RECEiVED

CLERK’s OFFICE

H) FE~’) TI F~\~l

I~

STATE OF ILLINOIS

~

Pollution Control Board

SENDER:

COMPLETE THIS SECTION

COMPLETE TPdS ~ECTIOPJON DELIVERY

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

item 4 ~fRestricted Delivery is desired.

• Print your name and address on the reverse

so that we can return the card to you.

• Attach this carti to the back of the mailpiece,

or on the front if space permits.

A. Sign~

‘V

/

DAgent

DA3&es~e

7~Re~Y/Printrer~C.

Da7yerY

Is ~llvery address different from item 1?

Ye

1. Article Addressed to:

4/

7

/

05

B M.

/

If YES, enter delivery address beIow~ 0 No

PCB 2005—174

V

Charles Schelkopf

623 Joanne Lane

DeKaib, IL 60115

5

3. Service Type

~ertified

Mail

0 Express Mail

D

Registered

0 Return Receipt for Merchandise

0 Insured Mail

0 C.OSD.

4~Restricted Delivery? (E~ctm

Fee)

0 Yes

2. Article Number

(rransferfrom service label)

7004 2890 0004 2296 4656

PS Form

3811,

February 2004

Domestic Return Receipt

102595-o2-M-is4O