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I~ISION OF MINERALS AND GEO~GY <br />CERTIFICATE OF SERVICE <br />Permit No. C-94-082 <br />NOV No. CV-97-004 <br />I hereby certify that I served a copy of the foregoing NOTICE AND ORDER TO PAY FIXED PENALTY <br />on APRIL 14. 1997 by depositing a true copy thereof, first class postage prepaid, in the <br />United States mail, to the operator at the address above, on APRIL 14 1997 <br />Certified Mail No. Z 416 952 565 <br />Retum Receipt Requested <br />Signature of Person Served Signature <br />if Personal Service <br />Name: 11AWID A. BERRY <br />Title: Assessment Officer <br />Name and Title <br />REQUEST FOR CONFERENCE <br />The operator above described hereby requests an assessment or settlement conference as permitted by <br />C.R.S. 34-33-123(8). <br />Operator <br />By <br />(Signature) <br />Date <br />