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MINED LAND RECLAMATION DIVISION <br />CERTIFICATE OF SERYICE <br />PERMIT NO.: C•SG) 'Cj2% I <br />N.O.V. NO.: (? - I3~uZ~ <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 (: )* rT ^_^>> ~9~ce <br />r r or ~,rJ (b) y eposi ing a rue copy Ltiereof <br />firs c ass pos age prepaidin the ni ed States mails. t Denver, Colorado, <br />addressed to the operator at the address above, on 'z 19f~. <br />Certified Mail No.: <br />Return Receipt Reques e <br />ignature o erson rve igna re <br />if personal service i <br />nn~ ~ ~~~- <br />rin ame an i e ran an i e <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 />igna re <br />Date 19 <br />05/90 <br />0311 (f) <br />