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DIVISION OF MINERALS AND GEOLOGY <br />CERTIFICATE OF SERVICE <br />PERMIT NO.: C-82-057 <br />C.O. NO.: N!A <br />N.O.V. NO.: C-93-136 <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 October 1B, 1993. <br />Certified Mail No.:,iP 296 527 266 <br />Return Receipt Re ested~'~ <br />Signature of Person Served <br />if personal service <br />David A. <br />Print Ndme and Title Print Name <br />REQUEST FOR CONFERENCE <br />gnature~ <br />sessmen <br />e <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 <br />19 <br />DAB/bjw <br />9043E <br />