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STATE OF COLORADO <br /> ,IVISION OF MINED LAND RECLAMA I <br /> COAL PROGRAM <br /> Civil Penalty Worksheet <br /> I. Identification II. Action <br /> Permi ttee/Operator Penalty Assessed ✓ Yes No <br /> Permit No. w 7 Proposed Amount 1 1200 . 00 <br /> NOV/CO No. Source of information or assessment <br /> Date of Issuance Q Operator/Permittee / <br /> Type of Violation Division ✓ <br /> Administrative <br /> Performance Std. <br /> Permit Condition <br /> III. Mandatory Penalties <br /> Cessation Order <br /> Failure to Abate $750.00 - $5,000.00/day X days <br /> Mining Without a Permit <br /> IV. Penalty Calculation Criteria - Rule 5.04.6 <br /> Category Comments <br /> A. History fTW A77AeffAl FJVT <br /> NOV's past 12 months x $50.00 <br /> CO' s past 12 months x $250.00 <br /> B. Seriousness <br /> Severe $1 ,500 $1 ,750 <br /> Significant $1 ,000 $1 ,250 <br /> Low(Moderate $250 $50 $750 <br /> Insignificant $0 <br /> Administrative $ <br /> C. Fault <br /> Intentional $1 ,000 $1 ,250 $1 ,500 <br /> Negligence $250 $50 $750 <br /> Unavoidable $0 <br /> D. Number of Days Penalty Assessed <br /> E. Good Faith (may not exceed $1 ,250.00) <br /> Credit - Extraordinary Effort <br /> Credit - Rapid Compliance <br /> TOTAL oo,Do <br /> Assessment Officer <br /> Signat e <br /> �arry P, �i�u7f�h Date 9Zw; lY9/ <br /> Name P inted <br /> 4672F <br />