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Legal Identity Report U.S. Depertntent of Labor //~ <br />Mine Satety and Health Administration <<* <br />This report is required by law 130 C.F.R. 411. Feilun to report can result Form Approved: OMB No. 1219-0008 Expim Dee 31, 1889 <br />in ase®rnent of a civil Isenelry. Knowingly making a taUe statement ran <br />result in crimirel prosecution uMer §110 of the Federal Mine Setery and <br />Health Act of 1977. This report should t» papered only by an official ®Initial Notice Effective Deta of Changes <br />n full knowledge of ownership information. This report mutt be sign- <br />Mere indintatl by snow, to ba valid. Type or print in ink only. <br />Note: If rtgre space is required in any section below, use a separate sheet. ~ Update Notice <br />1. Federal Mine Identifiotign Number 2. Mine Name Ito be used for all update noti®sl 3. Direction to the Mine (mileagedireaipnfrpm <br />(New I.D. required for new operation only.) neer®t town, dty, end landmark) <br />Hamilton Mine 2 Mi South Eaet of Naturita <br />4. Mine Location Atldrea 5. City 8. County 7, State 8. Zip Code <br />2Miles SouthEast of Naturita, Montrose County, Colorado <br />a. Onicml tfusmea Neme or Operator tu. 1 elepngne Number m 11. Commodity hype of product & otxxs- <br />Event of an Emergency tion~urfeoe, underground or itktiliryl <br />Aoneywood Coal Company (615) 352-5484 Surface -Coal <br />Penon et Mins in Charge of Health end Safety (Superinnndsnt or Prirrcipe/ OKn:er/ <br />12. Name and Title 13. Address <br />Mine Not Opened Yet <br />Person with Overall Responnbiliry for a Hselth end Safety Program et All of the Operaror's Minas, if the Operator is Not Directly Involved in the <br />Daily Operation of the Mina. lSahry Oirecror/ <br />14. Name end Title 15. Address <br />David Tate Rich, 95 White Bridge Road 11404 Nashville, Tn 37205 <br />Federal Mine Identifiation Numhen of All Other Mines in which the Sola Proprietor, Partnership, Corporation or Other Oryniration hen a 20% <br />or Greater Dwrership Interest. <br />Federal Mina Identification Number of All Other Minas in which Any Pertnsr, Corporate Offinr, Other Orgenixation Official or Mamher hen ^ <br />20%or Greeter Ownership Intsrmt (not spplivble to role proprietorfhipl . <br />17. ID Numbers <br />Northern Coal Company, Inc. 1112-02056, 1./12-02057, 1112-02055 <br />Marks Coal Company, Inc. 1112-02078 <br />Address of Recordr and Telephone Number (Service of doarmenrs upon me openror wi// be oavnp/strd by ensiling or persona/ mrrice o! the dacu- <br />msntr to this eddnns /I P.O. Box or Gsnsre/ Os/irsry it u+sd /or mailing addraa, a sepann+tnser eddrsa for persons! arvice mu+r be proridrd.) <br />18. Name of Penon to Receive ONleial Mail or Servi® Title 19. Telephone Number <br />Patti R. Gordon (615) 352-5484 <br />20. Street Atltlrea 21. City 22. State 23. Zip Code <br />95 White Bridge Road 11404 Nashvi77e '1T7 '77705 <br />201a1. Mail Addrea 21(al. City 221a1. State 231a1. Zip Code <br />Same <br />24. Pleefe Check the Appropriate Boz end Complete the Applimhls Section (cheek on/Y one box) <br />I. Sole Proprietorship ~ II. Partnership ~ III. Corporation ~ IV. Other <br />Section I. Sole Proprietorship <br />1. Tads Name of Company 2 Proprietor's Name entl Address pf flasidenoa <br />~prietor's Principal Offioa Adtlres lrtroetl 4. Clty 5. Stets 8. ZIP Code <br />Section 11. Partnership <br />1. Trade Name <br />Honevwood Coal Company <br />