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SIGNED, SEALED AND DATED this day of 6(n(W <br /> r' <br /> lolores �un Ro � �rtcQ IJ 6-r`�rnerc+ <br /> Operator <br /> c <br /> By: a...__ <br /> Title: Cex t_,n-u-. ROG-A u aer y l 5 o r' <br /> NOTARIZATION OF OPERATOR'S ACKNOWLEDGEMENT <br /> STATE OF I ra--dZ ) <br /> ) ss.: <br /> COUNTY OF O 16( Q S ) <br /> The foregoing instrument was acknowledged before me this 1 C I day of Tern U-0 r L ad z 1, <br /> y s olores Q-0V-y.1' of of ores Czun Qoc-cR - Pic g <br /> Notary Public �0Sp CQ IVe uCC-ess ar+ine.►� <br /> State of Colorado rr Notary Publ' h1cJ — <br /> Notary ID#20084007093 <br /> M Commission Expires 03-04-2024 My Commission Expires 03/0�(/ao�� <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 />