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<br />DIVISION OF MINERALS AND GEOLOGY <br />CERTIFICATE OF SERVICE <br />Permit No. c-80-006 <br />NOV No. r._96-09 t <br />I hereby certify that I served a copy of the foregoing NOTICE AND ORDER TO PAY FIXED PENALTY <br />on 01/07/97 by depositing a true copy thereof, first class postage prepaid, in the <br />United States mail, to the operator at the address above, on 01/07/97 <br />Signature of Person Served <br />if Personal Service <br />Name and Title <br />Certified Mail No. 1? 427 335 098 <br />Return Receipt Requested <br />Signature / <br />Name: OAVin A. S <br />Title: Assessment Officer <br />REQUEST FOR CONFERENCE <br />Operator <br />The operator above described hereby requests an assessment or settlement conference as permitted by <br />C.RS. 34-33-123(8). <br />sy <br />Date <br />(Signature) <br />