CLERK’s OFFICEH) FE~’) TI F~\~lI~ STATE OF ILLINOIS ~ Pollution Control BoardSENDER: COMPLETE THIS SECTION COMPLETE TPdS ~ECTIOPJON DELIVERYI Complete items 1, 2, and 3.
Also complete
item 4 ~fRestricted Delivery is desired.
• Attach this carti to the back of the mailpiece,
or on the front if space permits.
4~Restricted Delivery? (E~ctmFee) 0 Yes
2.
Article Number
(rransferfromservice label) 7004 2890 0004 2296 4656PS Form 3811, February 2004 Domestic Return Receipt 102595-o2-M-is4O
Allowed
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