STATE OF NEW MEXICO
BEFORE THE SECRETARY OF ENVIRONMENT
IN THE MATTER OF THE [APPLICATION/PETITION]
OF [NAME OF APPLICANT/PETITIONER]
FOR A [TYPE OF PERMIT/LICENSE/VARIANCE] FOR
[NAME OR DESCRIPTION OF FACILITY] No.
TITLE OF DOCUMENT
Text of document.
Signature
NAME
ADDRESS
TELEPHONE NUMBER
I hereby certify that on [month/day/year] a copy of [name of document] was [hand-delivered/mailed express or first class/faxed] to:
[names and addresses of persons upon whom service is made]
Signature
NAME
N.M. Admin. Code § 20.1.4.100