SENDER:

COMPLETE TI-US SECTION

U

Complete

items 1,

2, and 3. Also complete

item

4 if

Restricted

Delivery

is

desired.

U

Print your name

and

address on the

reverse

so that we can return the card to you.

U

Attach this

card

to the back of the mailpiece,

or on the front if space permits.

1.

AstlcleAddressedto:

10/6/05

B.M.

PCB

2006—023

DAle

Tippett

702

S.

Elevator

St.

Okawville,

IL

62271

ORiGINAL

Pollution Control Board

COMPLETE THIS SECTION ON

DELIVERY

A.

Signature

C)

Agent

—~--~~

7pdsved

by (PnntedNan,e)

Jo.

Date

of

Delivery

D.

Is

delivery address dfferent from fern 1?

0 Yes

If

YES,

enter delivery address below

C) No

3.

SeMce Type

itilied Mail

C)

Express Mali

RegIstered

0

Return

ReceIpt

for Mejthandlse

C)

Insured

Mall

Cl

cnn.

4.

RestrIcted

DelIvery?

(&tra Fee)

Cl

Yes

2. MIS

Number

(Trans1er~vmsen4oeIebe~)

7005

1160

0002

2069

3886

PS

Form

3811,

February

2004

Domestic Return

Receipt

10259&02-M- 1540