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d SENDER: O Ore I-. S+Kh <br /> 0 ■Complete items 1 and/or 2 for additional services. I also wish to receive the <br /> rn ■Complete items 3,4a,and 4b. following services(for an <br /> d ■Print your name and address on the reverse of this form so that we can return this <br /> card to you. extra fee): <br /> ■Attach this form to the front of the mail i r a ifs of ar <br /> W permit. <br /> p� �� 1. El Address <br /> IV ■Write'Return Receipt Requested'on the i e a 2. ❑ Restricted Delivery <br /> ■The Return Receipt will show to whom the article was delivered and the date _ <br /> c delivered. Consult postmaster for fee. a <br /> 3.Article Addressed to: ;I•_U0 4a.Article Number <br /> E ALEX DAVALOS �'1 I (0 39(04�1 ' <br /> e 4b.Service Type <br /> N ECONOXY SYOfi AND LUBE ❑ Registered Certified <br /> w 7700 M1 0FELA!'D ❑ Express Mail ❑ Insured m <br /> oSTOCKTON CA 95212 ❑ Return Receipt for Merchandise ❑ COD <br /> a 7�dress <br /> y <br /> Z j�b o5. Received By: (Print Name) 8ddress(Only if requested <br /> w and fee is paid) <br /> g 6.Signatu (Addressee or Agent) <br /> J�� ,yz <br /> PS Form 3811, December 1994 ij 102595-97-6-0179 Domestic Return Receipt <br /> Z 116 396 497 <br /> US Postal Service <br /> Receipt for Certified Mail <br /> No Insurance Coverage Provided. <br /> Do not use for International Mail See reverse <br /> Sent to <br /> ALEX DAVALOS <br /> ECONOMY SMOG AND LUBE <br /> 7700 MORELAiyD <br /> STOCKTON CA 95212 <br /> Special Delivery Fee <br /> Restricted Delivery Fee <br /> Return Receipt Showing to <br /> Whom&Date Delivered <br /> a Retum Receipt Showing to whom, <br /> Q Date,&Addressee's Address <br /> O <br /> 0 TOTAL Postage&FeesIs <br /> " Postmark or Date <br /> E <br /> 0 <br /> u- <br /> U) <br /> a <br /> -_---------------• --------------- ------ ---------- <br /> USED OIL ONLY <br /> Facility Nam_. er•r,n,OMY <br /> Facility Street Address: 7700 MORELAND Sr <br /> City: STOCKTON, CA 95212 f/ <br /> Contact Person: jl _ ci_Jyt Ll Phone: L/%T-2 6,6 / <br /> I certify that the only hazardous waste 3enerated by the above referenced Facility is USED <br /> 05 <br /> OIL and that the total amount enerate e year is less than 5 tons. <br /> Signed: <br /> A Division of San Joaquin County Health Care Services <br />