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Po stal 'a <br />ru CERTIFIED MAIL. RECEIPT <br />Q � (Domestic Mail O nly; <br />r-9 For delivery information visit our website at www.usps.como <br />co l OFFICIAL UST- <br />ru <br />c <br />ru Postage: ;' $0.44 <br />o Certified Fee: $2.80 <br />Return $2.30 <br />O (Endorseme Return Receipt Fee: of <br />p^ Restricted r all <br />rn (Endorse— Total Postage & Fees: �J, <$.654 <br />O p <br />Total Postage & Fees I $ <br />Ln <br />C3 Se nt Ti <br />San Juan Basin Health Department - - - - - -- <br />°fPO1 P.O. Box 140 - <br />c rry si <br />Durango, CO 81302 <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 />A. <br />0) gent <br />O <br />B. Rec ived by (Printed Name) V <br />C. Date of Delivery <br />D. Is delivery address different <br />item 1? n Yes <br />Durango, CO 81302 <br />If YES, enter delivery address below: ❑ No <br />San Juan Basin Health Department <br />P.O. Box 140 <br />Durango, CO 81302 <br />'3. Service Type <br />❑ Certified Mail <br />❑ Express Mail <br />❑ Registered <br />❑ Return Receipt for Merchandise <br />❑ Insured Mail <br />❑ C.O.D. _ <br />4. Restricted Delivery? (Extra Fee) ❑ Yes <br />2. Article Number 7005 <br />(tran from service label) <br />0390 0002 <br />8281 9028 <br />PS Form 3811 February 2004 Domestic Return Receipt <br />102595 -o2 -M -1540 <br />