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Complete items 1, 2,
and 3. Also complete
item 4 if Restricted Delivety is desired.
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Print your name and address on the reverse
so that we can
return the caitl to you.
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U
Attach this card to the back of the mailpiece,
oron the front if space
permits.
1.
ArticleAddressedto:
7/8/04
B.M.
AC 2004—076
Robert Wilson
Landfill, LLC
P.O. Box 657
______________________________
~
1~
3.
S9vice
Type
~
u~
r~.
~ranger
~àerhfiedMalI
DExpressMail
Harrisburg,
IL
62946
/0
Registered
0
Return
Receipt for Merthandise
0
Insured
Mail
0
C.O.D.
4.
Restncted
Delivery?
(Exba
Fee)
0
Yes
2.
Article Number
nsrfmmsj”iFceIabe~i
0~O2~O~
QQ~4~S~23j8968!
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F
PS
Foj~m
381i
,
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Return
Receipt
102595-o2-M.154o
RECE~VE~
CLERK’S OFFICE
JUL
22 2OO~
STATE OF ILLINOIS
Pollution
Control Board
A.
Sig
ture
x
DAgent
0
Addressee
B.
Rece
P
ed Name)
C.
Date of Delivery
0.
a
delivery
add
1?
0
Yes’
If
YES,
ente
d
ery~1ress
-
0
No