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1- <br /> SIGNED, SEALED AND DATED this I day of JUA-J-- , 017 <br /> keine, i4 -r n Sii-I! <br /> Operator <br /> By: 7azLJ t <br /> Title: Q(,(/n,Q/ <br /> NOTARIZATION OF OPERATOR'S ACKNOWLEDGEMENT <br /> STATE OF 0/00/16) <br /> ) ss.. <br /> COUNTY OF <br /> l;a- <br /> The foregoing instrument was acknowledged before me this day of v 17, <br /> n <br /> by 1 U kl9U,.Q Z as OW hd.✓ of BLL.. OU v bA A <br /> 1 Notary Public jr4/1 <br /> LORENA MEDINA 1 <br /> Notary Public - State of Colorado 0 My Commission Expires 9�a,Z_ alb <br /> Notary ID 20164032814 <br /> My Commission Expires Sep 22, 2020 <br /> STA <br /> DEPARTMENT OF NATURAL RESOURCES <br /> MINED LAND RECLAMATION BOARD <br /> DIVISION OF RECLAMATION,MINING AND SAFETY <br /> By: Date Executed: <br /> Division Director <br /> Rev.05/12 <br /> - 13 - <br />