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<br />MINED LAND RECLAMATION DIVISION <br />CERTIFICATE OF SERVICE <br />PERMIT NO.: C-81-018 <br />C.Q. NO.: N/A <br />N.O.V. NO.: C-92-012 <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 July 22, 1992. <br />S~nature of erson Served <br />if personal service <br />~~ <br />Print Name and Title <br />Certified Mail No.: P 860 170 773 <br />Return Receip ted <br />gnature> <br />David A. Berry, Sen. Reclamation Specialist <br />Print Name and Title <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 />W ~M. i-.L•~QJ~o ' ~' '~C~ <br />Operator <br />BY ' / ~ / l - C~C~~ <br />(Si ature) <br />Date 7-a~- ~1~-- 19_ <br />DAB/bjw REC~iVEU <br />4196E ~~'UL s 0 992 <br />DIVISIUr~! U'r <br />MINERALS 8 uEOI.UG` <br />