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<br />DIVISION OF MINERALS AND GEOLOGY <br />CERTIFICATE OF SERVICE <br />PERMIT NO.: C-81-041 <br />C.O. NO.: N/A <br />N.O.V. NO.: C-93-119 <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 D nver <br />Colorado, addressed to the operator at the address above, on <br />Certified Mail No.: P 296 527 492 <br />Return Receip~uested <br />Signature of Person Served (Signature) <br />if personal service <br />Daniel I. Hernandez, Assessment Officer <br />Print Name and Title 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 />Date <br />gnature <br />19 <br />DIH/bjw <br />8787E <br />