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HOLCIM <br /> This form has been approved by the Colorado Mined Land Reclamation Board pursuant <br /> to its authority under the Colorado Land Reclamation Act for the Extraction of <br /> Construction Materials and the Colorado Mined Land Reclamation Act ter Hard Rock, <br /> Metal, and Designated Mining Operations. Any alteration or modification to this form shall <br /> result in voiding this form. <br /> 213 <br />