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~iiP+EO LAIVU KCCLHI'IHTIUiV UIVISi0iv <br />CEKTIFIL'NTE OF SERVICE <br />N.O.V. N0. C-84-123 <br />i nereoy certify that I served a copy of the foregoing NOTICE OF PRUPOSEU Hi•IUUrrT <br />OF CIVIL PENr+LTY on the operator therein described by (a)* personal service <br />upon the operator or its representative at , <br />Colorado on 19_, or (b)* oy depositing a true <br />copy Thereof first class postage prepaid in the Unites States mails at Denver, <br />Colorado, addressed to the operator at the address above, on , <br />l9 <br />Certified r4ail No. p 397 145 641 <br />(~ig~rel <br />Anne Baldrige, Reclamation Specialist <br />'lame Printed <br />* ---- ChecK applicaole method of service. <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 />Operator <br />By <br />gnature <br />Date <br />(1/83) <br />19 <br />Doc. No. 251 <br />