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■Complete items 1 and/ I also wish to receive the <br /> ■Complete' 4a, following services(for an <br /> ■card to Print yoyyuOOr name on ''`f�ta�f'�'eMlt�ithis extra 1 �/A� <br /> ■Attach thiSu ,`OrAf1 the back If space not 1. bre6S� .M. •1 <br /> pemut form to the front of the <br /> ■write"Retum Receipt Requested•on he mallpiece below the a tier. 2•❑ Restricted Delivery <br /> ■The Return Receipt wig show to whom the article was delivered <br /> �N■�• Consult postmaster for fee. g <br /> ATTN EXECUTIVE OFFICER 4a. rticl <br /> CENTRAL VALLEY REGIONAL <br /> oz WATER QUALITY CONTROLBORAD 4b.Service Type <br /> 3443 ROUTIER RD STE A i❑ Registered rtified <br /> SACRAMENTO CA 95827-3098 ❑ Express Mail Insured CO <br /> ❑ Return Receipt for Merchandise ❑ COD <br /> 7.Date of Do v4gr , <br /> ,, ;6f <br /> 5.Received By:(Print Name) 8.A ressee's Address my if requested Y <br /> and fee is paid) <br /> 6.Sign e: (Addressee OV <br /> nt <br /> J2 PS Form 3811,December 1994 102595-98-9-0229 Dome c Aeturn Receipt <br /> S. <br /> M <br /> g ■Complete items 1 and/or 2 for a '' al services. UN T 1 Y I also wish to receive the <br /> � ■Complete items 3, 4and following services(for an <br /> ■ <br /> Print your name and he f s eLfboaturn this extra <br /> NP 1 6 <br /> mrd to ou. Ly77G4 •� <br /> ■Attach this form to the front of the mailpie e,or t back if space&q�no, 1. ddressee rens Z <br /> C-te <br /> ■Write"Return Receipt Requested"on the mailpiece below the 11 <br /> 2.❑ Restricted Delivery <br /> ■The Return Receipt will show to whom the article was deliver <br /> delivered. Consult postmaster for fee. <br /> 4a.Article Number <br /> ATTN MIKE SMITH �!".�2 0c <br /> CENTRAL VALLEY REGIONAL 4b.Service Type <br /> WATER QUALITY CONTROL BOARD ❑ Registered APertified <br /> 3443 ROUTIER RD STE A ❑ Express Mail El Insured <br /> SACRAMENTO CA 95827-3098 ❑ Return Receipt for Merchandise ❑ COD <br /> 7.Date of Delivery <br /> 0 <br /> 5.Received By: (Print Name) 8.A ee's A d ess(Only if requested ,Y <br /> and fee is palo <br /> L <br /> 6.Signa e:(Addressee or Agent) <br /> i" X _ <br /> PS Form 3811,December 1994 102595-9e-B-0229 mestic Return Receipt <br />