20040026 Ver 3_Certified Return Receipt_20070507

^ 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.
Article Addressed to:
Mr. Robert Polanco
8804 Albright Road
Raleigh ,NC 27612
DWQ# 04-0026-v3-Wake
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If Y S, enter delivery
^ Agent
Name) ~ C. Date of Delivery
MAY ~ 7 ~~d1 '~
3. Service
Certified Mail Express Mail
Registered ~ Retum•Receipt for Merchandise
^ Insured Mail ^ C.O.D.
4. Restricted Delivery? (Extra Fee) ^ Yes
2. ArticleNuml~r -2026 2760 0003 61,52 3422
(Transfer from ServlCe label)
PS FgrM ~1 ~ February 12PpA i j ! Donps>lic ~igtum Receipt 102595-02-M-1540
~ ..

UNITED STATES POSTAL SERVICE
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• Sender: Please print your name, address, and ZIP+4 in this box •
NC DENR Division of Water Quality
401 Oversight/Express Unit
2321 Crabtree Boulevard, Suite 250
Raleigh, NC 27604
First-Class Mail
Postage & Fees Paid
USPS
Permit No. G-10
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