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:.~ <br />MINED LHi10 RECLAi~IATIOn OIVISIOia <br />CErtTIFICATE OF SER'JICE <br />N.O.V. N0. C-84-063 <br />i nereuy certify that I served a copy of the foregoing hiOTICE OF PROPOSED APIOUWT <br />OF CIVIC PENALTY on the operator therein descrioed by _(a)* personal service <br />upon the operator or its representative at , <br />Colorado on 19 or (o)* oy depositing a true <br />copy thereof first class postage prepaid in the United States mails aL Uenver, <br />Colorado, addressed to the operator at the address above, on ~~ gn , <br />19~. <br />Return Receipt Requested <br />Certified Mail .JO. P 397 149 432 <br />Jl' ~. A n...~_ <br />(5iynature <br />Brian Munson <br />Name Printed <br />* ---- ChecK applicable method of service. <br />REQUEST FOR CONFERENCE <br />The operator above described hereby requests an assessment or settlement <br />conference as permitted by C.R.S. 34-33-123(8). <br />Operator <br />By <br />ignature <br />Date 19 <br />(1/83) <br />Doc. No. 251 <br />