HomeMy WebLinkAboutCertified Mail Reciept - OT General - 5/17/1996r
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UNITED STATES POSTAL SERVICE First-Class MailPostage&Fees Paid
' I LISPS
Permit No.G-10
• • Print your name, address, and ZIP Code in this box •
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N Mason County Dept. of Health Services
I Office of Water Quality I
410 N. 4th - P. 0. Box 1666
Shelton, WA 98584-5001
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RECEIVED
MAY 1 7 1VI16
ALTH SERVICFc
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SENDER:
■Complete items 1 and/or 2 for additional services. I also WISh t0 receive the
rn ■Complete items 3,4a,and 4b. following services(for an
j H ■Print your name and address on the reverse of this form so that we can return this extra fee):
card to you. u
d ■permit this form to the front of the mailpiece,or on the back if space does not 1. ❑ Addressee's Address
y ■Write'Return Receipt Requested'on the mailpiece below the article number. 2, ❑ Restricted C elivery N
Y •The Return Receipt will show to whom the article was delivered and the date
delivered. Consult postmaster for fee. •@
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0 3.Article Addressed to: 4a.Article Number ate,
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a �YU�` IYU19a• U°�Q ►�Lb���M
E 4b.Service Type
c(i PC) ❑ Registered ertified
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(n ❑ Express Mail ❑ Insured S
El Return Receipt for Merchandise El COD
0 7. Date of ivery
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m 5. Received By: (Print Name) 8.Addres e's Address(Only if requested
W and fee is paid) cc
6 ign ture: (Addressee or Agent)
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Ps Form 3811. December 1994 Domestic Return Receipt