SENDER:
    COMPLETE
    THIS SECTION
    •
    Complete items 1,
    2, and 3. Also compiete
    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 it
    space permits.
    •
    1.
    kticleMdressodto:
    10/6/05
    B.M.
    /
    PCB
    2006—018
    &
    PCB
    2006—02~
    Mane Kading
    V
    Gold Star ES,
    Inc.
    101
    N. East Street
    Cambridge,
    IL 61238
    ORIGINAL
    RECEIVED
    CLERK’S OFFICE
    OCT
    192005
    STATE OF ILLINOIS
    Pollution Control Board
    •?.MI~lN
    fSfllkt’t*it1.J#t.I#II14Il&4a’
    A
    Signs
    re
    —
    ci.
    yl
    ElAgent
    X L
    ~
    DAddressoe
    s.~~ker~pnmedN_
    ~y~pe~
    D.
    Is
    deiivocy
    address
    different from
    Item
    C
    Yes
    If YES, enter delivery
    address below:
    1
    No
    3.
    S
    rvlce Type
    Ified
    Mail
    0
    Express
    Mall
    C
    Registered
    El
    Return
    Receipt
    for Merchandise
    C
    kisured
    Mail
    0 CaD.
    4.
    Restricted
    Delivery?
    (Extra Fee)
    C
    Yes
    2.
    Axtlcte Number
    (Tmnsferfromsendcelabel)
    7005
    PS
    Form
    3811.
    February 2004
    1160 0002 2069 3879
    DomestIc
    Return Receipt
    102595-02.M-1540

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