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Deer Trail Pit Consent Agreement <br /> Page 4 of 4 <br /> March 11,2024 <br /> Operator's Notarized Signature: <br /> As an authorized representative of the Applicant,I hereby attest that the Operator concedes to the above <br /> described violation and agrees to comply with the Corrective Action and Civil Penalty proposed in this <br /> STAFF SUMMARY FORM FOR CONSENT AGENDA ITEMS. <br /> 4 <br /> Signed and dated this I ( day of j}s L.,ci L 2024. <br /> jj/ <br /> �v' <br /> (Applicant) <br /> Signature: _ _,--, — <br /> Titl '4 -',tit-,. c '` <br /> State of Col\p,r c_c n <br /> County of L,C EA a_ <br /> The foregoing instrument was acknowledged before me this I( `day of fria c,IA, , 2024, <br /> by T2.f i t..) Cctisp ieN as VP of 5' A 11.fe---cp-i-e._/ . <br /> J <br /> No ary Pub is <br /> My Commission Expires: y/a/0/20025 <br /> SIGNATURES MUST BE IN BLUE INK IACELVN MARIE LORMAN <br /> NOTARY L <br /> STATE OF C200P <br /> NOTARY ID 202140156PUB73 <br /> 25 <br /> MY COMMISSION EXPIRES APRIL 20,20 <br />