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SIGNED, SEALED AND DATED this (2 day of Wt ac L h ?D( <br /> i cs ( l't k�v _ <br /> Operator (SEAL) <br /> By: (2n be f r• C� • �� <br /> Title: ser or llrCe f«tden T <br /> NOTARIZATION OF OPERATOR'S ACKNOWLEDGEMENT <br /> STATE OF tam c: ) <br /> ) ss.: <br /> COUNTY OF [)0 A0A'5 ) <br /> The foregoing instrument was acknowledged before me this 1 a day of MCu-\Q Q t <br /> bye���tr�t.�iuzS asSeCl�GR\SC2Sa Z of1�tYlEs�nnlSiQuLiTtr3�n�, <br /> ;CATVERME ANN HARRISON Notary Public iS — <br /> NOTARY PUBLIC I <br /> �7ATE OF COLORADO hty Commission Expires a 1 <br /> NOTARY ID 19974014716 <br /> My Commission Expires August 21,2021 <br /> STATE OF COLORADO <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 /> -3 - <br />