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Phone Number: <br />Fax Number: <br />Email Address: <br />I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site operations are <br />being conducted in accordance with the Division approved mining and reclamation plans. <br />f /.,., % Z 3�- /.3 <br />Signature A Corporate Officer, Owner, or Documented Designee <br />Date <br />