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STATE BOARD OF EXAMINERS OF WATER WELL CONSTRUCTION <br />AND PUMP INSTALLATION CONTRACTORS <br />STATE OF COLORADO <br />STIPULATED SETTLEMENT <br />Jme 2004 Foam <br />RESPONDENT (Name) <br />(Address) <br />(City, State Zip) <br />License No. (if applicable) <br />WHEREAS, based upon an investigation or information received, the State Engineer, consistent with authority <br />delegated by the Board of Examiners of Water Well Construction and Pump hnstallation Contractors ('Board"), <br />allege: <br />1. <br />The following statements are acknowledged as true and correct: <br />The Board has jurisdiction over the matter described herein. <br />The action described in the allegation is a violation of the Colorado Revised Statutes and/or the Water Well <br />Construction Rules, 2 CCR 402-2. <br />Pursuant to Article 91 of Title 37, the Board has authority to impose a penalty and/or assess a fine up to <br />$1000 for each such violation. <br />You are hereby given notice that a hearing before the Board of Examiners of Water Well Construction and Pump <br />Installation Contractors is scheduled for to hear testimony and consider the facts of <br />this matter. The Respondent shall appear before the Board at AM/PM in Room 318 at 1313 Sherman <br />Street, Denver, Colorado. [Bring this Citation with you to the hearing.] <br />IN THE ALTERNATIVE, you may remit a fine in the amount of payable to the Division of Water <br />Resources (1313 Sherman Street, Room 818, Denver CO, 80203), within twenty (20) days of the date of this <br />stipulation. By remitting such fine, you admit that you do not dispute the validity of the allegation, you waive your <br />right to a hearing before the Board, and you agree that payment of the fine is final resolution of the matter and that <br />no further such violations shall occur. [Sign and return this Stipulation ONLY if you choose to remit a fine and <br />waive your right to a hearing.] <br />I have read the citation and fully understand its contents, including acknowledgements, admissions and agreements, <br />and waiver of right to a hearing before the Board. <br />Date: <br />(Respondent Signature) <br />Date: <br />Jack G. Byers, Deputy State Engineer <br />