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M <br />~\ <br />• <br />MINED LAPID RECL.A~"ATION DIVISION <br />CERTiFIC,4TE OF SERVICE <br />I hereby certify that I served a copy of the foregoing NOTICE OF PROPOSED APIOUNT OF CIVIL <br />PENALTY on the operator therein described by (a)* personal service upon the <br />operator or its representative at Colorado on , <br />19 or _g~(b)* by depositing a true copy thereof first class postage prepaid in the <br />United States mails at Denver, Colorado, addressed to the operator at the address above, on <br />W1RV ~- 1982. <br />Certified 1^.ail Number P?.A 193~i~3 <br />~~~*tif ~ <br />(Signature) <br />N~tiGa1AFL-~ ~ . ~~C.JAG-~ <br />Name Printed <br />* ---- Check applicable method of service. <br />REQUEST FOR CONFERENCE <br />The operator above described hereby requests an assessment or settlement conference as <br />permitted by C.R.S. 34-33-123(8). <br />Operator <br />gy <br />(Signature) <br />Date 19 <br />4/1/81 <br />