| RECEIVEDCLERK’S OFFICENOV 012004STATE OF ILLINOISPollution Control BoardSENDER: COMPLETE THIS SECTION • Complete items 1, 2, and 3.item 4 if Restricted Delivery is desired.- S Attach this card to the back of the mailpiece,
or on the front if space permits.Box 339Gilman, IL 60938 3.~~Certified Mailo Registeredo Insured Mailig ature 0 Agent0 Addressee~~ceiv by(P,intedNà e)p C./c2~~4~o~b. Is deflvery address different from item 1.? 0 YesIt YES, enter delivery address below: 0 NoPS Form 3811, February 2004 ... |
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