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

PCB 2007-098

Roy Wiegand

(Transferfmmserviceiabep 7006

010000007374 7750

i PS Form 3811, February 2004

Domestic Return Receipt

B . M .

B . Received b (Printed Name)

,

C

. Date of Delivery

-q~ n/C 14 -19

67

D. Is delivery addwe" different from item 1?

17 Yes

If YES, enter delivery address below :

Quo

ORIGIN

A l

1 °2595-02-M

fE

CLERK'S

C E

OFFICE1

V E D

MAY 0 2 2007

STATE OF ILLINOIS

Pollution Control Board

2254 County Road 1100 N .

Secor, IL 61771

II

3.

Ice Type

Wed Mail

Registered

0 Insured Mall

O Express Mall

0

Return Receipt for Merchandise

0 C.O.D

.

4. Restricted Delivery? (Extra Fee)

11 Yes

i 2

. Article Number