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v <br /> Postal <br /> a <br /> o <br /> CERTIFIED MAIL RECEIPT <br /> w <br /> (Domestic mail only, No insurance Coverage Provided) <br /> -0 <br /> m <br /> r <br /> `a Postage $ <br /> IT! Certified Fee <br /> 0 <br /> Pose.k <br /> ReturnReclep[Fee Here <br /> (Endorsement Required) <br /> Restricted Delivery Fee <br /> T (Endorsement Required) <br /> O d. <br /> R1 Total Postage&Fees $ <br /> rU <br /> p <br /> r 3`beet,Mt.No. .:..K..M.....� .... . ..... <br /> of PO Box No. <br /> Ciry Sfate,ZIP+4 <br /> :r 002 -See Reverse for instnuctires <br /> SENDER: • • rMPLETE TH;,SECTION ON <br /> ■ Complete items 1,2,and 3.Also complete A_ s11 t�Wr <br /> item 4 if Restricted Delivery is desired. ❑Agent <br /> ■ Print your name and address on the reverse (• ❑Addressee <br /> so that we can return the card to you. -g, (Printed N me) C. D��1�ppf Delivery <br /> ■ Attach this;.9ard to the back of the mailpiece, <br /> or on the front if space permits. I _ <br /> D. Is delfvery"rses 400449-M item 17 ❑yes <br /> 1. Article Addressed to: 'Jf�y€ .enter delivery address below: ❑ No <br /> C��Gto '4�RQ a,l ar�oN IV(J�/ 2 0 2002 <br /> VIRONMENT HEALTH <br /> ERMIT <br /> 3. Type <br /> Type <br /> g Certified Mail ❑ Express Mail <br /> ❑ Registered ❑ Return Receipt for Merchandise <br /> f] Insured Mail ❑C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑yes <br /> 2. Article Number 7002 2 30 0003 8788 7968 <br /> (Transfer from service labE <br /> PS Form 3811,August 2001 Domestic Return Receipt 102695.02-M-1540 <br />