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DIVISION OF MINERALS AND GEOLOGY <br />CERTIFICATE OF SERVICE <br />PERMIT NO.: C-82-055 <br />C.O. NO.: <br />N.O.V. NO.: C-93-001 <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 February 2, 1993. <br />Signature of Person Served <br />if personal service <br />Print Name and Title <br />Certified Mail <br />Return Receipt <br />~ec~l~,~ <br />REQUEST FOR CONFERENCE <br />179 165 524 <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/scg <br />6169E <br />