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M-2015-030 <br /> Consent Agenda Form <br /> June 9, 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 PA day of June, 2016. <br /> Dan Hunt for Asphalt Specialties Co. Inc. <br /> (Operator) <br /> Signature: 1� \k/\4 <br /> Title: %.0121Ad <br /> State of (tee/iia/4) ) <br /> ) ss. <br /> County of iVasois ) <br /> The foregoing instrument was acknowledged before me this /� — day of June, 2016, <br /> by 40,azz,i/ 12 //vs/ f as �if-r,d'tir t of Asphalt Specialties Co. Inc. <br /> //47/it, <br /> Nota P <br /> My Commission Expires: ///..1 /.? F <br /> NANCY HERBSTREiTH <br /> ti NOTARY PUBLIC <br /> STATE OF COLORADO <br /> NOTARY ID 20104047503 <br /> SIGNATURES MUST BE IN BLUE IN " COMMI SION EXPIRES NOVEMBER 22,2018_ <br />