310353_Return_20190916

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Donnell Kornegay
362 Scotts Store Road ------------------
Mt. Olive, NC 28365

Certified Mail service provides the following benefits:
■ A receipt (this portion of the Certified Mail label).
for an electronic return receipt, see a retail
■ A unique identifier for your mailpiece.
associate for assistance. To receive a duplicate
■ Electronic verification of delivery or attempted
return receipt for no additional fee, present this
delivery.
USPS®-postmarked Certified Mail receipt to the
■ A record of delivery (including the recipient's
retail associate.
signature) that is retained by the Postal Service —
for a specified period.
Important Reminders.
■ You may purchase Certified Mail service with
First -Class Mail', First -Class Package Service®,
or Priority Mail® service.
■ Certified Mail service is notavailable for
international mail.
■ Insurance coverage is notavailable for purchase
with Certified Mail service. However, the purchase
of Certified Mail service does not change the
insurance coverage automatically inducted with
certain Priority Mail items.
■ For an additional fee, and with a proper
endorsement on the mailpiece, you may request
the following services:
- Return receipt service, which provides a record
of delivery (including the recipient's signature).
You can request a hardcopy return receipt or an
electronic version. For a hardcopy return receipt,
complete PS Form 3811, Domestic Retum
Receipt; attach PS Form 3811 to your mailplece;
Restricted delivery service, which provides
delivery to the addressee specified by name, or
to the addressee's authorized agent
Adult signature service, which requires the
signee to be at least 21 years of age (not
available at retail).
Adult signature restricted delivery service,
requires the slgnee to be at least 21 years 9
and provides delivery to the addressee spa
by name, or to the addressee's authorized a
(not available at retail).
■ To ensure that your Certified Mail receipt is
accepted as legal proof of mailing, it should bear 6
USPS postmark If you would like a postmark on
this Certified Mail receipt, please present your
Certified Mail item at a Post office- for
postmarking. If you don't need a postmark on this
Certified Mail receipt, detach the barcoded portion
of this label, affix It to the mailpiece, apply
appropriate postage, and deposit the mailpiece.
IMPONANI: Save this receipt for your records.
PS Form 38OO, April tots (Reverse) PSN 7530-02-OW-W47

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■ Complete items 1, 2, and 3.
■ 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:
Donnell Kornegay
362 Scotts Store Road
Mt. Olive, NC 28365
1111111111111111111111111111111111111111111111111
9590 9402 5158 9122 7699 86
I 2. Article Number /Transfer frnm aarolro mean
�7018 1830 0000 9509 8232
A.
X
B.
D. Is delidery address different,
If YES, enter delivery addre
�o<E 20
ids 0, , .
❑ Agent
C79 to of,elivery
item 17 ❑ Yes
a7cw: ,mil No
3. Service Type �On `r�p� <r:' ❑ Priority Mall Express@
❑ Adult Signature ❑ Registered MaHM
❑�d uR Signature Restricted Derr ❑ Re red Mail Restricted
'Certified Mai® a Deifvery
❑ Certified Mall Restricted Delivery ❑ Return Receipt for
❑ Collect on Delivery Merchandise
❑ Collect on Delivery Restricted Delivery ❑ Signature ConfirmationTm
❑ Insured Mail ❑ Signature Confirmation
❑ Insured Mail Restricted Delivery Restricted Delivery
PS Form 3811, July 2015 PSN 7530-02-000-9053
Domestic Return Receipt 1

USPS TRACMG #
First -Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
9590 9402 5158 9122 7699 86
United States
Postal Service
• Sender: Please print your name, address, and ZIP+40 in this box*
NCDEQ
DIVISION OF WATER RESOURCES
WATER QUALITY OPERATIONS SECTION
943 WASHINGTON SQUARE MALL
WASHINGTON, NC 27889
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