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SIGNED, SEALED AND DATED this Z day of <br /> Operator ( EAL) <br /> By: - - - - - <br /> Title: <br /> NOI'ARIZATION OF OPERATOR'S ACKNOWLEDGEMEN'r <br /> STATE OF C ,6 6)(-CLA O ) <br /> ss.: <br /> COUNTY OFy0 ) <br /> gn <br /> foregoing instrument was ackntnenet,0 <br /> dged before me this day of t T"-P y' <br /> by + C(L�►'1 a CAW of A <br /> CAROL E.REEVES Notary Public ewla & 2 <br /> NOTARY PUBLIC My Commission Expires a <br /> STATE OF COLORADO <br /> NOTARY ID 19934011404 <br /> MY COMMISSION EXPIRES AUGUST 4,2021 <br /> STT i <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 />