~Recelved
    C~,41L
    by
    (Printed
    Name)
    ~Ok~(
    C.
    DateofJ~qIive~
    7/~z5j/,~!
    D
    Express Mail
    o
    Return
    Receipt for Merchandise
    o
    C.0;D.
    4.
    RestrIcted Delivery?
    (Extra Fee)
    0
    Yes
    2.
    Article Number
    I
    (77~nsfer
    from service
    label)
    7002
    2030
    0004
    5523
    9026
    r~~~Form
    3811
    ,~
    August
    2001
    Domestic Return
    Receipt
    1o2595-02-M-1540
    AUG
    2
    2004
    STATE OF ILLINOIS
    Pollutjo,-~Control Board
    SENDER:
    COMPLETE
    THIS SECTION
    FIPLETE
    THIS SECTION ON DELIVERY
    A.
    Signature
    •
    Complete items
    1
    2, and 3. Also complete
    item 4 if Restricted Delivery is desired.
    •
    Print your name and address on th&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.
    ArticleAddressedto:
    7/22/04
    B.M.
    /
    AC 2003—032
    Carl Benedict
    2500
    West Farmington Road
    West Peoria,
    IL
    61604
    o
    Agent
    ~
    Addressee
    D.
    Is
    deliveryaddress different from Item 1?’
    0 Ye~
    If YES, enter delivery address below:
    No
    3.
    Service Type
    Kcertifed
    Mail
    o
    Registered
    o
    Insured Mail
    C~ED

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