ture

~

.

~

Agent

0

Addressee

B.

Received by

(PrfntedNanie)

7/

C.

Date of

Delivery

~

7-/7--cfr

D. lsdeliveiyaddressdifferentfrornfternl?’ Dyes

If

YES,

enter delivery

address

below:

0

No

3.

S~rvice

Type

~~Certified

Mail

0

Registered

0

Insured Mail

O

Express Mall

o

Return

Receipt for

Merchandise

o

C.O.D.

0

Yes

RECEIVED

CLERK’S OFFICE

JUL21

2004

Pollution Control Board

SENDER:

COMPLETE THIS SECTION

•

Complete itemsi, 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.

a

Attach

this card to the back of the mailpiece,

or on the frent if space

permits..

1.

ArticleMdressedto:

7/8/04

B.H,

AC 2004—056

.

.

Danvifle, IL

4.

RestrIcted

Delivery?

fExtra Fee)

2.A~icleNumber

(rmnserfromsen’I~IabeQ

.

70022030

0004

552~~51

102595-02-M-1540

D~esticRófu~iR&ai~t~