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_ 7 <br /> omplete items 1 and/or 2 for additional services. I also wish to receive the <br /> w ■Complete items 3,4a,and 4b. following services(for an <br /> f rprint o yoname end address a his fo at a return this e�rd{L O Q � d{ <br /> f � card to you. "..��{{lLll V c,I <br /> -Attach this form to the front Pie r o P s 1. ❑ Addressee's Address <br /> Permit. i <br /> C3 m rWrite'Retum Receipt Requested'on the mailpi low the article number. 2. ❑ Restricted Delivery <br /> Ln ,•t„ ■The Return Receipt will show to whom the article was delivered and the date « <br /> s delivered. Consult postmaster for fee. ar <br /> 'o <br /> Ln ir'o 3.Article Addressed to: Article Number <br /> n.,l ¢, C <br /> a ATFN_JAMES E BRATHOV.DE CHG 4b.Service Type <br /> o u CENTRAL VALLEY-REGIONAL ❑ Registered Certified <br /> sn WATER QUALITY CONTROL BOARD Ln ❑ Express Maid,, Insured 5 <br /> UJ 3443 ROUTIER RD STE A• 3 <br /> a SACRAMENTO CA 95827-3098 ❑ ReturnRecetptforMrchandse ❑ COD 0i <br /> o Y 7.Date okqbGr}r' r <br /> _. C. <br /> ,� <br /> 5.Received By:(Print Name) 8.Addressee's Addr s(Only if requested <br /> and fee is paid) r. <br /> ,N 6.Signatur (Addressee or Agent) <br /> X <br /> U) <br /> — PS Form 3811, December 1964 Do estic Return Receipt <br />