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• ~ ~ STAiE OF COLORADO <br />DIVISION OF MINED LAND RECLAMATION <br />COAL PROGRAM <br />Civil Penalty Worksheet <br />I. Identification <br />Permittee/Operator 1Iw lr.~n I,UeS I'r/ <br />Permit No. ~ rl+l-y > 1 <br />Date of Issuance `c~~'j I rl ?~ <br />Type of Violation <br />Administrative <br />Performance Std. y <br />Permit Condition <br />II. Action <br />Penalty Assessed Yes ~ No <br />Proposed Amount ~ <br />Source of information or assessment <br />Operator/Permittee <br />0lvision <br />III. Mandatory Penalties <br />Cessation Order <br />Failure to Abate $750.00 - $5,000.00/day X days <br />Mining Without a Permit <br />IV. Penalty Calculation Criteria - Rule 5.04.6 <br />Cateaorv Comments <br />A. History <br />~ NOV's past 12 months x $50.00 ~s 1, Pr '~~1 p y~,l,Z~~j,~ ~om~~4~~P <br />CO's past 12 months x $250.00 <br />B. Seriousness <br />Severe $1,500 $1,750 <br />Significant $1,000 $1,250 <br />Low/Moderate $250 $500 $750 <br />Insignificant b0 <br />Adminl5tratlve ; <br />C. Fault <br />Intentional $1,000 $1,250 $1,500 <br />Negligence $250 $500 $750 <br />Unavoidable $0 <br />D. Number of Davs Penalty Assessed <br />E. Good Faith (may not exceed $1,250.00) <br />Credit - Extraordinary Effort <br />Credit - Rapid Compliance _ - _ _- <br />~GrPAnPq~ ~e~+PA+ ~AMif ON Vj~PS~[YQi <br />/P/Nr,~~l ~4a~ I~PC(gna~Jli /~/ISI.~N <br />q~,~/ ~1te /if/~cs~ L~y~1 R nr(anYafl~H Bm~ <br />no Ci/fl ! Pnq~ ( U f Ge 4JJPJS~ fir <br />v`ro~afatJ 4f ~P AFC (i/esf Pt <br />wit frgey- (INGI rµnirlfeu"/' <br />Uh~2l~~a //~I~nr // <br />r/Sfi t p.rnia~ {lea/tN Y-S/A~fy pcrurJ <br />~P~ ~~ '(-~te Col~,__//of Ce44J/~tJG74oN <br />ir~C«gSC'f /ver I NPr of r'r~s' / <br />hes Ot~~~ure~{ QI 4 fPl~~! Of fA/~ <br />V~OIGIfON, <br />~, ~ O <br />~~~.~.~~ .%~~~u~i'O.F> Assessment Officer <br />S~gna ure <br />LG/'ry ~'. ~~ou7`ff/1 Date 0~-1-2( /9`/-Z <br />Name P inted ' <br />4672E <br />