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Signature of Person Served <br />DIVISION OF RECLAMATION, MINING AND SAFETY <br />CERTIFICATE OF SERVICE <br />Permit No. C- 1981 -033 <br />NOV No. CV- 2012 -009 <br />I hereby certify that I served a copy of the foregoing NOTICE OF PROPOSED CIVIL PENALTY on Bear <br />Coal Company, Inc. by depositing a true copy thereof, first class postage prepaid, in the United States <br />mail, to the operator at the address above, on January 18, 2013. <br />Certified Mail No.: 7009 2820 0003 5700 6779 <br />Return Receipt Requested <br />if Personal Service Signature <br />Name and Title 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 />By <br />Date <br />(Signature) <br />'L�cYGC 'Lvt�T <br />Name: Daniel I. Hernandez <br />Bear Coal Company, Inc. <br />Operator <br />