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DIVISION OF MINERALS AND GEOLOGY <br />CERTIFICATE OF SERVICE <br />PERMIT NO.: C-81-013 <br />N.O.V. NO.: C-94-008 <br />MAY 12 1994 <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;~,g~p~,Lx,i,i,}&~~y~rtygci~c~py <br />thereof first class postage prepaid in the United States mails at Denver, <br />Colorado, addressed to the operator at the address above, on May 3, 1994. <br />Certified Mail - P 179 165 774 <br />Return Recei Rea+s>=Sted <br />Signature of Person Served <br />if personal service <br />Print Name and Title Print Name a <br />REQUEST FOR CONFERENCE <br />Siy}rfature) <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 />G gnature) <br />Date sf, <br />19 <br />DAB/5cm <br />0313E <br />