ORIGINAL

SENDER :

COMPLETE THIS SECTION

•

Complete items 1, 2, and 3. Also complete

item 4 If Restricted Delivery Is desired

.

∎ Print your name and address on the reverse

so that we can return the card to you

.

•

Attach this card to the back of the mailplece,

or on the front if space permits .

1. ArtlcleAddressed to

:

4/20/06 B.M .

I

AC 2004-077

Frank Bencie

10220 Bencie Lane

West Frankfort, IL 62896

i

4. Restricted Delivery? (Extra Fee)

2. Article Number

(atans/erfrom servkeaabel)

7005 1160

0002

2067 8975

(_ PS Form

3811,

February 2004

Domestic Return Receipt

RECEIVED

CLERK'S OFFICE

MAY 0 1 2006

STATE OF ILLINOIS

Pollution Control Board

COMPLETE THIS SECTION ON DELIVERY

A. Signature

X

D Agent

A,

D Addressee

I

by

(Ranted

Name)

C. Date of Delivery

D. s delivery address different from item 1?

Dyes

A

If YES, enter delivery address below :

D No

ce Type

ed Mall

D Express Mall

Registered

D Return Receipt for Memhandlee

D Insured Mill

D

C.O.D.

D Yes

I02595.02-n1-,540