SENDER:

COMPLETE THIS SECTION

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

item 4 if Restricted

Delivery

is desired.

U

Print your name and address on the reverse

so that we can return the card to you.

• Attach this card to the

back

of the màilpiece,

or on the front if:space permits.

I. Article Addressed

to:

9

/ 2 /

04 B

. N.

PCB

2005—034

Jerry L. Moss

Moss Family Farms, Inc.

RR 1, Box 189

Baylis, IL 62314

CLERK’S OFFICE

SEP 17 2OO~

STATE OF ILLINOIS

Pollution Control Board

‘~‘r1~r,~T~

.~ISip~re

- ‘~1JAgent

*7//ftjjj

0 Addressee

B!R~c~ivéd’

(

r~tpd

!~a,qie)

C. D~teof D~1ive~y

0. ls.delivery a~Ydressdifferentf~rnitemi~?

rtoss,//57~y

0 Yea’

if YES; enterdelivery address below~ 0 Nø

3.~9rviceType

~~erfified t~ail

ID. Registered

‘

q E~cpressMail.

0

Return. Receipt for Metthandise

0 insured Mal!

0 C.O.D.

4. Re~t~1ctedDelivery?

(EXtt~F)

0 Yes

1 2. Article Number

~

(Thsisfei from ser.’Ice (abel)

7004 1160 0005 4123

.

1485

PS Form

3811,

February 2004

‘ Dbmèstio Return Receipt

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