ILLINOIS ENVIRONMENTAL PROTECTION AGENCY
1021 NORTH GRAND AVENUE EAST,
P.O.
Box 19276,
SPRINGFIELD, ILLINOIS
62794-9276 - ( 217) 782-3397
JAMES R.
THOMPSON CENTER, 1 00 WEST RANDOLPH, SUITE
11-300,
CHICAGO,
IL 60601 - (312) 814-6026
ROD R.
BLAGOJEVICH, GOVERNOR?
DOUGLAS
P.
SCOTT, DIRECTOR
(217) 782-9817
TDD: (217) 782-9143
0
im
(._D I
\
I
im
RECEIVED
CLERK'S
OFFICE
MAR 2 0 2008
Pollution
STATE
OF
Control
ILLINOIS
Board
March 18, 2008
John Therriault, Clerk
Illinois Pollution Control Board
James R. Thompson Center
100 West Randolph Street, Suite 11-500
Chicago, Illinois 60601
Re:
Illinois Environmental Protection Agency v.William Dixon
IEPA File No. 28-08-AC; 1810255016—Union County
Dear Mr.Therriault:
Enclosed for filing with the Illinois Pollution Control Board, please find the original and nine
true and correct copies of the Administrative Citation Package, consisting of the Administrative
Citation, the inspector's Affidavit, and the inspector's Illinois Environmental Protection Agency
Open Dump Inspection Checklist, issued to the above-referenced respondent(s).
On this date, a copy of the Administrative Citation Package was sent to the Respondent(s) via
Certified Mail. As soon as I receive the return receipt, I will promptly file a copy with you, so
that the Illinois Pollution Control Board may calculate the thirty-five (35) day appeal period for
purposes of entering a default judgment in the event the Respondent(s) fails or elects not to file a
petition for review contesting the Administrative Citation.
If you have any questions or concerns, please do not hesitate to contact me at the number above.
Thank you for your cooperation.
Sincerely,
Michelle M. Ryan
Assistant Counsel
Enclosures
ROCKFORD -
4302 North Main Street, Rockford, IL 61 103 – (815) 987-7760 • DES PLAINES -
9511 W. Harrison St., Des Plaines, IL 60016 – (847) 294-4000
ELGIN -
595 South State, Elgin, IL 60123 – (847) 608-3131 ?•
PEORIA -
5415 N. University St., Peoria, IL 61614 – (309) 693-5463
BUREAU OF LAND - PEORIA -
7620 N. University St., Peoria, IL 61614 – (309) 693-5462 •
CHAMPAIGN -
2125 South First Street, Champaign, IL 61820 – (217) 278-5800
SPRINGFIELD -
4500 S. Sixth Street Rd., Springfield, IL 62706 –
(217) 786-6892 • COLLINSVILLE -
2009 Mall Street, Collinsville, IL 62234 – (618) 346-5120
MARION -
2309 W. Main St., Suite 116, Marion, IL 62959 – (618) 993-7200
PRINTED ON RECYCLED PAPER
AC
6
(IEPA No. 28-08-AC)
Respectfully submitted,
J
Michelle M. Ry
Assistant Counsel
RECIEWEEb
CLERK'S OFFICE
MAR 2 0 2008
STATE
OF
ILLIOIS
Pollution Control
Board
BEFORE THE ILLINOIS POLLUTION CONTROL BOARD
ADMINISTRATIVE CITATION
ILLINOIS ENVIRONMENTAL
PROTECTION AGENCY,
Complainant,
v.
WILLIAM DIXON,
Respondents.
NOTICE OF FILING
To:
William Dixon
512 Ashlar Street
Jonesboro, IL 62952
PLEASE TAKE NOTICE that on this date I mailed for filing with the Clerk of the Pollution
Control Board of the State of Illinois the following instrument(s) entitled ADMINISTRATIVE
CITATION, AFFIDAVIT, and OPEN DUMP INSPECTION CHECKLIST.
Illinois Environmental Protection Agency
1021 North Grand Avenue East
P.O. Box 19276
Springfield, Illinois 62794-9276
(217) 782-5544
Dated: March 18, 2008
THIS FILING SUBMITTED ON RECYCLED PAPER
BEFORE THE ILLINOIS POLLUTION CONTROL BOARD
IRICZOF
. FICE
TCAMLTAEER OF
2 0i:2:
01;0
IS
ADMINISTRATIVE CITATION
Yollution Control Board
ILLINOIS ENVIRONMENTAL
OR
PROTECTION AGENCY,
Complainant,
v.
WILLIAM DIXON,
iNA
AC
11
(IEPA No. 28-08-AC)
Respondent.
JURISDICTION
This Administrative Citation is issued pursuant to the authority vested in the Illinois
Environmental Protection Agency by Section 31.1 of the Illinois Environmental Protection Act, 415
ILCS 5/31.1 (2006).
FACTS
1.
That William Dixon ("Respondent") is the present operator of a facility located at the
following legal address: SEC 30, TWP 12, RNG 1W, PART OF THE NW SE, .28 ACRES, in
Jonesboro, Union County, Illinois. The property is commonly known to the Illinois Environmental
Protection Agency as Jonesboro/Rendleman-Farrell-Dixon.
2.
That said facility is an open dump operating without an Illinois Environmental
Protection Agency Operating Permit and is designated with Site Code No. 1810255016.
3.
That Respondent has operated said facility at all times pertinent hereto.
4.
That on January 29, 2008, Sheila Williams of the Illinois Environmental Protection
Agency's Marion Regional Office inspected the above-described facility. A copy of her inspection
report setting forth the results of said inspection is attached hereto and made a part hereof.
VIOLATIONS
Based upon direct observations made by Sheila Williams during the course of her January
29, 2008 inspection of the above-named facility, the Illinois Environmental Protection Agency has
determined that Respondent has violated the Illinois Environmental Protection Act (hereinafter, the
"Act") as follows:
(1)
That Respondent caused or allowed the open dumping of waste in a manner
resulting in litter, a violation of Section 21(p)(1) of the Act, 415 ILCS 5/21(p)(1)
(2006).
(2)
That Respondent caused or allowed the open dumping of waste in a manner
resulting in scavenging, a violation of Section 21(p)(2) of the Act, 415 ILCS
5/21(p)(2)(2006).
(3)
That Respondent caused or allowed the open dumping of waste in a manner
resulting in open burning, a violation of Section 21(p)(3) of the Act, 415 ILCS
5/21(p)(3)(2006).
(4)
That Respondent caused or allowed the open dumping of waste in a manner
resulting in Deposition of General Construction or Demolition Debris: or Clean
Construction or Demolition Debris a violation of Section 21(p)(7) of the Act, 415
ILCS 5121(p)(7) (2006).
CIVIL PENALTY
Pursuant to Section 42(b)(4-5) of the Act, 415 ILCS 5/42(b)(4-5) (2006), Respondent is
subject to a civil penalty of One Thousand Five Hundred Dollars ($1,500.00) for each of the
2
violations identified above, for a total of Six Thousand Dollars ($6,000.00). If Respondent elects not
to petition the Illinois Pollution Control Board, the statutory civil penalty specified above shall be due
and payable no later than April 15, 2008, unless otherwise provided by order of the Illinois Pollution
Control Board.
If Respondent elects to contest this Administrative Citation by petitioning the Illinois Pollution
Control Board in accordance with Section 31.1 of the Act, 415 ILCS 5/31.1 (2006), and if the Illinois
Pollution Control Board issues a finding of violation as alleged herein, after an adjudicatory hearing,
Respondent shall be assessed the associated hearing costs incurred by the Illinois Environmental
Protection Agency and the Illinois Pollution Control Board. Those hearing costs shall be assessed
in addition to the One Thousand Five Hundred Dollar ($1,500.00) statutory civil penalty for each
violation.
Pursuant to Section 31.1(d)(1) of the Act, 415 ILCS 5/31.1(d)(1) (2006), if Respondent fails
to petition or elects not to petition the Illinois Pollution Control Board for review of this Administrative
Citation within thirty-five (35) days of the date of service, the Illinois Pollution Control Board shall
adopt a final order, which shall include this Administrative Citation and findings of violation as
alleged herein, and shall impose the statutory civil penalty specified above.
When payment is made, Respondent's check shall be made payable to the Illinois
Environmental Protection Trust Fund and mailed to the attention of Fiscal Services, Illinois
Environmental Protection Agency, 1021 North Grand Avenue East, P.O. Box 19276, Springfield,
Illinois 62794-9276. Along with payment, Respondent shall complete and return the enclosed
Remittance Form to ensure proper documentation of payment.
If any civil penalty and/or hearing costs are not paid within the time prescribed by order of the
Illinois Pollution Control Board, interest on said penalty and/or hearing costs shall be assessed
against the Respondent from the date payment is due up to and including the date that payment is
received. The Office of the Illinois Attorney General may be requested to initiate proceedings
3
against Respondent in Circuit Court to collect said penalty and/or hearing costs, plus any interest
accrued.
4
Douglas P. •cott, Director
6
Illinois Environmental Protection Agency
110
Date:
3
/18)0'8
PROCEDURE FOR CONTESTING THIS
ADMINISTRATIVE CITATION
Respondent has the right to contest this Administrative Citation pursuant to and in
accordance with Section 31.1 of the Act, 415 I LCS 5/31/1 (2006). If Respondent elects to contest
this Administrative Citation, then Respondent shall file a signed Petition for Review, including a
Notice of Filing, Certificate of Service, and Notice of Appearance, with the Clerk of the Illinois
Pollution Control Board, State of Illinois Center, 100 West Randolph, Suite 11-500, Chicago, Illinois
60601. A copy of said Petition for Review shall be filed with the Illinois Environmental Protection
Agency's Division of Legal Counsel at 1021 North Grand Avenue East, P.O. Box 19276, Springfield,
Illinois 62794-9276. Section 31.1 of the Act provides that any Petition for Review shall be filed within
thirty-five (35) days of the date of service of this Administrative Citation or the Illinois Pollution
Control Board shall enter a default judgment against the Respondent.
Prepared by:
Susan E. Konzelmann, Legal Assistant
Division of Legal Counsel
Illinois Environmental Protection Agency
1021 North Grand Avenue East
P.O. Box 19276
Springfield, Illinois 62794-9276
(217) 782-5544
5
O
R
IGI
NA
REMITTANCE FORM
RECEIVED
CLERK'S OFFICE
MAR
2
0
2008
STATE OF ILLINOIS
Pollution Control Board
ILLINOIS ENVIRONMENTAL
PROTECTION AGENCY,
Complainant,
v.
WILLIAM DIXON,
AC 0
>.
(IEPA No. 28-08-AC)
Respondent.
FACILITY:
?
Jonesboro/Rendleman-Farrell-Dixon
?
SITE CODE NO.: 1810255016
COUNTY:
?
Union
?
CIVIL PENALlY: $6,000.00
DATE OF INSPECTION:
?
January 29, 2008
DATE REMITTED:
SS/FEIN NUMBER:
SIGNATURE:
NOTE
Please enter the date of your remittance, your Social Security number (SS) if an individual or
Federal Employer Identification Number (FEIN) if a corporation, and sign this Remittance Form. Be
sure your check is enclosed and mail, along with Remittance Form, to Illinois Environmental
Protection Agency, Attn.: Fiscal Services, P.O. Box 19276, Springfield, Illinois 62794-9276.
6
William Dixon
512 Ashlar St.
Jonesboro, IL 62952
CLERK'S OFFIce
MAR
2 D 200f?
sTAT
F
Agnus Rendleman & Nancy Farrell
618 W. Washington
Napoleon, OH 43545
P
ILLINOIS ENVIRONMENTAL PROTECTION AGENCY
Open Dump Inspection Checklist
County:?
Union
?
LPC#:?
1810255016
?
Region:?
7 - Marion
Location/Site Name:
?
Jonesboro/Rendleman - Farrell - Dixon
Date:
?
01/29/2008 Time: From 12:45 PM To 1:03 PM
?
Previous Inspection Date: 01/10/2008
Inspector(s):
?
S. Williams
?
Weather: overcast, –45 F.
No. of Photos Taken: #
?
11?
Est. Amt. of Waste: 61
?
yds3 Samples Taken: Yes #
Interviewed:?
Complaint #: 08-077
Latitude: N 37A4353 Longitude: W -89.25919 Collection Point Description: Site Entrance -
(Example:
?
Lat.: 41.26493
Collection Method: GPS -
?
Long.: -89.38294)
No El
Responsible Party
Mailing Address(es)
and Phone Number(s):
SECTION
.
,f-,,,stution corm
DESCRIPTION
_
--,,,..e
Mar
VIOL
ILLINOIS ENVIRONMENTAL PROTECTION ACT REQUIREMENTS
1.
9(a)
CAUSE, THREATEN OR ALLOW AIR POLLUTION IN ILLINOIS
a
2.
9(c)
CAUSE OR ALLOW OPEN BURNING
I
I
3.
12(a)
CAUSE, THREATEN OR ALLOW WATER POLLUTION IN ILLINOIS
4.
12(d)
CREATE A WATER POLLUTION HAZARD
5.
21(a)
CAUSE OR ALLOW OPEN DUMPING
6.
21(d)
CONDUCT ANY WASTE-STORAGE, WASTE-TREATMENT, OR WASTE- DISPOSAL
OPERATION:
(1)
Without a Permit
(2)
In Violation of Any Regulations or Standards Adopted by the Board
■
7.
21(e)
DISPOSE, TREAT, STORE, OR ABANDON ANY WASTE, OR TRANSPORT ANY
WASTE INTO THE STATE AT/TO SITES NOT MEETING REQUIREMENTS OF ACT
8.
21(p)
CAUSE OR ALLOW THE OPEN DUMPING OF ANY WASTE IN A MANNER WHICH RESULTS
IN ANY OF THE FOLLOWING OCCURRENCES AT THE DUMP SITE:
(1)
Litter
(2)
Scavenging
(3)
Open Burning
(4)
Deposition of Waste in Standing or Flowing Waters
q
(5)
Proliferation of Disease Vectors
I?
I
(6)
Standing or Flowing Liquid Discharge from the Dump Site
q
Revised 6/21/2007
?
(Open Dump - 1)
LPC
# 1810255016
Inspection Date:
?
01/29/2008
( 7 )
Deposition of: (i) General Construction or Demolition Debris as defined in Section
3.160(a); or (ii) Clean Construction or Demolition Debris as defined in Section 3.160(b)
■
9.
55(a)
NO PERSON SHALL:
(1)
Cause or Allow Open Dumping
of Any Used or Waste Tir
q
(2)
Cause or Allow Open Burning of Any Used or Waste Tire
ri
35 ILLINOIS ADMINISTRATIVE CODE REQUIREMENTS
SUBTITLE G
10.
812.101(a)
FAILURE TO SUBMIT
AN
APPLICATION FOR A PERMIT TO DEVELOP AND
OPERATE A LANDFILL
■
12.
11.
808.121722.111
SPECIAL
HAZARDOUS
WASTE
WASTE
DETERMINATION
DETERMINATION
ri
q
13.
809.302(a)
ACCEPTANCE OF SPECIAL WASTE FROM A WASTE TRANSPORTER WITHOUT A
WASTE HAULING PERMIT, UNIFORM WASTE PROGRAM REGISTRATION AND
PERMIT AND/OR MANIFEST
q
OTHER REQUIREMENTS
14.
APPARENT VIOLATION OF:
(
q
)
PCB;
(
q
)
CIRCUIT COURT
CASE NUMBER:?
ORDER ENTERED ON:
q
15.
OTHER:
q
n
Informational Notes
1.
[Illinois] Environmental Protection Act: 415
ILLS 5/4.
2.
Illinois Pollution Control Board: 35 III. Adm. Code, Subtitle G.
3.
Statutory and regulatory references herein are provided for convenience only and should not be construed as legal
conclusions of the Agency or as limiting the Agency's statutory or regulatory powers. Requirements of some statutes
and regulations cited are in summary format. Full text of requirements can be found in references listed in 1. and 2.
above.
4.
The provisions of subsection (p) of Section 21 of the [Illinois] Environmental Protection Act shall be enforceable either
by administrative citation under Section 31.1 of the Act or by complaint under Section 31 of the Act.
5.
This inspection was conducted in accordance with Sections 4(c) and 4(d) of the [Illinois] Environmental Protection Act:
415 ILLS 5/4(c) and (d).
6.
Items marked with an "NE" were not evaluated at the time of this inspection.
Revised 6/21/2007
(Open Dump - 2)
NARRATIVE INSPECTION REPORT
Date: January 29, 2008?
Inspector: Sheila Williams
Site Code: 1810255016
?
County: Union
Site Name: Jonesboro/Rendleman – Farrell - Dixon
?
Time: 12:45 P.M. – 1:03 P.M.
GENERAL REMARKS
On January 29, 2008 a follow up inspection was conducted at the Jonesboro/Dixon
site. The initial inspection was conducted on November 15, 2007 at which time
apparent violations pertained to open dumping & open burning. Amongst other debris,
an open burn area & a dilapidated mobile home were present during the first
inspection. On January 10, 2008 a site visit was conducted. Besides the appearance of
additional waste having been burned in the open burn area, it was apparent the
dilapidated mobile home had been burned on site.
During the current inspection four areas of apparent violations, as well as scattered
waste, were observed. The four areas have been designated as Area A – Area D.
Among the scattered wastes were demolition wood, insulation & general refuse. Area A
is the same shallow pit previously noted that is used for open burning. Among the
waste in Area A were pieces of charred furniture, tire beads, clothing, metal, landscape
waste, a partially melted plastic bucket, demolition debris & general refuse. The pieces
of charred furniture were not present during previous visits. It appears this area is still
being utilized for open burning. Area A was estimated to be approximately eight cubic
yards (17.5'x12.5'x1) in size. Area B appeared to be the remains of the dilapidated
mobile home that was previously observed. During the January 10, 2008 site visit, the
metal frame was amongst the debris. It was obvious during the current inspection that
the large piece(s) of metal had been removed. Because of this, it is apparent
scavenging has occurred. Area B was estimated to be approximately 47 cubic yards
1
(67.5'x12.5'x1.5) in size. Area C consisted of a trailer holding dimensional lumber still
exposed to the elements. Area C was estimated to be approximately five cubic yards
(10/x5'x2.5') in size. Area D was a new area containing metal, ash & demolition debris.
Area D was estimated to be approximately one cubic yard (5
1x7.5
1
x1') in size.
Following the initial inspection I was told by the Union County Assessors Office that
they did not show a William Dixon as owning property in this area. I was also told that
there was one piece of property in the vicinity of this site that had no name or identity
associated with it. An incident report dated November 11, 2007 from the Jonesboro
Police Dept. indicated William Dixon resides at this location & he was found to be
burning brush & tires. As a result Mr. Dixon was sent an ACWN. I recently spoke with
the assessors office again & was informed that their updated records reflect Agnus
Rendleman (with no mailing address) et. al owns the property, but Nancy Farrell of
Napoleon, Ohio receives the tax bill for this piece of property.
2
Ashlar St.
11\
mobile
home
fence
Area B
/
Area A
ar a of open
burning
burned /
6
mobile
home
4/?
5
N
\lo
3
E3
rea D
Area C
Ashlar St.
Jonesboro/Rendleman - Farrell - Dixon
#1810255016 — Union County
Not to Scale
Locations are Approximate
1/29/2008
Illinois Environmental Protection Agency
Bureau of Land
Division of Land Pollution Control
LPC #1810255016 – Union County
Jonesboro/Rendleman - Farrell - Dixon
FOS File
DIGITAL PHOTOGRAPHS
File Names: 1810255016"01292008 - [Exp.
#].jpg
Date: 1/29/2008
Time: 12:45 P.M.
Direction: north
Photo by: S. Williams
Exposure #: 001
Comments: appears
furniture & other
waste open burned
Date: 1/29/2008
Time: 12:46 P.M.
Direction: northwest
Photo by: S. Williams
Exposure #: 002
Comments: open burn
area
Page 1 of 6
Illinois Environmental Protection Agency
Bureau of Land
Division of Land Pollution Control
LPC #1810255016 – Union County
Jonesboro/Rendleman - Farrell - Dixon
FOS File
DIGITAL PHOTOGRAPHS
File Names: 1810255016^i01292008 - [Exp. #].jpg
Date: 1/29/2008
Time: 12:49 P.M.
Direction: southeast
Photo by: S. Williams
Exposure #: 003
Comments: scattered
debris
Date: 1/29/2008
Time: 12:49 P.M.
Direction: northeast
Photo by: S. Williams
Exposure #: 004
Comments: ash,
insulation, metal,
demolition wood & a
toilet
Page 2 of 6
Illinois Environmental Protection Agency
Bureau of Land
Division of Land Pollution Control
LPC #1810255016 – Union County
Jonesboro/Rendleman - Farrell - Dixon
FOS File
DIGITAL PHOTOGRAPHS
File Names: 1810255016"01292008 - [Exp. #].jpg
Date: 1/29/2008
Time: 12:50 P.M.
Direction: northeast
Photo by: S. Williams
Exposure #: 005
Comments: trailer
holding dimensional
lumber
Date: 1/29/2008
Time: 12:52 P.M.
Direction: southwest
Photo by: S. Williams
Exposure #: 006
Comments: charred
demolition debris, ash
& general refuse
Page 3 of 6
Illinois Environmental Protection Agency
Bureau of Land
Division of Land Pollution Control
LPC #1810255016 – Union County
Jonesboro/Rendleman - Farrell - Dixon
FOS File
DIGITAL PHOTOGRAPHS
File Names: 1810255016",
01292008 - [Exp.
#].jpg
Date: 1/29/2008
Time: 12:54 P.M.
Direction: north
Photo by: S. Williams
Exposure #: 007
Comments: charred
demolition debris &
ash
Date: 1/29/2008
Time: 12:55 P.M.
Direction: southwest
Photo by: S. Williams
Exposure #: 008
Comments: metal,
demolition debris &
ash
Page 4 of 6
Illinois Environmental Protection Agency
Bureau of Land
Division of Land Pollution Control
LPC #1810255016 – Union County
Jonesboro/Rendleman - Farrell - Dixon
FOS File
DIGITAL PHOTOGRAPHS
File Names: 1810255016
,v
01292008 - [Exp. #].jpg
Date: 1/29/2008
Time: 12:57 P.M.
Direction: south
Photo by: S. Williams
Exposure #: 009
Comments:
windblown waste
Date: 1/29/2008
Time: 12:58 P.M.
Direction: northwest
Photo by: S. Williams
Exposure #: 010
Comments: in the
center of the picture
is charred vegetation
amongst the charred
demolition debris
Page 5 of 6
Illinois Environmental Protection Agency
Bureau of Land
Division of Land Pollution Control
LPC #1810255016 – Union County
Jonesboro/Rendleman - Farrell - Dixon
FOS File
DIGITAL PHOTOGRAPHS
Date: 1/29/2008
Time: 1:02 P.M.
Direction: northwest
Photo by: S. Williams
Exposure #: 011
Comments: plastic
bottles, a toy,
demolition debris &
other general refuse
File Names: 1810255016"01292008 - [Exp. #].jpg
Page 6 of 6
BEFORE THE ILLINOIS POLLUTION CONTROL BOARD
ILLINOIS ENVIRONMENTAL PROTECTION AGENCY
Complainant,
IEPA DOCKET NO.
v.
Respondent.
AFFIDAVIT
Affiant, Sheila Williams, being first duly sworn, voluntarily deposes and states as follows:
1.
Affiant is a field inspector employed by the Land Pollution Control Division of the
Illinois Environmental Protection Agency and has been so employed at all times pertinent hereto.
2.
On January 29, 2008, between 12:45 p.m. and 1:03 p.m., Affiant conducted an
inspection of a disposal site operated by William Dixon, located in Union County, Illinois, and
known as Jonesboro/Rendleman-Farrel-Dixon by the Illinois Environmental Protection Agency.
Said site has been assigned site code number 1810255016 by the Agency.
3.
Affiant inspected said Jonesboro/Rendleman-Farrel-Dixon site by an on-site
inspection which included walking and photographing the site.
4. As a result of the material actions referred to in paragraph 3 above, Affiant completed
the Inspection Report foim attached hereto and made a part hereof, which, to the best of Affiant's
knowledge and belief, is an accurate representation of Affiant's observations and factual
conclusions with respect to said Jonesboro/Rendleman-Farrel-Dixon.
Subscribed and Sworn to before me
this
DcV
. 3/
(g-
day of
'‘,..--eree-4,44€4,4..- 0? 00 a)
•
Notary
Pub
b, 0--
r-FICIAL EAU:
I
MARCIA A. ENGLISH
Notary Pubfic. State of Illinois
My Commission Expires: 03/06/08
SRW:jkb/34501/02-26-08
C R I
ii,114 CiFISERVICE
REceivED
CLERK'S
MAR 2
0
OFFICE
200R
I hereby certify that I did on the 18th day of March 2008, send by Certif
Nag
IDRLItagcq67t
of ution Control Board
Requested, with postage thereon fully prepaid, by depositing in a United States Post Office Box a true
and correct copy of the following instrument(s) entitled ADMINISTRATIVE CITATION,
AFFIDAVIT, and OPEN DUMP INSPECTION CHECKLIST
To:
William Dixon
512 Ashlar Street
Jonesboro, IL 62952
and the original and nine (9) true and correct copies of the same foregoing instruments on the same
date by Certified Mail, Return Receipt Requested, with postage thereon fully prepaid
To:
John Therriault
Pollution Control Board
James R. Thompson Center
100 West Randolph Street, Suite 11-500
Chicago, Illinois 60601
Michel e M. Ryan
Assistant Counsel
Illinois Environmental Protection Agency
1021 North Grand Avenue East
P.O. Box 19276
Springfield, Illinois 62794-9276
(217) 782-5544
THIS FILING SUBMITTED ON RECYCLED PAPER
A.
Signature
X
B. Received by (
Printed Name)
U.S. Postal
C
E RTIRE*
(ftwg*(65
irififithiation visit
our
webSit
Postage
Certified Fee
Return Receipt Fee
(Endorsement Required)
Restricted Delivery Fee
(Endorsement Required)
Total Postage & Fees
Sent To
William Dixon
Postmark
Here
Street, Apt. No.;
or PO Box No.
512 Ashlar St.
City, State, ZIPI-t
Jonesboro,
01057wwwwrn
IL 62952
26L,'As.,04
11.111■=11111111■
11••■■•■
SENDER:
COMPLETE THIS SECTION
COMPLETE THIS SECTION
OM DELIVERY
■
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:
William Dixon
512 Ashlar St.
Jonesboro, IL 62952
q
Agent
q
Addressee
C. Date of Delivery
D. Is delivery address different from item 1?
q
Yes
If YES, enter delivery address below:?
q
No
3. Service Type
q
Certified Mail
q
Registered
q
Insured Mail
q
Express Mail
q
Return Receipt for Merchandise
q
C.O.D.
4. Restricted Delivery?
(Extra Fee)
?
q
Yes
2. Article Number
(Transfer from service label)
7007 0220 0000 0152 3144
PS Form 3811,
February 2004
Domestic Return Receipt
102595-02-M-1540
