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MINED LAND RECLAMATION DIVISION 1?4 <br /> FIVE <br /> CERTIFICATE OF SERVICE 0 <br /> N.O.V. NO. C-84-091 �CF�141vo <br /> D' Rtcu <br /> I hereby certify that I served a copy of the foregoing NOTICE OFRtR �r1V,S <br /> OF CIVIL PENALTY on the operator therein described by (a)* personal s' es��l'J <br /> upon the operator or its representative at <br /> Colorado on , 19 or x b * by depositing a true <br /> copy thereof first class postage prepaid in the United States mails at Denver, <br /> Colorado, addressed to the operator at the address above, on <br /> 19 <br /> Ret rn Receipt Requ t d <br /> Ce ified Mail No./ <br /> L- <br /> (Signature <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 /> hkkt) ,cox�zlucN� c�ou�.CES �t�C• <br /> Operator <br /> By w <br /> Signature <br /> Date j 19 <br /> (1/83) <br /> Doc. No. 251 <br />