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IDLE COPY <br /> Page 2 <br /> SITE CODE: 1760ro <br /> Z" 128 ' 784 460 <br /> US Postal Service <br /> SITE NAME: WATERLOO SHELL Receipt for Certified Mail <br /> 4315 WATERLOO RD - 1;� , ' <br /> STOCKTON CA 95205 KAREN PETRYNA <br /> EQUILON ENTERPRISES LLC <br /> RESPONSIBLE PARTY(IES): P o BOX-7869 <br /> BURBANK CA 91501-7869 <br /> L <br /> KAREN PETRYNA Postage $ <br /> SHELL OIL/EQUIVA SERVICES LLC <br /> P O BOX 7869 wed Fee <br /> 'j BURBANK CA 91501-7869 Special Delivery Fee <br /> i <br /> Restricted Delivery Fee <br /> u� <br /> cb <br /> Return Receipt Showing to <br /> Whom&Date Delivered <br /> CL <br /> Return Receipt Slawrtmg to Wham, i <br /> I Q .Date,&Addressee's Address <br /> 0 TOTAL Postage&Fees is i <br /> Postmark or Date i <br /> Li <br /> COMPLETE •N COMPLETE THIS SECTIONON DELIVERY <br /> ■ Complete items 1,2,and 3.Also complete A. Received by(Please Print Clearly) B.Date of Delivery <br /> item 4 if Restricted Delivery is desired. <br /> ■ Print your name and address on the reverse <br /> li so that we can return the card to you. C. Signature <br /> ■ Attach this card to the back of they 1rr�ailp'ece, ❑Agent <br /> or on the f 1/1Vf I �v X > ZS ri ❑Addressee <br /> D. 11 delivery address different from item 1? ❑Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: ❑ No <br /> KAREN PETRYNA <br /> EQUILON ENTERPRISES LLC <br /> P O BOA 7869 ,- 3AS -ice Type <br /> BURSANK ertifieMail ❑ Express Mail <br /> CA 91501-7869 . ❑ Registered ❑ Return Receipt for Merchandise <br /> - -- -- — ❑ Insured Mail ❑ C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number(Copy from service label) <br /> /497 VZZO66 <br /> PS Form 3811, em <br /> Jjlly%199� Desti turn Receipt 102595-00-M-0952 <br /> i <br />