R?

L

RECIEWED

CLERK'S

OFF/CE

APR 1 1 2008

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 mallpiece,

or on the front if space permits.

COMPLETE THIS SECTION ON DELIVERY

r1

t_.L■r

_.■ /

,A01.-

?

Addressee

nt

Fra„,It

D. Is

Is

?

delivery address

I

different from item 1?

If YES, enter delivery address below:

?

0

No

3.

t

Service

Certified

TypeMall

0 Express Mail

?

Registered

?

0 Return Receipt for Merchandise

?

0 Insured Mall?

0

C.O.D.

4.

Restricted Delivery?

(Extra Fee)

?

q

Yes

1. ArticleAddressed to:

4/3/08 B.M.

PCB 2t,08-053

Terry Grote

204 South Street

Sims, IL 62886

es

q

ij,viii.),4,1;zi

‘0

• Article Number

(Transfer fmm service label)

7007 3020 0000 4630 5845

PS Form

3811,

February 2004?

Domestic?

Return Receipt

ON*

102595-02-M-1540