20071049 Ver 5_Certified Return Receipt_20070721

^ 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:
Robert Neil araclcett
704 Deacon Drive
Marion,NC ?8752
DWQ#07-1049-McDowell
A. Sig~e
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B. Received by (Printed Name)
/ Agent
~• Addressee
C. Date of Delivery
D. Is delivery address different from item 1? ^ Yes
If YES, enter delivery address below: ^ No
3
rvice Type
~
Certified Mail ^ Express Mail
^ Registered ,Return Receipt for Men;handise
^ Insured Mail ~j C.O.D.
4. Restricted Delivery? (Extra Fee)
^ Yes
2. Article Number
(transfer from service label) 7 CI D 6 ~ 1 ~ 0 a o a 3 2 3 8 5 5 8 5
PS Form 3811, February 2004 Domestic Return Receipt toz595-oz-M-t54o

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• Sender: Please print your name, address, and ZIP+4 in this box •
NC UI/NR Division of Water Quality
401 Oversight/Express Unit
2321 Crabtree Boulevard, Suite 250
Raleigh, NC 27604
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