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MINED LAND RECLAMATION DIVISION <br />CERTIFICATE OF SERYICE <br />PERMIT NO.: C~' ~~ -.D j~ <br />C.O. NO.: ---~- <br />N.O.V. NO.: ~'-9~-~Oj <br />I hereby certify that I served a copy of the foregoing NOTICE OF PROPOSED AMOUNT <br />OF CIYIL PENALTY on the operator therein described by (a,~~vice <br />assn thu nnera O cenn+a+ivu a+ n-~---ten <br />y epost tng a rue copy thereof <br />firs c ass pos age prepaidin the nt ed States mails at Denver, Colorado, <br />addressed to the operator at the address above, on M~rnti ~ 19~.z <br />tgnature o erson rve <br />if personal service <br />r n ame an t e <br />Certified Mail No.: ~ S'6`n 179 ~l <br />Ret-u~rln/ Receipt Reques e <br />=1,~' ~ ~~ ~ ,2 <br />LDfrY 1 • ~Du'7`~~N : /~sf PsS~~J Po:T ~7~P/' <br />~i n ame an T3- <br />* ---- Check applicable method of service. <br />REQUEST FOR CONFERENCE <br />The operator above described hereby requests an assessment or settlement <br />conference as permitted by r,.R.S. 34-33-123(8). <br />Operator <br />By <br />tgna re <br />Date 19 <br />05/90 <br />0311 (f) <br />