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MINED LAND RECLAMATION DIVISION '�EC <br /> CERTIFICATE OF SERVICE ��ti <br /> N.O.V. NO. C-84-102 Mr�Ep JUL <br /> I hereby certify that I served a copy of the foregoing NOTIAra06e gip , OUNT <br /> OF CIVIL PENALTY on the operator therein described by (a)* perAn"�?jr � �i�'Bl�l��r <br /> upon the operator or its representative at ours , <br /> Colorado on , 19 or x b * by depositing a true <br /> copy thereof first c ass postage prepaid in the United States mails at Denver, <br /> Colorado, addressed to the operator at the address above, on <br /> 19 <br /> Return Receipt Reques d <br /> Certified Mail No. <br /> (Sign ture) <br /> James Herron <br /> Name Printed <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 C.R.S. 34-33-123(8) . <br /> [A i P--C O I i u Sa $ r&-50URe65 INS- <br /> Operator <br /> By VJ <br /> (Signature) <br /> Date �Q , 190 <br /> (1/83) <br /> Doc. No. 251 <br />