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■ Complete items 1, d 3.Also complete A. Received by(Pleas Clearly) B. Date o Delivery <br /> item 'f ' fired. ,- l0 <br /> ■ PrintUWa� the reverseSO tht you. C. Signature <br /> ■ Attach this card to the back of the mailpiece, ❑Agent <br /> or on the front if space permits. - ❑Addressee <br /> D. Is delivery address different from kem 1? 4 Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: No <br /> BERNIE BROOKS ENV SERVICES <br /> LODI HEALTH CARE CENTER <br /> 1120 SYLVIA DR s. Service Type <br /> LODI CA 95240 Certified Mail ❑ Express Mail <br /> ❑ Registered ❑ Return Receipt for Merchandise <br /> ❑ Insured Mail ❑ C.O.D. <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number(Copy from service label) <br /> A nolo 161-0 opo 461 0) 2423 KF <br /> PS Form 3811,July 1999 Domestic Return Receipt 102595.00-M-0952 <br />