20071797 Ver 1_Certified Return Receipt_20071031

^ 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:
Mahlon Vanea Mangum
l 6 ~ Latoma Drive
Roxboro,NC 27574
DWQ# 07-1797-Person
A. S'gnature `
X ^ Agent
^ Addressee
B. Received by (Printed Name) C. D e of livery
O .~/ ~ ~
D. Is delivery address different from item 1? ^ Yes
If YES, enter delivery address below: ^ No ~(
~` I
3. Service Type
ertified -Mail Express Mail
Registered Return Receipt for Merchant 'se
^ Insured Mail C.O.D.
4. Restricted Delivery? (Extra Fee) ^ Yes
2. Article Number 7pp7 1490 ~p03 5602 3669
(transfer from service lab~~____________
__ __ ~-
PS Form 3811. February 2004 Domestic Return Receipt 102595-o2-M•1540

UNITED STAB''•PQ~~'J4G.~RI/1~~`~`'`-7s;.i '~-~~ ~,
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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
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