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<br />MINED LAND RECLAMATION DIVISION <br />CERTIFICATE OF SERVICE <br />•.G .0. N0. C-84-167 <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 _(a)* personal service <br />upon the operator or its representative at , <br />Colorado on 19 or XX b * by depositing a true <br />copy thereof trst c ass postage prepaid in the Untted States mails at Denver, <br />Colorado, addressed to the operator at the address above, on ~Wy L/ , <br />19~. <br />Certified Mail No. P 652 674 440 <br />~ N~ - <br />Signature <br />Michael S, Savage <br />Name Printed <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 C.R.S. 34-33-123(8). <br />Operator <br />By <br />ignature <br />Date 19 <br />(1/83) <br />Doc. No. 251 <br />