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:

5/3/07 B .M .

AC 2005-047

Stacy Hess

1965 W

. Cruger Road

Washington, IL 61571

2. Article Number

(Transfer from servicelabeq 7006 0100 0000 7374 7798

I PS Form 3811, February 2004

Domestic Return Receipt

COMPLETE THIS SECTION ON DELIVERY

D. Is delivery add

di eren from item 1? D Yes

If YES, enter .elivery address below

:

D No

Agent

D Addressee

C. Date of Delivery

/5-0

7

3 . Service Type

certlfled Mall D Express Mall

~_MSistered

---

D Insured Mail

[3 Return Receipt for Merchandise

0 C .O.D.

4. Restricted Delivery? (Eha Fee)

D Yes

102595-02-M-1540

RER

CLE

EoVED

MAY 1 7 2007

STATE OF ILLINOIS

Pollution Control Board

ORIGINAL