SENDER:

COMPLETE

THIS

SECTION

•

Complete

items

1,

2,

and

3.

AlSO

complete

item

4

if

Restricted

Delivery

is

desired.

H

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.

ArticleAddressedto:

9/30/08

B.M.

AC

2009—010

Brian

Bellemey

2945

Stiegel

Road

Carbondale,

IL

62901

ECEVED

CLERK’S

OFFICE

OCT

14

2O

STATE

OF

ILLINOIS

Pollution

Control

Board

cff

.It.h’I.JIaJ1Wa’:V

X/j(1j/Addressee

B.

Received

by

(Printed

Name)

C

ate

f

Dlivery

4iLu3#ç&i

D

Is

delivery

address

different

from

item

1’?

Yes

If

YES,

enter

delivery

address

below:

D

No

3.

Service

Type

CertifiedMail

EJ

Express

Mail

D

Registered

9

Return

Receipt

for

Merchandise

C

Insured

Mail

C

C.O.D.

4.

Restricted

Delivery?

(Extra

Fee)

C

Yes

2.

Article

Number

(Transferfrom

service

label)

7007

3020

0000

4631

0016

PS

Form

381

1,

February

2004

Domestic

Return

Receipt

102595-02-M-1540