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<br />MINED LAND RECLAMATION DIVISION <br />CERTIFICATE OF SERVICE <br />N.O.V. N0. C-84-175 <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 X b * by depositing a true <br />copy thereof first c ass postage prepaid in the Uni ed States mails at Denver, <br />Colorado, addressed to the operator at the address above, on , <br />19 <br />Certified Mail No. P 652 676 319 <br />S gnat <br />Susan Mowry„ <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 />