•
    Complete items 1, 2,
    and 3. Also complete.
    J
    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.
    I.
    ArticleAddressedto:
    4/7/05
    B.N.
    PCB
    2005—173
    Gene
    Lane
    2044
    Quarry
    Road
    Kirkland,
    IL
    60146
    RECEIVED
    CLERK’S OFFICE
    APR
    2 52005
    STATE OF ILLINOIS
    Pollution Control Board
    SENDER:
    COMPLETE THIS SECTION
    COMPLETE THIS SECTION ON DELIVERY
    A. Signature
    x
    ~772lJ1~l,
    )~4,~~~qu)0
    Agent
    0
    Addressee
    ~/c3eceived
    t~/(Pfmnted
    Name)
    C.
    Date of DeIive~
    L/.fl-C~S
    0.
    Is
    delivery address different fmm item 1?
    0
    Yes
    If
    YES,
    enter delivery address below:
    0
    No
    3.
    Service Type
    ertified
    MalI
    0
    Express Mail
    Registered
    0
    RetUrn
    Receipt for Merchandise
    0
    Insured Mail
    0
    C.O.D.
    2.
    ArtIcle
    Number
    (rransfeifromseMcelabeO
    7004
    2890
    0004
    2296
    4649
    PS
    Form
    3811,
    February
    2004
    Domestic Return
    Receipt
    4.
    Restricted
    Delivery?~
    (Extra
    Fee)
    0
    ‘~‘~
    102595-02-M-l 540

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