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SIGNED, SEALED AND DATED this day of Doi 5 . <br /> Vayd G:: fowe I t l -L L <br /> Operator (SEAL) <br /> By: 40�� <br /> Title: 9(_e 51CW\'-k <br /> NOTARIZATION OF OPERATOR'S ACKNOWLEDGEMENT <br /> STATE OF GQI lbY&�0 } <br /> N� <br /> ss.: <br /> COUNTY OF <br /> The foregoing instrume t was acknowledged before me this I day off <br /> by as ��Q51&� of lJ-�1� -YYiI Cl�1J� Uc <br /> Notary Public ' ;W vWJlu/r t <br /> My Commission Expires <br /> STATE OF COLORADO <br /> DEPAKTMENT OF NATURAL RESOURCES <br /> MINED LAND RECLAMATION BOARD <br /> DIVISFON OF RECLAMATION, MINING AND SAFETY <br /> By: Date Executed: <br /> Division Director <br /> Rev.05/12 <br /> - 13 - <br /> Et'd GZ699L90Z6 sa}inS V uui uituno"en18 dog:�091 ZL AeW <br />