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SIGNED, SEALED AND DATED this_�_day of i-&G , <br /> J us+i CC, <br /> Gk_; o� =v, <br /> Operator (SEAL) <br /> By: z C� <br /> Title: �Idle- <br /> NOTARttIZATION OF OPERATOR'S ACKNOWLEDGEMENT <br /> STATE OF Co(c,ctd c, ) <br /> n `d ) ss.: <br /> N COUNTY OF ( 2 <br /> The foregoing instrument was acknowledged before me this l day of F c;� r tk <br /> by f t,esS e_l( C-i. .-Tuks-6 c e- as (ire s t d��� of <br /> DELANIE MCMORRIS Notary Public <br /> NOTARY PUBLIC <br /> STATE OF COLORADO My Commission Expires <br /> NOTARY ID 20164045049 <br /> MY COMM.EXPIRES NOVEMBER 29,2020 <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 /> - 13 - <br />