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RLE COPY <br /> Page 2 <br /> SITE CODE: 1746 <br /> SITE NAME: SHELL SERVICE STATION Z 128 784 335 <br /> 880 VICTOR ROAD OS Postal Service <br /> LODI CA 95240 Receipt for Certified Mail <br /> KAREN PETRYNA <br /> RESPONSIBLE PARTY(IES): EQUILON ENTERPRISES LLC <br /> P O BOR 6249 <br /> KAREN PETRYNA CARSON CA 90749-6249 <br /> EQUILON ENTERPRISES LLC <br /> P O BOX 6249 Postage $ <br /> CARSON CA 90749-6249 Certified Fee <br /> Special Delivery Fee <br /> Restricted Delivery Fee <br /> N <br /> Return Receipt Shoving to <br /> Whom&Date Delivered <br /> n Rehm Receipt Sip"to N7am, <br /> Date,It Addressee's Address <br /> O <br /> O� TOTAL Postage&Fees <br /> Postmark or Date <br /> E <br /> `o <br /> LL <br /> m <br /> a <br /> SENDER: — <br /> L complete items 1 an or 2 or add' <br /> -Complete items 3,4a,and 4D.< i as I also wish to receive the <br /> •Print your name and address rxf e reSerse,o!this din ap that we can return this following services(for an <br /> card to you. extra fee): <br /> >, •Attach this form to the front of the mailptece,or on the back if space does not 41 <br /> d permit. 1. ❑ Addressee's Address 2 <br /> 0 •Wme'Retum Receipt Requested,on the mailpieca below the article number. <br /> •The Return Receipt will show to whom the aside was delivered and the date 2. ❑ Restricted DBVBry y <br /> tlelivered. <br /> o Consult postmaster for fee. a <br /> v 3.Article Addressed to: Z <br /> m 4a.Article Number m <br /> irE KAREN PETRYNAy�� r <br /> EQUILON ENTEgrnISES LLC 4b.Service Type 9 <br /> o Y 0 BOX 624\ ❑ Registered Certified <br /> rn ❑ Express Mail ❑ Insured S <br /> CARSON (!A 90749-6249 <br /> G ❑ Return Receipt for Merchandise ❑ COD <br /> o .2a \ 7. Date of Delivery <br /> z -�, ii <br /> 5. Receive (dot ) 0 <br /> w 8.Addressee's Address(Only if requested 'r <br /> A/ [. ,� and fee is paid) m <br /> g 6.Signatur Addr a or Agent) <br /> w X _ <br /> PS Form 3811, December 1 94 10259&9]-e-01)9 Domestic Return Receipt <br />