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Affidavit For Import of Materials into Uncompahgre Pit <br />Date or Time Period of Import: <br />Description of Import Material: <br />Entity Providing Material to Pit (not the trucking Company): <br />I hereby certify that the material described above and brought to the Uncompahgre Pit site is <br />inert, which means it is free from any chemicals, toxic substances, acid forming material, or any <br />other material which would violate the material waste disposal laws of the State of Colorado. <br />Signature Written Name of Signer <br />Signer's Position in Company Company <br />Date: <br />Uncompahgre Pit, February 2013 D -12 <br />