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HomeMy WebLinkAboutSWG Onsite Survey - 10/29/1996 I First-Class Mail UNITED STATES POSTAL SERVICE Postage&Fees Paid USPS ThC01' A 14A 984 2:3 : :31 Permit No.G-10 I I • Print your name,address, and ZIP Code in this box • � I I ' I I L �n Martin County Dept. of Health Servi s „- �L Office of Water Quality .n 410 N. 4th - P. 0. Box 1666 'AG I Shelton, WA 98584-5001 1 I I � I I II I I r SENDER: v ■Complete items 1 and/or 2 for additional services. I also wish to receive the in ■Complete items 3,4a,and 41b. following services(for an N ■Print your name and address on the reverse of this form so that we can return this extra fee): card to you. ai j ■Attach this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address •2 v permit. a! ■Write-peturn Receipt Requested'on the mailpiece bek'.w the article number. 2. ❑ Restricted Delivery fn .L ■The Return Receipt will show to whom the article was delivered P�d the date delivered. Consult postmaster for fee. a o at v 3. rticle Addressed to: 4a.Arti Number a a gat B 4b.Service Type m a ❑ Registered Certified °C rn w ❑ Express Mail El Insured E y ¢ w ❑ Return Receipt for Merchandise ❑ COD 7. Date of Delivery i cc occ >, p 5. Received By: (Print Name) 8.Addressee's Address(Only if requested � T�/ and lee is paid) r cc 6.Signatu e: (A ressee or Age ) r )— — r rn PS Form 81 , December 994 Domestic Return Receipt