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Legal Identity Report U.S. Department of Labor <br /> Mine Safety and Health Administration. •, <br /> This report is required by law(30 C.F.R.41). Failure to report can result Form Approved: OMB No.1219-0008 Expires Jan 31, 1987 <br /> in assessment of a civil penalty. Knowingly making a false statement can <br /> result in criminal prosecution under§110 of the Federal Mine Safety and <br /> Health Act of 1977. This report should be prepared only by an official C1Initial Notice Effective Date of Changes <br /> yr""dull knowledge of ownership information. This report must be sign- <br /> re indicated by arrow,to be valid. Type or print in ink only. r [1/ <br /> No If more space is required in any section below,use a separate sheet. I--1 Update Notice <br /> 1. Federal Mine Identification Number 2.Mine Name (to be used for all update notices) 3 Directions to the Mine(mileage-direction frpm <br /> (New I.D.required for new operation only.) nearest ,sty,aOn�d laand�mark�l C0• <br /> 05-W266 KING COAL MINM o12. c_a. i?o <br /> 4.Mine Location Address 5.City 6.County 7.State B.Zip Code <br /> 4424 C.H. 120 Hesperus La`plata Co 81326 <br /> 9.Official Business Name of Operator 10.Telephone Number in 11.Commodity (type of product&opera- <br /> Event of an Emergency tion-surface,underground or facility) <br /> bational King Coal, Inc. (303) 385-4.528 Coal - Underground <br /> Person at Mine in Charge of Health and Safety iSuperintendant or Principal Officer) <br /> 12.Name and Title 13.Address <br /> Tom Bird - Superintendent 4424 C.R. 120Hesperus, CO <br /> Person with Overall Responsibility for a Health and Safety Program at All of the Operator's Mines,if the Operator is Not Directly Involved in the <br /> Daily Operation of the Mine. (Safety Director) <br /> 14,Name and Title 15.Address <br /> Tom Bird - Superintendent 4424 C.R. 120 <br /> Hesperus, CO <br /> Federal Mine Identification Numbers of,All Other Mines in which the Sole Proprietor,Partnership,,CoToration or Other Organization has a 20% <br /> or Greater Ownership Interest. <br /> 16. 1 D Numbers <br /> A <br /> Federal Mine Identification Numbers of All Other Mines in which Any Partner,Corporate Officer,Other Organization Official or Member has a <br /> 20%or Greater Ownership Interest [not applicable to sole proprietorship]. <br /> 17. ID Numbers <br /> N/A <br /> Address of Records and Telephone Number[Service of documents upon the operator will be completed by mailing or personal service of the docu- <br /> ments to this address. if P.O. Box or General Delivery is used for mailing address,a separate street address for personal service must be provided.] <br /> 18.Name of Person to Receive Official Mail or Service Title 19.Telephone Number <br /> Tom. Bird - Superintendent (303) 38.5-4528 <br /> 20.Street Address 21.City 22.State 23.Zip Code <br /> 4424 C.R. 120 Hesperus, CO 81326 <br /> 20(a).Mail Address 21(a).City 22(a).State 23(a).Zip Code <br /> 4424 C.R. 120 Hesperus, CO $1326 <br /> 24.Please Check the Appropriate Box and Complete the Applicable Section(check only one box) <br /> I.Sole Proprietorship 11.Partnership III.Corporation C3 IV. Other <br /> Section 1.Sole Proprietorship <br /> 1.Trade Name of Company 2.Proprietor's Name and Address of Residence <br /> 3 orietor's Principal Office Address(street) 4.City 5.State 6.Zip Code <br /> Section 11.Partnership <br />