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RECEIVED <br /> 61k` DIVISION OF RECLAMATION <br /> V 1. <br /> MINING AND SAFETY <br /> • • Postal <br /> RECEIPTCERTIFIED MAIL. RECEIPT CERTIFIED MAIL. <br /> Ln (Domestic MAU Only,No Insurance Coverage Provided) <br /> (DoMestic Mail Only;No Insurance Coverage Provided) <br /> un ru For delivery information visit our website at www.uspsxom� <br /> In 0501 <br /> r-q Postage " _ n y r r_q Pos V <br /> 1( <br /> Certified Fee l l•0 0 J��4: Certified Fee CI 0 <br /> ra •_ Postmark r) _ <br /> � Return Receipt Fee �jt��Ij i Here , I d Return Receipt Fee (1�j Ii1 �• s• � Here <br /> O (Endorsement Required) _ p (Endorsement Required) _ _ 4' <br /> o . - . ; AUG 1 5 2019 �, -,- <br /> Restricted Delivery Fee § Restricted Delivery Fee <br /> (Endorsement Required)$0.55 ✓� ',\ (Endorsement Required) AUG 2j)1 i� <br /> l ri 10 <br /> Total Postage&Fees ,{ t 1�1" Ln Total Postage&Fees r f 1 r?019, <br /> r $6.�. —_ '' r-R J�, � 4 <br /> Se To = Sent To •V:' c i,•,.._,I��L <br /> a Dr�(e�Odam&,- 'r /�a,1t + a t S <br /> Street, (/ �l Street,Apt No.; <br /> --PO Box No. ,3 f 3 S �m� J7 -d 1 or PO Box No. 3 ( D ( y <br /> ----------------------- - ftf ------------------------------------------------------------------------------------- <br /> City,State,ZIP+4 '/o f /TR d'O�3 City;State,ZIP+4 ^b �y� ct n <br /> PS Form 3800,August 2006 See Reverse for Instructions PS Form 3800,August 2006 See Reverse for Instructions <br /> - 'L�.y'T..1,^•:r.�'�5•1 ,.l dA;:.t'�`K'+..• �£„,j-%-=< .,:a:,.v' Y. ei.� s.+.w ^ <br /> SECTIONSENDER: COMPLETE THIS • • ON DELIVERY <br /> ■ Complete items 1,2,and 3. <br /> A. Signature <br /> ■ Print your name and address on the reverse X ❑Agent <br /> so that we can return the card to you. ❑Addressee <br /> ■ Attach this card to the back of the mailpiece, B. Received by(Printed Name) C. Date of Delivery <br /> or on the front if space permits. <br /> 1. Article Addressed to: G ❑D. Is delivery address different from item 1? ❑Ye: <br /> n I Yls("K c` C�QIY1Q�tSll� If YES,enter delivery address below: No <br /> C-ell 6YQgO �� �, <br /> Mi an dam�15 <br /> /�(3 sh�rn� �3 <br /> II I IIIIII I II ICI I II II I I II II I I III II III II ICI III 3. Service Type ❑Priority Mail TM se <br /> ❑Adult Signature ❑Registered MaIIaiIT'^ <br /> ❑Adult Signature Restricted Delivery ❑Registered Mail Restricted <br /> 9590 9402 3702 7335 5532 25 ❑C❑Certified Mail Restricted Delivery ❑Return Receipt for <br /> ❑Collect on Delivery Merchandise <br /> 2. Article Number(Transfer from service label) ❑Collect on Delivery Restricted Delivery ❑Signature Confirmation"' <br /> i ❑Signature Confirmation <br /> 7 011 15 7 0 0001 4161 5565 1 Restricted Delivery Restricted Delivery <br /> PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br />