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C <br />r~ • • <br />DIVISION OF MINERALS AND GEOLOGY <br />CERTIFICATE OF SERVICE <br />PERMIT NO.: C-81-018 <br />C.O. NO.: N/A <br />N.O.V. NO.: C-93-156 <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 in the United States mails at Denver, <br />Colorado, addressed to the operator at the address above, on January 4, 1994. <br />Signature of Person Served <br />if personal service <br />Print Name and Title <br />Certified Mail No.: P 296 525-7afi <br />Return Receipt Requested= ~=~ <br />~.~~; <br />David~A~ Berr <br />Se r Environmental Protection Specialist <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(8). <br />Operator <br />By <br />(Signature) <br />Date 19_ <br />DAB/scm <br />9612E <br />