivery
Restricted Delivery
(over $500)
Domestic Return Receipt i

USPS TRACKING #
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
9590 9402 5158 9122 7692 21
United States
Postal Service
• Sender: Please print your name, address, and ZIP+4® in this box*
NCDEQ
DIVISION OF WATER RESOURCES
WATER QUALITY OPERATIONS SECTION
943 WASHINGTON SQUARE MALL
WASHINGTON, NC 27889