c~L

Article Addressed to:

10/7/04 B.

N.

PCB 19~—119

George~~apas

5017 W’~1ectra Lane

G1endaf~,AZ 85310—3807

RECEIVED

CLEriK’S OFFICE

NOV 05 2004

STATE OF ILLINOIS

Pollution Control Board

2 ArtIcle Number

4~Restri

~

cted Delivery?

(

Eictra

Fee)

Dyes

(rransferfrom seivice label)

7004 1160 0005 4126

3851

• Complete items 1, 2, and 3. Aiso complete

item

4

if Restricted Delivery is desired.

• Print your name and address on the reverse

so that we can return the card to you.

U Attach this card to the back of the mailpiece,

or on the front ~fspace permits.

Agent

—

I

3. Service Type

~JJertified Mail

D Express Mail

D Registered

D Return Receipt for Merchandise

0 Insured Mail

0 C.O.D.

j PS Form 3811, February 2O04

Doriiestic Return Receipt

102595-02-M-1

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