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<br />DIVISION OF MINERALS AND GEOLOGY <br />CERTIFICATE OF SERVICE <br />PERMIT NO.: C-92-080 <br />C.O. NO.: N/A <br />N.O.V. NO.: C-94-021 <br />I hereby certify that I served a copy of the foregoing NOTICE OF PROPOSED AMOUNT OF <br />CIVIL PENALTY on the operator therein described by depositing a tnle copy thereof first class, <br />postage prepaid in the United States mails at Denver, Colorado, addressed to We operator at the <br />address above, on September 12, 1994. <br />Certified Mail No. P 296 603 188 <br />Signature of Person Served <br />if personal service <br />Print Name and Title <br />REQUEST FOR <br />The operator above described hereby requests an assessment or settlement conference as permitted by <br />C.R.S. 34-33-123(8). <br />Operator <br />By <br />(Signature) <br />Date , 19 <br />M:\oss\srw\9421A <br />Print Name and Title <br />