CLERK’S OFFICEFEB 1 6 2005STATE OF ILUNOISPollution Control BoardSENDER COMPLETE THIS SECTIONU Complete items 1, 2, and 3.
Also complete
item 4 if Restricted Delivery is desired.
• Attach this card to the back of the mailpiece,
or on the front if space permits.
12343 East Blackhawk Road
COMPLETE THiS SECTION.
Date of Delivery
/~, r.~-i.’s~ 0-c s ~ -~ 0.
is delivery address different from item 1? 0 Yes
If YES, enter delivery address below: 0 No3. Service Type~‘~Certified MailIJ Registered0 Insured Mail..7004 0750 0004 3960 2779 o Express Mailo Return Receipt for M...
Allowed
Adobe Portable Document Format (.pdf) - application/pdf
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