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<br />MINED LAND RECLAMATION DIVISION <br />CERTIFICATE OF SERVICE <br />PERMIT NO.: C~'~.~-ash <br />C.O. NO.: --~ <br />N.O.V. NO.: (=q~ -003 <br />RECEIVE~~ <br />MAR 1 6 1992 <br />Mined Land <br />Reclamation n,.~:-° - <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)~vice <br />y epost tog a rue copy thereof <br />firs c ass pos age prepaidi'n the nt ed States mails at Denver, Colorado, <br />addressed to the operator at the address above, o.. /1~J,,~~~, ~ 192,E <br />tgnature o erson rve <br />if personal service <br />r n ame an t e <br />Certified Mail No.: ~ X60 !79 ~,?1 <br />Return Receipt Reques(e ~.., <br />igna re <br />_Lar~v ~ ~ouY `~ , /~ssPSS~fi~vrT of~~P~ <br />r n ame an t <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 />05/90 <br />0311 (f) <br />Operator <br />By ~~ <br />tgna re <br />Date ~~~~/y 19-2 <br />