1. page 1

 
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REC
EWED
APR 0 2 2007
STATE OF ILLINOIS
Pollution Control Board
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 .
. Article Addressed to :
3/15/07 B .M .
PCB 2005-212
and PCB 2005-213
Thomas G . Safley
Hodge Dwyer
Zeman
3150 Roland Avenue
Post
Office Box 5776
Springfield, IL
62705-5776
I PS Form 3811, February 2004
SENDER
:
COMPLETE THIS SECTION
I ∎ 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 . Article Addressed to
:
3/15/07 B .M.
IPCB 2005-212 and PCB 2005-213
I
Edward W
. Dywer
Hodge Dwyer Zeman
3150 Roland Avenue
Post Office Box 5776
I Springfield, IL 62705-5776
I
SENDER :
COMPLETE THIS SECTION
∎ Complete items 1, 2, and 3
. Also complete
Item 4 it 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,
i
or on the front If space permits .
1 . ArtlcleAddressedto :
3/15/07 B .
PCB 2005-212 and PCB 2005-213
Ryan E . Mohr
Hodge Dwyer Zeman
3150 Roland Avenue
Post Office Box 5776
Springfield, IL 62705-5776
Domestic Return Receipt
COMPLETE THIS SECTION ON DELIVERY
A. Signature
B . Received by (Printed Name)
11 Agent
0Address
Lee 3
C. Date
-27
of Deliv,
D. Is delivery address different from item 1? 0 Yes
If YES, enter delivery address below :
0 No
2 . Article Number
(Transfer from service label)
7001 1140 0002 7469 0282
Ice Type
rtifled Mail 0 Express Mail
Registered
O Insured Mail
0 Return Receipt for Merchandi
0 C.O D .
4
. Restricted Delivery? (Extra Fee)
COMPLETE THIS SECTION ON DELIVERY
B . Received by
(Printed Name)
C
4. Restricted Delivery? (Extra
Fee)
0 Yes
A SignM
2
. Article Number
I
(rransferfrom semcelabel) 7001
1140 0002 7469 0398
PS Form 3811,
February 2004
Domestic Return Receipt
2 . Article Number
(Transfer from service label)
7001 1140
0002 7469 0299
PS Form 3811, February 2004
Domestic Return Receipt
0
Yes
102595-02-Ma :
0 Agent
2
U Address
B. /~R~Jeceived by (Printed Name)
,l
/roil
-1-dr
4 . Restricted Delivery?
(Extra Fee)
Date of Deliver)
D
. Is delivery address different from item 1?
0 Yes
If YES, enter delivery address below
:
0 No
3
. Service Type
-*Certified Mall
0
Express Mail
0
Registered
0
Return Receipt for Merchandisi
0
Inured Mail 0 C .O.D
.
102595-02-M.1S
COMPLETE THIS SECTION ON DELIVERY
A. Sign
X
0
Agent
0Addresse
C . Date of Deliver
D
. Is delivery address different from Item
3-
1?
3701
0 Yes
If YES, enter delivery address below
:
0 No
3. Service Type
rtlfled Mall
0 Express Mall
Registered
0
Return Receipt for Merchandit
El Insured Mail
0 C.O.D .
0
Yes
102595-02-M-15

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