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SENDER: COMPLETE THIS SECTION COMPLETE THIS SECTION ON DELIVERY <br /> • Complete items 1,2,and 3. A. Signature <br /> • Print your name and address on the reverse XiAgent <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. Arti' ` . '' D. Is delivery fii��' I r1? El Yes <br /> If YES,entiriv dPe?f5•:ow: ❑No <br /> Mason Chamberlain <br /> Chamberlain Concrete JUN 04 2024 <br /> 36415 U.S.;--Hwy 385 <br /> P.O. Box 425 DIVISION OF RECLAMATION <br /> Wray,CO 80758 MINING AND SAFTEY <br /> I I/III' I'I1111 !EH <br /> I I 111 (I 11 <br /> I 3. Service Type ❑Priority Mail Express® <br /> ❑Adr Signature ❑Registered MailrM <br /> 0 Adult Signature Restricted Delivery 0 Registered Mail Restricted <br /> 'I Certified Mail® Delivery <br /> 9590 9402 3488 7275 7548 15 0 Certified Mail Restricted Delivery 0 Return Receipt for <br /> 0 Collect on Delivery Merchandise <br /> 2. Article Number(Transfer from service label) ❑Collect on Delivery Restricted Delivery 0 Signature Confirmationuo <br /> ail 0 Signature Confirmation <br /> 7 017 2400 0000 9119 3642 til Restricted Delivery Restricted Delivery <br /> I <br /> PS Form 3811,July 2015 PSN 7530-02-000-9053 Domestic Return Receipt <br />