ORIGINAL JAN ~92OU5STATE OFPollutio~.,Control BoardSENDER COMPLETE THIS SECTIONa Complete items 1, 2, and 3.
Also complete A.
Signature
~ 0 .Agentitem 4 if Restricted Delivery is desired.
B.
1~ceivedby (Printed Name) C Date a Delivery
a Attach this card to the back of the mailpiece,or on the front if space permits.
Lomac Payton
Knox County Landfill CommitteeKnox County Courthouse 3. Service TypeGalesburg, IL 61401 ~Certified•Mail 0 Express MailRegistered 0 Return Receipt for Merchandise0 Insured Mail 0 C.O.D.4. Restricted Delivery?
Allowed
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