1. Page 1

 
RECEIVED
CLERK'S
OFFICE
AUG
1
8
2008
STATE OF ILLINOIS
Pollution Control
Board
Complete Items 1, 2, and
3. Also
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.
Attach this card to the back of the mailpiece,
or on the front if space permits.
1. Article Addressed to:
8/7/08 B.M.
PCB 2007-071
Monica T. Rios
Hodge Dwyer Zeman
3150 Roland Avenue
Post Office Box 5776
Springfield, IL 62705-5776
q
Agent
q
Addressee
B/fie
?
by
(Printed Name)
?
C. Date of Delivery
/2d1'w.i
. ?
C_
?
S'S-IS-10k
D. Is deliveryaddress dif
ewat from Item
12 CI
Yes
If YES, enter delivery address below:
?
q
No
3. Service Type
'tined Hied
ManMall
0
Insured Mall
q
Express Mail
q
Return Receipt for Merchandise
q
C.O.D.
4. Restricted Delivery?
(Extra
Fee)?
q
Yes
2. Article Number
(Transfer from service label)
7007 3020 0000 4630 6880
PS
Form 3811, February 2004
?
Domestic Return Receipt
102595-02-M-1540

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