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i <br /> m S I also-wish to receive,the <br /> a ■Co p ete i ems andlor 2 for additio services. �� <br /> w ■Complete items 3,4a,and'4b. f rvlC@s f ran a <br /> ,V ■Prix»your name and address on re ft to so a rr t ' 1 VQ <br /> 0 card 1a you. a <br /> ■Attach this form to the front of the ailpt e,o e a c if space does not ❑ Addressee's Addr 5s '� <br /> I m ■ <br /> permit. <br /> „te Aetum Aeterpt Aequest�d'on the mailpiec+�b� a article number. 2. ❑ Restricted DBIIv6 N <br /> ■The Return Receipt Witt show So whom the art!"61 delivered and the date a <br /> delivered. s Consult postmaster for fee. � `w <br /> � 11 <br /> .Article Number d <br /> 0 ATTN EXECUTIVE OFFICER I �/ '! <br /> '' 1 a CENTRAL VALLEY REGIONAL i � 7oT ��� <br /> 1 g E 4b.Service Type d <br /> a WATER QUALITY CONTROL BORAD ¢ <br /> l a ❑ Registered Certified <br /> 3443 ROUTIER RD STE A Im <br /> { ” ❑ Express Mail Insured S <br /> ku SACRAMENTOCA 95827-3098 <br /> cc ❑ Return Receipt for Merchandise ❑ COD L <br /> 1t '; 7.Date 61 <br /> > # a� T <br /> 5.Received By: (Print Name) 8.Addresse Address(Only if requested <br /> ' W and!2nestic <br /> 6.Signatur :(Addressee orAgent) <br /> XPS Form 811, December1994 Return Receipt <br />