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PERMIT NO.: C-81-019 <br />C.0. NO.: <br />N.O.V. NO.: C-92-030 <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 C1d55 postage prepaid in the Unitad States mails at Denver, <br />Colorado, addressed to the operator at the address above, on November 24, 1992. <br />Certified Mail No <br />Return Receipt-R,e <br />Signature of Person Served <br />if personal service <br />Print Name and Title <br />* ---- Check applicable method of service. <br />REQUEST FOR CONFERENCE <br />733 339 <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 <br />DAB/scg <br />19 <br />5461E <br />David A. Berry, Sr. Reclamation Specialist <br />Print Name and Title <br />