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z <br />MINED LAND RECLAMATION DIVISION <br />CERTIFICATE OF SERVICE <br />PERMIT NO.: 79-60/ug/c; C-S1-015 <br />C.O. NO.: N/A <br />N.O.V. NO.: C-91-OOa <br />I hereby certify that I served a copy of the foregoing NOTICE OF PROPOSED AMOUNT <br />OF CIVIL PENALTY on the operator therein described by depositing a true copy <br />thereof first class postage prepaid in the United States mails at Denver, <br />Colorado, addressed to the operator at the address above, on July 12, 1991. <br />Signature of Person Served <br />if personal service <br />Print Name and Title <br />Certified Mail No.: P 666 579 201 <br />Return Receipt Requested <br />//(i2~Ci1.!~ii <br />(Signature) <br />Larrv P. Routten, Assessment Officer <br />Print Name and Title <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 />(Signature) <br />Date 19 <br />LPR/ern <br />6963E <br />