ORIGINAL

SENDER: COMPLETE THIS SECTION

∎ Complete Items 1, 2, and 3. Also complete

I

Item 4 if Restricted Delivery

Is

desired .

∎

Print your name and address on the reverse

so that we can return the card to you .

i ∎ Attach this card to the back of the mailpiece,

or on the front

if space permits.

j

i

1 . Article Addressed to;

2/2/06 B.M .-

I

I

PCB 2005-066

J.D

. Bergman, R.A .

108 E .

Ogden Avenue

Hinsdale, IL 60521-3572

I

I

PS.Forn,

3811,

February 2004

Domestic Return Receipt

COMPLETE THIS SECTION ON DELIVERY

ved by (PA^

nted Name)

t

.

T-

;-\'

C S

0. Is delivery address different from item 1?

CI Yes

if YES, enter delivery address below:

WNo

Ice Type

rtifled Mail

CI

Express man

Registered

O

Return Receipt for Merchandise

0

Insured Mail

Cl C.O.D.

4. Restricted Delivery? (Exam Fee)

2. Article Number

(Transfer!mmservIcelew

7005 1160 0002 2443 1620

RECEIVED

FEB 1 6 2006

STATE OF ILLINOIS

Pollution Control Board

{Agent

D

Addressee

C. Date of Delivery

E3

Yes

10259502.M4540