ORIGINAL

SENDER:

COMPLETE THIS SECTION

•

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.AjticleAddressedto:

10/6/05

B.M.

PCB

2004—084

Deborah

Helms

Smith

RECEIVED

CLERK’S

OFFICE

OCT

182005

STATE OF ILLINOIS

Pollution Control Board

_______

C

Addressee

B.

4d~A~Ny

~4*nW

Q~M

E

~clj)ate

of Deilvery

QCT17~

D.

Is

delivery

addressdittemntfiom Item

1?

If YES, enter delivery address below:

o

Yes

o

No

DuPage County

State’s

Attorney

Office

505

North

County

Farm

Road

Wheaton,

IL 60187

3.

§ervlce 1~pe

~.CertIfled

Mail

0

Express Mall

‘0

RegIstered

0

Return ReceIpt

for Merthendise

o

Insured Mall

0

C.O.D.

4.

RestrIcted

Delivery?

(Extm Fee)

2.

Article Number

(flvnsferfrom service label)

7005

1160

0002

2069

3794

0

Yes

A.

signá4~~’1

n/I

x

9

OAgent

PS

Form

3811,

February

2004

Domestic

Return Receipt

102595-O2-M.1540