RECE~VED
    CLERK’S OFFICE
    FEB
    1
    6
    2005
    STATE OF ILUNOIS
    Pollution
    Control Board
    SENDER
    COMPLETE THIS SECTION
    U
    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
    return the card to you.
    •
    Attach this
    card to the back of the
    mailpiece,
    or on the front if space permits.
    1.
    ArticJeAdclressedto:
    2/3/05
    B.N.
    AC 2005—032
    James Haas,
    Jr.
    12343 East Blackhawk Road
    COMPLETE THiS SECTION. ON
    DELIVERY
    A.
    Signature
    xL~~
    ~J
    ~-~-
    ~/Received
    by
    (Printed Né,ne)
    Ic.
    Date of Delivery
    /
    ~,
    r.~-i.’s
    ~
    0-c
    s
    ~
    -~
    0.
    is
    delivery
    address different from item 1?
    0
    Yes
    If YES, enter delivery address below:
    0
    No
    3.
    Service Type
    ~‘~Certified Mail
    IJ
    Registered
    0
    Insured Mail..
    7004 0750 0004 3960 2779
    o
    Express Mail
    o
    Return
    Receipt for Merchandise
    o
    C.O.D.
    ~t~AL
    o
    Agent
    0
    Addressee.
    Stockton, IL 61085
    2.
    Article Number
    (Transferf~om
    service label)
    4.
    Restricted
    Delivery?
    (Extra Fee)
    0
    Yes
    PS Form
    3811,
    February
    2004
    Domestic Return
    Receipt
    I 02595-02-M-I 540

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