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COy <br />Form APCD-400 <br />Colorado Department of Public Health and Environment <br />Air Pollution Control Division ; <br />Colorado Deparunent <br />of Public 1 Iealdi <br />and E ivironmenr <br />AIR POLLUTION CONTROL DIVISION CONSTRUCTION PERMIT <br />GENERIC FINAL APPROVAL SELF -CERTIFICATION FORM <br />Ver. September 10, 2008 <br />Company Name: Peabody Sage Creek Mining, LLC. <br />Source Name": Peabody Sage Creek Mine <br />Source AIRS ID B: 107/0098 <br />Permit Number: I OROI 175F Issuance Date: 09/04/2012 <br />All information related to the Final Approval certification of the above referenced Initial Approval construction <br />permit must be certified by a responsible official as defined in Regulation 3, Part A, Section I.B.38. This <br />certification means that each condition of the Initial Approval or Construction permit has been reviewed and the <br />source is in compliance with all conditions of the permit. A Final Approval permit or letter of Final <br />Authorization to operate under the Constriction permit will only be issued if all permit conditions are being <br />met. This signed certification document must be submitted to the Air Pollution Control Division (APCD) along <br />with all supporting documents (i.e. Compliance test and/or sampling results, opacity readings, operating & <br />maintenance plans, etc.) necessary to fulfill self -certification requirements of the Initial Approval or <br />Construction permit. Each individual permit requires a separate signed self -certification fora. <br />I have reviewed the above paragraph, the terms and conditions of the Initial Approval or Construction <br />permit referenced above and the information being submitted for Final Approval of this permit in its <br />entirety. Based on information and belief formed after reasonable inquiry, I certify the source is in full <br />compliance with each term and condition of the referenced Initial Approval or Construction permit. In <br />addition, the statements and information contained in this self -certification submittal are true, accurate <br />and complete. <br />Please note, the Colorado Statutes state that any person who knowingly, as defined in § 18-1-501(6), <br />C.R.S., makes any false material statement, representation, or certification in this application is guilty of <br />a misdemeanor and may be punished in accordance with the provisions of § 25-7 122.1, C.R.S. <br />B. Scott Cowman Senior Enviromnental Specialist <br />Printed or Typed Name Title <br />tgnature <br />Footnotes: <br />01-09-2013 <br />Date Signed <br />Source name is how the company references the facility (i.e. Little Creek Compressor Station) <br />Source AIRS ID is the ten -digit identification number issued by the APCD for the emissions source (i.e. <br />123/3456/001). This may be found in the lower left hand comer of the permit. <br />Page I of 1 APCD_Se1 CertForm_20130109 <br />