2017-04-14_REPORT - M1977004

• Permit No: M1977004
• IBM Index Class Name: REPORT
• Doc Date: 4/14/2017
• Doc Name: Annual Fee/Report/Map
• From: Barrick Gold
• To: DRMS
• Annual Report Year: 2017
• Email Name: DMC
• Media Type: D
• Archive: No

-6-
NOTARIZATION OF OPERATOR'S ACKNOWLEDGEMENT
STATE OF 1
ss.
COUNTY OF
The foregoing instrument was ac1otowlcd3cd before me this_____,___day of
by of
NOTARY PUBLIC
My Commission expires-_ --
APPROVED:
State of Colorado
Mined Laud Reclamation Board
Division of Minctals and Geology
By. Date:
Division Director
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