‘SENDER:
    COMPLETE THIS SECTION
    •
    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 ~turn the card to you.
    •
    Attach this card to the back of the mailpiece,
    or on
    the front if space permits.
    1.
    ArticleAddressedto:
    7/8/04
    B.M.
    PCB 2002—177
    James Mezo
    418 East Main Street
    A.
    Si
    ture
    X~~O
    0
    Addressee
    eceived by
    (Printed
    Name)
    C.
    Da~
    0
    elivery
    i/I
    D.
    Is delivery address different from
    item
    17’
    DYes
    If YES, enter delivery addressbelow:
    0
    No
    P.O. Box 220
    Benton,
    IL 62812
    3.
    Service
    Type
    ~~4~ertified
    Mail
    o
    Registered
    0
    Express Mail
    0
    Return
    Receipt
    for
    Merchandise
    o
    Insured Mail
    0
    C.O.D.
    2.
    Article
    ~
    ~
    ~ns~r
    ee~
    7002
    4~RestrI
    ,v
    VUtI~’
    \
    203~0UQi4~52~
    cted
    Delivery’?
    (Extia
    Fee)
    9002
    PS FQ~3S1¶i~t’2OO~i
    Do~rtcrt~rnR,t
    102595-02-M-1540
    RECE~VED
    CLERK’S OFFICE
    DYes
    JUL
    19
    2004
    STATE OF ILLINOIS
    Pollution Control Board

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