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SIGNED, SEALED AND DATED this PrLb day of IV I aA,-k <br /> L <br /> Operator (SEAL) <br /> By: 4f---7 A <br /> Title: r (&;4Q0" <br /> NOTARIZATION OF OPERATOR'S ACKNOWLEDGEMENT <br /> STATE OF �.�f.-'-�J ) <br /> ss.: <br /> COUNTY OF <br /> The foregoin instru ent was acknowle g d before me this day of ffi4l� <br /> , <br /> by1y, ,( � as of <br /> ,RA D W Y N N Notary P is <br /> Notary Public <br /> State of Colorado My Commission Expir <br /> -ary ID#20044032091 <br /> mmission Expires 09-09-2024 <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 /> - 3 - <br />