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M-1986-074 <br /> Consent Agenda Form <br /> October 16,2014 <br /> Page 3 of 3 <br /> Operator(s) Signature: <br /> By signing this,the Operator agrees to the stated violation and will comply with the Corrective Action(s)and <br /> Civil Penalty outlined above on the Staff Summary Form for Consent Agenda Items. <br /> Operator Signature Date Notary Public <br /> My Commission expires: <br />