SENDER:
    COMPLETE THIS
    SECTION
    • Complete items 1 2, and 3. Also complete
    item 4 if Restricted Delivew 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. AsticleAddressedto:
    9/1/05
    EM
    PCB 2004—139
    Terry R. Young
    6525 Majors Lane
    Decatur, IL 62521
    /
    RECEIVED
    CLERK’S OFFICE
    SEP 1 J 2005
    STATE OF ILLINOIS
    Pollution Control Board
    Bt~~edby
    (Printed 4me)
    $6.
    Date of Delivery
    \Lt&
    WLLnI
    ‘b.
    Is delivery address different from item 1?
    0
    Yes
    II YES, enter delivery address below:
    0
    No
    3.
    Service Type
    ?Certlfied Mail
    9
    RegIstered
    0
    Express
    Mall
    0
    Return Recelpt for Merchandise
    9
    Insured MaIl
    0 C.O.D.
    4. Resblcted Delivery? (&tm
    Fee)
    9
    y~s
    2. Micle
    Number
    7005
    1160 0002 2069 3596
    (Traii star
    from
    service IabeQ
    102595-02-M-1540
    A. SI ature
    X(~jj~
    L~fljj~~
    o Agent
    O
    Addressee
    PS
    Form 3811,
    February 2004
    Domestic Return Receipt

    Back to top