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MINED LAND RECLAMATION DIVISION <br />CERTIFICATE OF SERVIf,E <br />PERMIT NO.: C=81-012 <br />C.O. NO.: N/A <br />N.O.V. NO.: C-91-Old <br />I hereby certify that I served a cony of the foregoing NOTICE OF PROPOSED AMOUNT <br />OF CIVIL PENALTY on the operator therein described by depositing a true cony <br />thereof first class postage prepaid in the United States mails at Denver, <br />Colorado, addressed to the operator at the address above, on September 4, 1991. <br />Certified Mail .: P 666 579 3d0 <br />Return Re Requested <br />Signature of person Served <br />if personal service <br />qna <br />. _ .. _ .. _ .. .. .. _ . ~ ~~~MQ./IYI (~C/~ Mn1~.V ~ta./sw+r.+ S/1 fc.1411~/ <br />Print Name and Title Print Name and ltle ~- <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(81. <br />Operator <br />8y <br />(Signature) <br />Date 19 <br />DAB/ern <br />7977E <br />