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<br />~~ MINED LAND RECLAMATION DIVISION <br />CERTIFICATE OF SERVICE <br />PERMIT NO.: ~'~~-~7~ <br />C.O. NO.: --~- <br />N.O.V. NO.: ('-91'c'nj <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 ___ -(~)~;<rvice <br />y eposi ing a rue copy thereof <br />firs c ass pos age prepaidin the ni ed States mails at Denver, Colorado, <br />addressed to the operator at the address above, on /LJ~, ~~, ~ 19~~ <br />ignature o erson rve <br />if personal service <br />Certified Mail No.: (~ £fd ~ 179 .2~ 1 <br />Return Receipt~Requ/e/,s((~e <br />~~~'~i gna re ~2 <br />LCF~rY ( • l~Dui/cN. ; f~ffPfSifIP~.T 4~cP_/' <br />r n ame an i e grin ame an i <br />* ---- Check applicable method of service. <br />REQUEST FOR CONFERENCE <br />The operator above described hereby requests an assessment or settlement <br />conference as permitted by r„ R.S. 34-33-123(8). <br />Operator <br />ey <br />igna re <br />Date <br />19 i <br />05/90 <br />0311 (f) <br />