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COLORADO <br /> Division of Reclamation, <br /> Mining and Safety <br /> Department of Natural Resources <br /> 1313 Sherman Street,Suite 215,Denver,CO 80203 <br /> 7014 2120 0001 7869 8145 <br /> 341300000 <br /> 7014 2120 0001 7869 8145 <br /> ; o <br /> Q N n N 0 <br /> 0 o 3� 3 <br /> 5 • <br /> m � ppp <br /> .n c•2 cD � ` <br /> W O <br /> j CD <br /> Q <br /> n x <br /> w <br /> � Cr <br /> M d <br /> CD Cl) <br /> SENDER: COMPLETE THIS SECTION COMPLETE THIS <br /> CO <br /> i <br /> C <br /> i <br /> SECTIONON DELIVERY <br /> ■ Complete items 1,2,and 3.Also complete A. Signature <br /> item 4 if Restricted Delivery is desired. ❑'Agent <br /> ■ Print your name and address on the reverse X ❑Addressee <br /> so that we can return the card to you. B. Received by(Printed Name) C. Date of Delivery <br /> • Attach this card to the back of the mailpiece, <br /> or on the front if space permits. <br /> D. Is delivery address different from item 1? El Yes <br /> 1. Article Addressed to: If YES,enter delivery address below: ❑ No <br /> Deb Rudibaugh <br /> 5291 C R 76 3. Service Type <br /> Parlin, CO 81239 ❑Certified Mail° ❑Priority Mail Express" <br /> ❑ Registered ❑ Return Receipt for Merchandise <br /> ❑ Insured Mail ❑ Collect on Delivery <br /> 4. Restricted Delivery?(Extra Fee) ❑Yes <br /> 2. Article Number 7014 212 0 0001 7869 814 5 <br /> (Transfer from service labs <br /> PS Form 3811,July 2013 Domestic Return Receipt <br />