Part 101 Appendicies-APPENDIX GFormsIllustration A Citizen’s Formal Enforcement ComplaintFOR OFFICE USE ONLYSTATE OF ILLINOISPOLLUTION CONTROL BOARDDate Filed: ____________ Correct Number of Copies FiledJAMES R.
THOMPSON CENTER, SUITE 11-500
100 WEST RANDOLPH STREETRec’d by:_____________ Signatures on OriginalCHICAGO, ILLINOIS 60601(312) 814-3620CITIZEN’S FORMAL ENFORCEMENT COMPLAINT ) ){insert name of citizen(s) or organization )who is filing the complaint} ) Complainant, ) ) v.
) PCB {Clerk’s office Use}
) (Citizen Enforcement - X) {for ) Clerk’s office use}{insert the name of...
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Microsoft Office Word (.doc, .dot) - application/msword
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