CLERK’S OFFtCE

AUG

232005

STATE OF ILLINOIS

Pollution

Control Board

Cisne,

IL

62823

3.

Service Type

El

Certified

Mail

0

Express

Mail

0

Registered

0

Return

Receipt for Merchandise

0

Insured Mail

0

COD.

4.

Restncted Delivery?

(Extra Fee)

0

Yes

2.

Article

Number

(rransferfromservicelabe;)

70042890

0004

2307

1520

PS

Form

3811,

February 2004

Domestic

Return Receipt

1025u5-o2-M• 1540

N4~i

!‘

U

Complete items

1,

2,

and

3. Also cor~

item 4

it

Restricted Delivery is desire

.~

•

Print your

name and

address on the

I

so

that we can return the Card

to you.

•

Attach this card

to the back of the m~

or on the front

if space

permits.

1.

Article Addressed to:

I

FOB

2006—012

8/4/05

B.M.

David

Billingtun

I

/

Rural

Route

2,

box

96

5041.

Richfield

Road

address different

from

item

1?

i

Yes

It YES,

enter delivery address

below:

0

No