2016-07-28_REVISION - C1981008

• Permit No: C1981008
• IBM Index Class Name: Revision
• Doc Date: 7/28/2016
• Doc Name: Incompleteness Notice
• From: DRMS
• To: Tri-State Generation and Transmission Association, Inc
• Type & Sequence: SO2
• Email Name: JLE
• Email Name: DIH
• Email Name: BFB
• Media Type: D
• Archive: No

EXECUTION BY THE STATE OF COLORADO:
DIVISION OF MINERLS AND GEOLOGY
MINED LAND RECLAMATION BOARD
In witness whereof, this Agreement is dated and effective as of , 20.
DATE:
Division Director
STATE OF:
COUNTY OF: )
The foregoing instrument was acknowledged, subscribed and sworn to before me this day of
, 20
Witness my hand and official seal.
(Notary Public)
My Commission Expires:
02-07-97
sb indem agree fd