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SIGNED, SEALED AND DATED this y day of N),4L/ <br /> Operator <br /> Title: &,,,,+o ���•�/i <br /> PU <br /> NOTARIZATION OF OPERATOR'S ACKNOWLEDGEMENT � d , •• <br /> I3r�. cl�i <br /> STATE OF L [DV-a A,o ) <br /> ss.: <br /> COUNTY OF <br /> ran <br /> The foregoing instrument was acknowledged before me this_q_day of / T ^ • j <br /> by. v-r %f ld� as f/4Q CeUJ- of i' <br /> Notary Public AL&U-e'la <br /> My Commission Expires <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: 3 •2 ( • <br /> Division Director <br /> Rev.05/12 <br /> - 13 - <br />