Here is the full list of all 23 POSTAL 4: No Regerts achievements.
Install all bidets for Mike without killing anyone
Finish a mission with all 3 Dudes
Reunite with an old enemy, again
Turn 10 toilets yellow with piss
Beat the Fix Race errand by crossing the finished line with a fully bloodied scooter
Kill all of the mountain men on Thursday
Get all 10 petition signatures using the drag outfit.
Beat all highscores of the Scooter Challenge
Hit all barrels with an immigrant during the Border Smuggler errand
As the Cat Dude, kill 10 chicks
Run over 50 people with the mobility scooter.
Reach maximum heat level with the police and survive!
Find the secret crack den!
Flush after taking a piss in a toilet
Kill 100 pigeons from thrown cages
Make your homeless sign
Kill 4 fast-food workers during the Mexicleaner errand with the FOURnicator
Kill 7 people at the same time using Dude Eye
Collect all the paintings in the game
Finish all rampages
Collect all Krotchy, Kunny, & Larry collectibles
Beat the game by only using kicks to open doors and kill people
Completed the story with no kills