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i <br />1 <br />~ 1 <br />MINED LAND RECLAMATION DIVISION <br />CERTIFICATE OF SERVICE <br />PERMIT NO.: C-SO-006 <br />C.0. NO.: N/A <br />N.O.V. NO.: C-92-O11 <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 depositing a true copy <br />thereof first class postage prepaid 1n the United States mails at Denver, <br />Colorado, addressed to the operator at the address above, on July 22, 1992. <br />Signature of Person Served <br />if personal service <br />Print Name and Title <br />Certified Mail No.: P 860 170 862 <br />Ret~Cu..r/-n Receipt Re~que~stfed~ <br />(Signature) <br />Larry P. Routten, A55essment Officer <br />Print Name and Title <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(9). <br />Operator <br />LPR/bjw <br />4193E <br />By <br />(Signature) <br />Date <br />19 <br /> <br />--- Credit - Extraordinary Effort <br />Credit - Rapid Compliance <br />