20050823 Ver 4_Certified Return Receipt_20080108

^ 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:
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I 1,/,~(~~/ ^ Agent
^ Addressee
D. Is delivery address different from item 1? ^ Yes
If YES, enter delivery address below: ^ No
,]DC.l ~11VCS1111E11tS
['.U. fox 595
Selma,NC 27529
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3. Service Type
^ Certified Mail ^ Express Mail
^ Registered ^ Return Receipt for Merchandise
^ Insured Mail ^ C.O.D.
4. Restricted Delivery? (Extra Fee) ^ Yes
2. Article Number
(rransferfromservice 727 2560 ~fl01 1381 5433
PS Form 3811, February 2004 Domestic Return Receipt 102595=02-M-1540 ;

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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 Suite250
Raleigh,NC 27604
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