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DIVISION OF RECLAMATION, MINING AND SAFETY <br />CERTIFICATE OF SERVICE <br />Permit No. C -1984 -065 <br />NOV No. CV- 2012 -005 <br />I hereby certify that I served a copy of the foregoing NOTICE OF PROPOSED CIVIL PENALTY on C.B. <br />Minerals Company, LLC by depositing a true copy thereof, first class postage prepaid, in the United <br />States mail, to the operator at the address above, on July 27, 2012. <br />Signature of Person Served <br />if Personal Service <br />Name and Title <br />Certified Mail No.: <br />Return Receipt Requested <br />Signature <br />Name: <br />Title: Assessment Officer <br />REQUEST FOR CONFERENCE <br />The operator above described hereby requests an assessment or settlement conference as permitted by <br />C.R.S. 34 -33- 123(8). <br />C.B. Minerals Company, LLC <br />Operator <br />By <br />(Signature) <br />Date <br />