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UNITL619*k <br />• Sender: Please print your name, address, <br />OCT 0 4 2016 <br />State of Colorado <br />Department of Natural Resources DMSII OF RECLAMATION <br />MINING AND SAFETY <br />Division of Reclamation, Mining & Safa <br />1313 Sherman Street, Room 215 C-1981-041 <br />Denver, CO 80203 SL -9 <br />Inspection <br />Notification <br />jle/dih ! <br />i.ljllltiF=i==II°i;ill#li=-iilf.-►iilliiliiitltijiiilii,{i,lj;-i-ilj� <br />■ Complete items 1, 2, and 3. Also complete <br />item 4 if Restricted Delivery is desired. <br />■ Print your name and address on the reverse <br />so that we can return the card to you. <br />■ Attach this card to the back of the mailpiece, <br />or on the front if space permits. <br />1. Article Addressed to: <br />U.S. Bureau of Land <br />Management <br />Grand Junction Field Office <br />2815 H Road <br />Grand Junction, CO 81506 <br />A. Signature <br />X j, n Agent <br />�L— El Addressee <br />B. Received br(Printed Name) I C. Date of Delivery <br />rrua n n A K.«xt\v-,a� I 910-61JUL <br />D. 14 delivery address different from item 1? es <br />If YES, enter delivery address below: No <br />3. Service Type <br />❑ Certified Mail® ❑ Priority Mail Express - <br />[3 Registered ❑ Return Receipt for Merchandise <br />❑ Insured Mail ❑ Collect on Delivery <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number <br />(transfer from service label) 7 014 2120 0001 7871 0571 <br />PS Form 3811, July 2013 Domestic Return Receipt <br />