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iii iiiiiiiiiiiiiiii <br />DIVISION OF MINERALS AND GEOLOGY <br />CERTIFICATE OF SERVICE <br />PERMIT NO.: C-81-012 <br />C.O. NO.: N/A <br />N.O.V. NO.: C-94-O18 <br /> <br />sEP i s <br />-, ;.airs u, ,.....e <br />'a~.. .. ~..~ _i <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 September 7, 1994. <br />Certified MailiNo.: P 296 603 186 <br />Return Rece~f~Requested <br />Signature of Person Served <br />if personal service <br />Print Name and Title <br />csi ature~ <br />D~'d A. Berry, ssessment Officer <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 />~i~-s ~^~ ~~sv~~c ~ <br />gyrator <br />(Signature) <br />Date ~/~~~/7~ 19_ <br />DAB/bjw <br />0929E <br />