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 . Article Addressed to

:

4/19/07

B .M .

PCB 2007-100

E .

Bergbower

Street

2

. Article Number

(Transfer from service label)

7006 0100 0000 7374 7767

'I PS Form

3811, February 2004

Domestic Return Receipt

RECEIVE D

MAY 01 2007

STATE OF ILLINOIS

Pollution Control Board

D. Is delivery address

If YES, enter delivery

3. Service Type

0 Certified Mail

O Express Mall

0 Registered

0 Return Receipt for Merchandlsr

0 Insured Mail

0 C.O.D .

4. Restricted Delivery? (Extra Fee)

0 Yes

102595-02-M-154

ORIGINAL

Wayne A .

13433 N

.

Newton,

& Susan

1425th

IL 62448