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UNITED STATES* bSTIA'L'SE'R.YI V-� <br />r E�V First -Class Mail <br />Posta <br />USPSe &Fees Paid <br />E- <br />�'. a... ,>;_ - �; • 216 Permit No. G-10 <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 />MR ALAN BOEHMS <br />OFFICE OF SURFACE MINING <br />WESTERN REGIONAL <br />COORDINATING CEAITER <br />1999 BROADWATE 3320 <br />DENVER, CO 8020$._ <br />Sender: Please print yo4r , 1&ress, yand ZIP: 46 i KiWis box' <br />p�visMtning &safety , <br />State of Colorado <br />Department of Natural Resources '` LL OF KCLA314AT104 <br />Division of Reclamation, Mining & Safety— {u;k„ , SAFETY <br />1313 Sherman Street, Suite 215 <br />Denver, CO 80203 1981-008 <br />' <br />C - <br />S09 <br />ion <br />Inspection Notificat <br />bfbiahh - <br />'11111111111 u111oil11'1C11,11i1�1' <br />A. Signature <br />❑ Agent <br />Addressee <br />B. Received by (Printed Name) C. Date of Delivery <br />D. Is delivery address different from item 1? ❑ Yes <br />If YES, enter delivery address below: ❑ No <br />s. service Type <br />❑ 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 />Z Article Number <br />(Transfer from service label) 7 014 2120 0001 7871 0236 <br />NS Form 6611, July 2013 Domestic Return Receipt <br />