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M-2005-070 <br /> 0 <br /> Consent Agenda Form <br /> May 18, 2016 <br /> Page 3 of 3 <br /> Operator's Notarized Signature: As an authorized representative of the Operator, I hereby attest that <br /> the Operator concedes to the above described violation and agrees to comply with the Cease and Desist <br /> Order, Corrective Action, and Civil Penalty proposed in this STAFF SUMMARY FORM FOR <br /> CONSENT AGENDA ITEMS. <br /> Signed and dated this Cp day of SC-t.aC, , 2016. <br /> Operator: Ritchey's Redi-Mix Concrete, Inc. <br /> Name: ,SU i' /2 (7 GJLcy (please print clearly): <br /> Signature: <br /> Title: O W ✓1. C pr , •1-cn <br /> State of C mt v ) <br /> ) ss. <br /> County of ) <br /> The foregoing instrument was acknowledged before me this 641^ day of TAA,r-i-- , 2016, <br /> by as •0/1.1244..feof Ritchey's Redi-Mix <br /> Coni�'rete, In .. <br /> LEONA M.OLSEN <br /> NOTARY PUBLIC Notary Public <br /> STATE OF COLORADO <br /> NOTARY ID 19894012817 <br /> MY COMMISSION EXPIRES SEPTEMBER 6,2017 �J6,f. o 17 <br /> My Commission Expires: <br /> SIGNATURES MUST BE IN BLUE INK <br />