20091153 Ver 1_Certified Return Receipt_20091125

■ 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:
�i Blue Ridge Environmental Consultants
� Mr�._Derek Goddard 11/23/,09
i 467 Callo�vay Gap Road �
i West Jefferson North Carolina 28694
,- . �
i DWQ 09�;1153 Wilkes Co�mty
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A.
X
❑ Agent
❑ Addressee
B. Receiv "d y(Printed Name) C. Da4e of Delivery
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D. Is delive address different from item 1? ❑ Yes
If YES, enter delivery address below: ❑ No
3. Service Type
❑.Certified Mail
❑ Registered
❑ Insured Mail
� Express Mail
❑ Return Receipt for Merchandise
❑ C.O.D.
4. Restricted Delivery? (Exira FeeJ ❑ Yes
2. Article Number -- - ---- - - — - -- I
(Transfer frorri seiyice label) } j ti j� f � J 7 0 � 9 2 2 5 ��:0 O;0 2� 7�8 2 3 7;4 2 6�
PS Form 3811, February 2004 � Domestic Return Receipt �o2sss-o2-n�t-�sao

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UNITED STATES POS:'�AG'��RVIG'£`. . . . . , .���� � ��1,-
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• Sender: Please print your name, address, and ZIP+4 in this box •
- - - - - -- �
NC DENR DNISION OF WA��LR QUf1LITY !
401 OVERSIGI-IT/GXPRGSS UNIT i
2321 CRAB"I'RCG BOUL�VARD, SUITG 250 '
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RALI:IGH, NC 27604
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