2010-09-10_REVISION - M2002094

• Permit No: M2002094
• IBM Index Class Name: REVISION
• Doc Date: 9/10/2010
• Doc Name: Inadequate Submittal of Operators Application and Performance Warranty
• From: DRMS
• To: Oldcastle SW Group, Inc. dba United Companies
• Email Name: GRM
• Media Type: D
• Archive: No

- 6 -
NOTARIZATION OF OPERATOR'S ACKNOWLEDGEMENT
STATE OF et) to rQ WE) )
) ss.
COUNTY OF -e S?a )
The fo egoing instrument was acknowledged befor me thish day of
by I e -T. i 2 W U n a s (.. A e 5? aPe.,I,t of 17 egs,?lr S to G ro 4" Inc. ce hej
Me-
YP&
20r A/ NOT RY PUBLIC
CiENl?111EVE
?+ + M8LOC4A My Commission expires: Y? ill
q? oa
a,= co1,a
APPROVED: CSS
State of Colorado
Mined Land Reclamation Board
Division of Reclamation, Mining and Safety
By
Date:
Division Director
M:\tnin\share\bondforms\Corporate Surety REVISED 10/16/07