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SIGNED, SEALED AND DATED this day of 6 ,-J <br /> Operator (SEAL) <br /> By: ✓r,�� --- <br /> Title: CF�� <br /> NOTARIZATION OF OPERATOR'S ACKNOWLEDGEMENT <br /> STATE OF L� ) <br /> ss.: <br /> COUNTY OF <br /> The foregoing instrument was acknowledged before me this irkday of TL, I <br /> by �� P�n� as � of P U <br /> a <br /> RENEE HANSEt'; Notary Public <br /> Notary Public <br /> State of Colorado My Commission Expires �— �� <br /> Notary ID x 201 7401641 7 <br /> My Commission Expires 04-14-2021 <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: I / <br /> Division Director <br /> Rev.05/12 <br /> - 13 - <br />