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Home My WebLink About20183217.tiffaa DNR July 11, 2019 COLORADO Division of Reclamation, Mining and Safety Department of Natural Resources 1313 Sherman St. Room 215 Denver, CO 80203 Weld County Commissioners 915 10th St Greeley, CO 80631 RECEIVED JUL 1 5 2019 WELD COUNTY COMMISSIONERS RE: Notice of 112 Construction Materials Reclamation Permit Amendment Application Consideration Black Mountain Sand Weld LLC, Lost Creek Mine, Permit No. M-2018-051 AM01 Please be advised that on July 11, 2019, Black Mountain Sand Weld LLC, whose address and telephone number are 500 Main St Suite 1200, Fort Worth, TX 79102; , filed an Amendment application to M-2018- 051, Lost Creek Mine, which is located at or near Section 3, Township 3N, Range 61W, 6 Principal Meridian, in Weld County. The application decision is scheduled for October 9, 2019. A copy of the application is available for review, unless you receive a CD, at the Weld County Clerk & Recorder's office and at the office of the Division of Reclamation, Mining and Safety, Room 215, 1313 Sherman Street, Denver, Colorado 80203. If you desire to make comments or objections of the mine plan and/or the reclamation plan, they must be submitted within twenty (20) days of the date of the last newspaper public notice to be considered in the application review process by the Division. You should contact the applicant for the newspaper publication date. If we do not receive your comments or any objection by the end of the public comment period, the Office will assume you have no objection or comment to the proposed activity. If you have any questions, please contact me. ottie Tate Administrator III for Peter S. Hays Environmental Protection Specialist M -AR -08 1313 Sherman St. Room 215 Denver, CO 80203 P (303) 866-3567 F (303) 832-8106 https://mining.state.co.us Jared Polls, Governor I Dan Gibbs, Executive Director I Virginia Brannon, Director (mac.)bl is Rc-v;e 4 07/ac-1/(9 cG PLCTP), Pw(3/Y)/CH/£R/C K) 07/17/19 BLACK MOUNTAIN SAN D 500 Main Street, Suite 1200, Fort Worth, TX 76102 (817) 698-9901 June 3, 2019 ATTN: Weld County Commissioners 1150 O Street P.O. Box 758 Greeley, CO 80631 RECEIVED JUN 0 7 20:3 WELD COUNTY COMMISSIONERS RE: Notice of Filing Application Amendment - Black Mountain Sand Weld LLC Lost Creek Mine To Whom It May Concern, Please find included a copy of the "Notice of Filing Application" on behalf of Black Mountain Sand Weld LLC for their Construction Materials Regular (112) Operation Reclamation Permit Application Amendment. Black Mountain Sand Weld LLC (changed from Black Mountain Sand DJ LLC) has submitted an amendment to their original application, which was filed in February 2019, to reflect changes made to the location of the proposed mining operation. A copy of this amendment has been put on file with the Weld County Clerk and Recorder's Office. Per the requirements of Section 1.6.2(1)(a) of the Act, we have attached a new Notice of Filing Application. Please let me know if you have any questions. Thank you, litmgdi Chris Axness VP Operations Enclosure: Notice of Filing Application CC: Kira Coff, Millcreek Engineering Matthew J. Hazleton, TRC Publcc Plevie to cc;. PLC -r t�� POWM/E,RIONCY) CJ7/��IIq Ln/1111 2018- 32\1 NOTICE OF FILING APPLICATION FOR COLORADO MINED LAND RECLAMATION PERMIT FOR REGULAR (112) CONSTRUCTION MATERIALS EXTRACTION OPERATION NOTICE TO THE BOARD OF COUNTY COMMISSIONERS WELD COUNTY Black Mountain Sand Weld LLC, (the "Applicant/Operator") has applied for a Regular (112) reclamation permit from the Colorado Mined Land Reclamation Board (the "Board") to conduct the extraction of construction materials operations in Weld County. The attached information is being provided to notify you of the location and nature of the proposed operation. The entire application is on file with the Division of Reclamation, Mining, and Safety (the "Division") and the local county clerk and recorder. The applicant/operator proposes to reclaim the affected land to original use. Pursuant to Section 34-32.5- 116(4) (m), C.R.S., the Board may confer with the local Board of County Commissioners before approving of the post -mining land use. Accordingly, the Board would appreciate your comments on the proposed operation. Please note that, in order to preserve your right to a hearing before the Board on this application, you must submit written comments on the application within twenty (20) days of the date of last publication of notice pursuant to Section 34-32.5-112(10), C.R.S. If you would like to discuss the proposed post -mining land use, or any other issue regarding this application, please contact the Division of Reclamation, Mining, and Safety, 1313 Sherman Street, Room 215, Denver, Colorado 80203, (303) 866-3567. COLORADO Division of Reclamation, Mining and Safety Department of Natural Resources 1313 Sherman St. Room 215 Denver, CO 80203 RECEIVED APR 01 Ke l WELD COUNTY COMMISSIONFP NOTICE Consideration of 112c Construction Materials Reclamation Permit Application DATE: March 25, 2019 TO: Weld County Commissioners 915 10th St Greeley, CO 80631 RE: Lost Creek, CO, File No. M-2018-051 Please be advised that on March 25, 2019, Black Mountain Sand DJ LLC, whose address and telephone number are 420 Commerce Street Suite 500, Fort Worth, TX 76102; (817) 698-9901, filed an application to conduct a(n) Surface mining and reclamation operation, at or near Section 3, Township 3N, Range 61W, 6th Principle Meridian, in Weld County. Please be advised that the permit area may be located in more than one Section, Township, and Range. Affected lands will be reclaimed to support a Rangeland post -mining land use. The application decision date is scheduled for June 23, 2019. A copy of the application is available for review at the Weld County Clerk & Recorder's office and at the office of the Division of Reclamation, Mining and Safety. The application, as well as all other permit documents, can be found at http://drmsweblink.state.co.us/ by searching M2018051 in the "Permit No" field. A user guide is available to help first time users of the imaged document system and can be viewed at http://mining.state.co.us/SiteCollectionDocuments/Laserfische%20User%20Guide.pdf. To be considered in the review process, comments or objections on the application must be submitted in writing within twenty (20) days of the date of the last newspaper public notice. You should contact the applicant for the newspaper publication date. The Office will assume you have no comment or objection to the proposed activity if none are received by the end of the public comment period. If you need additional information or have any questions regarding the above -named application, please contact Peter Hays at the Division of Reclamation, Mining and Safety, 1313 Sherman Street, Room 215, Denver, CO 80203, by telephone at 303-866-3567 x 8124, or by email at Peter.hays@state.co.us. M -AP -05G 1313 Sherman St. Room 215 Denver, CO 80203 P (303) 866-3567 F (303) 832-8106 https://mining.state.co.us PVb,1G 2,ev-tieto Jared Polls, Governor I Dan Gibbs, Executive Director I Virginia Brannon, Director 14 r8 /iq cc...ctc-rp),pwcsrivEarcA/cyl y�l X19 *1876 2.ofg -3Z1 BLACK. MOUNTAIN 420 Commerce St. Suite 500, Fort Worth, TX 76102 (817) 698-9901 February 15, 2019 ATTN: Weld County Commissioners 1150 O Street P.O. Box 758 Greeley, CO 80631 RECEIVED FEB 19 2019 WELD COUNTY COMMISSIONERS RE: Notice of Filing Application - Black Mountain Sand DL LLC Lost Creek Mine To Whom It May Concern, Please find included a revised copy of the "Notice of Filing Application" on behalf of Black Mountain Sand DJ LLC. This notice supersedes the previously submitted notice, dated October 2, 2018. Please let me know if you have any questions or need additional information. Thank you, Chris Axnes VP Opera ions Enclosure: Notice of Filing Application CC: Kira Coff, Millcreek Engineering Matthew J. Hazleton, TRC ?ubNic. P121J'1em) cc. PL(TO, PW(SM Ir✓Rlc Ps) s) 21►q/�q 2/25/Iq 2.0ks3— 3Z►1 NOTICE OF FILING APPLICATION FOR COLORADO MINED LAND RECLAMATION PERMIT FOR REGULAR (112) CONSTRUCTION MATERIALS EXTRACTION OPERATION NOTICE TO THE BOARD OF COUNTY COMMISSIONERS WELD COUNTY Black Mountain Sand DJ, LLC, (the "Applicant/Operator") has applied for a Regular (112) reclamation permit from the Colorado Mined Land Reclamation Board (the "Board") to conduct the extraction of construction materials operations in Weld County. The attached information is being provided to notify you of the location and nature of the proposed operation. The entire application is on file with the Division of Reclamation, Mining, and Safety (the "Division") and the local county clerk and recorder. The applicant/operator proposes to reclaim the affected land to original use. Pursuant to Section 34-32.5- 116(4) (m), C.R.S., the Board may confer with the local Board of County Commissioners before approving of the post -mining land use. Accordingly, the Board would appreciate your comments on the proposed operation. Please note that, in order to preserve your right to a hearing before the Board on this application, you must submit written comments on the application within twenty (20) days of the date of last publication of notice pursuant to Section 34-32.5-112(10), C.R.S. If you would like to discuss the proposed post -mining land use, or any other issue regarding this application, please contact the Division of Reclamation, Mining, and Safety, 1313 Sherman Street, Room 215, Denver, Colorado 80203, (303) 866-3567. r� TRC Results you can rely on 1526 Cole Boulevard Building 3, Suite 150 Lakewood, CO 80401 ATTN: Weld County Commissioners 1150 0 Street P.O. Box 758 Greeley, CO 80631 RE: Notice of Filing Application — Black Mountain Sand DJ, LLC To Whom It May Concern, October 2, 2018 ECE VED OCT 0 4 2018 Please find attached a copy of a "Notice of Filing Application" on behalf of Black Mountain Sand DJ, LLC. Sincerely, TRC Environmental Corporation Matthew J. Hazleton Colorado Office Lead -Planning, Permitting, and Licensing Enclosure: Notice of Filing Application wb l i c ( view 10110/(9' cc, PLCTP),PCO(ER/CH/SMMK) (O/5/ IS 2018-3217 NOTICE OF FILING APPLICATION FOR COLORADO MINED LAND RECLAMATION PERMIT FOR REGULAR (112) CONSTRUCTION MATERIALS EXTRACTION OPERATION NOTICE TO THE BOARD OF COUNTY COMMISSIONERS WELD COUNTY Black Mountain Sand DJ, LLC, (the "Applicant/Operator") has applied for a Regular (112) reclamation permit from the Colorado Mined Land Reclamation Board (the "Board") to conduct the extraction of construction materials operations in Weld County. The attached information is being provided to notify you of the location and nature of the proposed operation. The entire application is on file with the Division of Reclamation, Mining, and Safety (the "Division") and the local county clerk and recorder. The applicant/operator proposes to reclaim the affected land to original use. Pursuant to Section 34-32.5-116(4) (m), C.R.S., the Board may confer with the local Board of County Commissioners before approving of the post -mining land use. Accordingly, the Board would appreciate your comments on the proposed operation. Please note that, in order to preserve your right to a hearing before the Board on this application, you must submit written comments on the application within twenty (20) days of the date of last publication of notice pursuant to Section 34-32.5-112(10), C.R.S. If you would like to discuss the proposed post -mining land use, or any other issue regarding this application, please contact the Division of Reclamation, Mining, and Safety, 1313 Sherman Street, Room 215, Denver, Colorado 80203, (303) 866-3567. STATE OF COLORADO DIVISION OF RECLAMATION, MINING AND SAFETY Department of Natural Resources 1313 Sherman St., Room 215 Denver, Colorado 80203 Phone: (303) 866-3567 FAX: (303) 832-8106 CONSTRUCTION MATERIALS REGULAR (112) OPERATION RECLAMATION PERMIT APPLICATION FORM CHECK ONE: There is a File Number Already Assigned to this Operation Permit # I' I New Application (Rule 1.4.5) Conversion Application (Rule 1.11) n COLORADO DIVISION OF RECLAMATION MINING — &— SAF ETY M - - (Please reference the file number currently assigned to this operation) Amendment Application (Rule 1.10) Permit # M - - (provide for Amendments and Conversions of existing permits) The application for a Construction Materials Regular 112 Operation Reclamation Permit contains three major parts: (1) the application form; (2) Exhibits A -S, Addendum 1, any sections of Exhibit 6.5 (Geotechnical Stability Exhibit; and (3) the application fee. When you submit your application, be sure to include one (I ) complete signed and notarized ORIGINAL and one ( I) copy of the completed application form, two (2) copies of Exhibits A -S, Addendum 1, appropriate sections of 6.5 (Geotechnical Stability Exhibit, and a check for the application fee described under Section (4) below. Exhibits should NOT be bound or in a 3 -ring binder; maps should be folded to 8 1/2" X 11" or 8 1/2" X 14" size. To expedite processing, please provide the information in the format and order described in this form. GENERAL OPERATION INFORMATION Type or print clearly, in the space provided, ALL information requested below. 1. Applicant/operator or company name (name to be used on permit): Black Mountain Sand DJ, LLC 1.1 Type of organization (corporation, partnership, etc.): Limited Liability Corporation (LLC) 2. Operation name (pit, mine or site name): Lost Creek, CO 3. Permitted acreage (new or existing site): 3.1 Change in acreage (+) 3.2 Total acreage in Permit area 4. Fees: 4.1 New Application 4.2 New Quarry Application 4.4 Amendment Fee 4.5 Conversion to 112 operation (set by statute) Industrial Sand SIC Code 1446 5. Primary commoditie(s) to be mined: 5.1 Incidental commoditie(s) to be mined: 1. Range From -2 400,000 lbs/Tons/yr 2. -3,069.1 -3,069.1 $2,696.00 $3.342.00 $2.229.00 $2.696.00 Range To permitted acres acres acres application fee quarry application amendment fee conversion fee -4,800.000 lbs/Tons/yr 3. lbs/Tons/yr 4. / lbs/Tons/yr 5. / lbs/Tons/yr 5.2 Anticipated end use of primary commoditie(s) to be mined: Industrial Sand for primary use in hydraulic fracturing 5.3 Anticipated end use of incidental commoditie(s) to be mined: - 2 - 6. Name of owner of subsurface rights of affected land: Black Mountain Land LP If 2 or more owners, "refer to Exhibit O". 7. Name of owner of surface of affected land: Black Mountain Land LP 8. Type of mining operation: 9. Surface Underground Location Information: The center of the area where the majority of mining will occur: COUNTY: Weld PRINCIPAL MERIDIAN (check one): SECTION (write number): TOWNSHIP (write number and check direction): RANGE (write number and check direction): QUARTER SECTION (check one): QUARTER/QUARTER SECTION (check one): 6th (Colorado) 10th (New Mexico) fl Ute 3 (app. center) T 03 R 61 © NE NE FT North El South FlEast I West ENW SE El SW NW ' SE SW GENERAL DESCRIPTION: (the number of miles and direction from the nearest town and the approximate elevation): The site is located approximately 7 miles NE of Roggen, CO and ranges in elevation from —4,530' to —4,770' MSL 10. Primary Mine Entrance Location (report in either Latitude/Longitude OR UTM): Latitude/Longitude: Example: (N) 39° 44' 12.98" (W) 104° 59' 3.87" Latitude (N): deg min sec Longitude (W): deg min sec OR Example: (N) (W) Latitude (N) 40 23969 Longitude(W) 104 20684 OR 39.73691° -104.98449° Universal Tranverse Mercator (UTM) Example: 201336.3 E NAD27 Zone 13 4398351.2 N (5 decimal places) (5 decimal places) UTM Datum (specify NAD27, NAD83 or WGS 84) Easting Northing Nad 83 (2 decimal places) (2 decimal places) 13 Zone 11. Correspondence Information: APPLICANT/OPERATOR (name. address, and phone of name to be used on permit) Contact's Name: Rick Steiskal Company Name: Street/P.O. Box: City: Black Mountain Sand DJ, LLC Title: EHS Manager 420 Commerce Street, Suite 500 Fort Worth P.O. Box: State: Texas Z:„ Code: 76102 Telephone Number: Fax Number: ( ) - (817 ) _ 698-9901 PERMITTING CONTACT (if different from applicant/operator above) Contact's Name: Company Name: Street/P.O. Box: City: State: Telephone Number: Fax Number: INSPECTION CONTACT Contact's Name: Company Name: Street/P.O. Box: City: State: Telephone Number: Fax Number: Title: P.O. Box: Zip Code: ( )- ( )- Rick Steiskal Black Mountain Sand DJ, LLC Title: EHS Manager 420 Commerce Street, Suite 500 Fort Worth P.O. Box: Texas (817 ) _ 698-9901 ( )- Zip Code: 76102 CC: STATE OR FEDERAL LANDOWNER (if any) Agency: Street: City: State: Telephone Number: Zip Code: ( )- CC: STATE OR FEDERAL LANDOWNER (if any) Agency: Street: City: State: Zip Code: Telephone Number: ( ) - -4- 12. Prima h uture (Post -mining) land use (check one): Cropland(CR) n Pastureland(PL) l R• angeland(RL) JJ Forestry(FR) ri R• esidential(RS) ri Recreation(RC) F D• eveloped Water Resources(WR) 13. Primary present land use (check on .17 Cropland(CR) -IIIIIMP Pastureland(PL) _ri Rangeland(RL) Forestry(FR) RResidential(RS) Recreation(RC) Developed Water Resources(WR) General Agriculture(GA) Wildlife Habitat(WL) Industrial/Commercial(IC) Solid Waste Disposal(WD) General Agriculture(GA) Wildlife Habitat(WL) Industrial/Commercial(IC) 14. Method of Mining: Briefly explain mining method (e.g. truck/shovel): Mining in the quarry will be conducted via conventional methods including excavators, dozers, loaders, trucks and conveyors and will be generally similar to sand and gravel mining. 15. On Site Processing: I ✓ I Crushing/Screening 13.1 Briefly explain mining method (e.g. truck/shovel): Sand will be removed from working face via excavators/dozers and transported to the sand plant where it will be crushed, screened, washed and dried. Plant byproduct sand (sand outside of the salable range) will be returned to the quarry and used in reclamation of the site. List any designated chemicals or acid -producing materials to be used or stored within permit area: No acid producing chemicals are anticipated to be used in the operation, and the mining of sand will not use any chemicals. Flocculants commonly used in water treatment plants will be used in the sand plant to facilitate reuse of water 16. Description of Amendment or Conversion: If you are amending or converting an existing operation, provide a brief narrative describing the proposed change(s). N/A -5 - Maps and Exhibits: Two (2) complete, unbound application packages must be submitted. One complete application package consists of a signed application form and the set of maps and exhibits referenced below as Exhibits A -S, Addendum 1. and the Geotechnical Stability Exhibit. Each exhibit within the application must be presented as a separate section. Begin each exhibit on a new page. Pages should be numbered consecutively for ease of reference. If separate documents are used as appendices, please reference these by name in the exhibit. With each of the two (2) signed application forms, you must submit a corresponding set of the maps and exhibits as described in the following references to Rule 6.4, 6.5, and 1.6.2(I)(b): EXHIBIT A EXHIBIT B EXHIBIT C EXHIBIT D EXHIBIT E EXHIBIT F EXHIBIT G EXHIBIT H EXHIBIT I EXHIBIT J EXHIBIT K EXHIBIT L EXHIBIT M EXHIBIT N EXHIBIT O EXHIBIT P EXHIBIT Q EXHIBIT R EXHIBIT S Rule 1.6.2(1)(6) Rule 6.5 Legal Description Index Map Pre -Mining and Mining Plan Map(s) of Affected Lands Mining Plan Reclamation Plan Reclamation Plan Map Water Information Wildlife Information Soils Information Vegetation Information Climate Information Reclamation Costs Other Permits and Licenses Source of Legal Right -To -Enter Owners of Record of Affected Land (Surface Area) and Owners of Substance to be Mined Municipalities Within Two Miles Proof of Mailing of Notices to County Commissioners and Conservation District Proof of Filing with County Clerk or Recorder Permanent Man -Made Structures ADDENDUM 1 - Notice Requirements (sample enclosed) Geotechnical Stability Exhibit (any required sections) The instructions for preparing Exhibits A -S, Addendum 1, and Geotechnical Stability Exhibit are specified under Rule 6.4 and 6.5 and Rule 1.6.2(1)(b) of the Rules and Regulations. If you have any questions on preparing the Exhibits or content of the information required. or would like to schedule a pre -application meeting you may contact the Office at 303-866-3567. Responsibilities as a Permittee: Upon application approval and permit issuance, this application becomes a legally binding document. Therefore, there are a number of important requirements which you, as a permittee, should fully understand. These requirements are listed below. Please read and initial each requirement, in the space provided, to acknowledge that you understand your obligations. If you do not understand these obligations then please contact this Office for a full explanation. 1. Your obligation to reclaim the site is not limited to the amount of the financial warranty. You assume legal liability for all reasonable expenses which the Board or the Office may incur to reclaim the affected lands associated with your mining operation in the event your permit is revoked and financial warranty is forfeited; -6- 2. The Board may suspend or revoke this permit, or assess a civil penalty, upon a finding that the permittee violated the terms or conditions of this permit, the Act. the Mineral Rules and Regulations, or that information contained in the application or your permit misrepresent important material facts: 3. If your mining and reclamation operations affect areas beyond the boundaries of an approved permit boundary, substantial civil penalties, to you as permittee can result; 4. Any modification to the approved mining and reclamation plan from those described in your approved application requires you to submit a permit modification and obtain approval from the Board or Office; 5. It is your responsibility to notify the Office of any changes in your address or phone number; 6. Upon permit issuance and prior to beginning on -site mining activity, you must post a sign at the entrance of the mine site, which shall be clearly visible from the access road, with the following information (Rule 3.1.12): a. the name of the operator; b. a statement that a reclamation permit for the operation has been issued by the Colorado Mined Land Reclamation Board; and, c. the permit number. 7. The boundaries of the permit boundary area must be marked by monuments or other markers that are clearly visible and adequate to delineate such boundaries prior to site disturbance. 8. It is a provision of this permit that the operations will be conducted in accordance with the terms and conditions listed in your application, as well as with the provisions of the Act and the Construction Material Rules and Regulations in effect at the time the permit is issued. 9. Annually, on the anniversary date of permit issuance, you must submit an annual fee as specified by Statute, and an annual report which includes a map describing the acreage affected and the acreage reclaimed to date (if there are changes from the previous year), any monitoring required by the Reclamation Plan to be submitted annually on the anniversary date of the permit approval. Annual fees are for the previous year a permit is held. For example, a permit with the anniversary date of July 1, 1995, the annual fee is for the period of July 1, 1994 through June 30, 1995. Failure to submit your annual fee and report by the permit anniversary' date may result in a civil penalty, revocation of your permit, and forfeiture of your financial warranty. It is your responsibility, as the permittee, to continue to pay your annual fee to the Office until the Board releases you from your total reclamation responsibility. 10. For joint venture/partnership operators: the signing representative is authorized to sign this document and a power of attorney (provided by the partner(s)) authorizing the signature of the representative is attached to this application. -7 - NOTE TO COMMENTORS/OBJECTORS: It is likely there will be additions, changes. and deletions to this document prior to final decision by the Office. Therefore, if you have any comments or concerns you must contact the applicant or the Office prior to the decision date so that you will know what changes may have been made to the application document. The Office is not allowed to consider comments, unless they are written, and received prior to the end of the public comment period. You should contact the applicant for the final date of the public comment period. If you have questions about the Mined Land Reclamation Board and Office's review and decision or appeals process, you may contact the Office at (303) 866-3567. -8 Certification: As an authorized representative of the applicant, I hereby certify that the operation described has met the minimum requirements of the following terms and conditions: 1. To the best of my knowledge, all significant, valuable and permanent man-made structure(s) in existence at the time this application is filed, and located within 200 feet of the proposed affected area have been identified in this application (Section 34-32.5-I 15(4)(e), C.R.S.). 2. No mining operation will be located on lands where such operations are prohibited by law (Section 34-32.5-115(4)(f), C.R.S.; 3. As the applicant/operator, I do not have any extraction/exploration operations in the State of Colorado currently in violation of the provisions of the Colorado Land Reclamation Act for the Extraction of Construction Materials (Section 34-32.5-120, C.R.S.) as determined through a Board finding. 4. I understand that statements in the application are being made under penalty of perjury and that false statements made herein are punishable as a Class 1 misdemeanor pursuant to Section 18-8-503, C.R.S. This form has been approved by the Mined Land Reclamation Board pursuant to section 34-32.5-112, O R.S., of the Colorado Land Reclamation Act for the Extraction of Construction Materials. Any alteration or modification of this form shall result in voiding any permit issued on the altered or modified form and subject the operator to cease and desist orders and civil penalties for operating without a permit pursuant to section 34-32.5-123, C.R.S. Signed and dated this day of DC ob , 2.o\ca b\acx.mciL,Lincti-.N � d Applicant/Operator or Company Name Signed: Title: v • p. State of <n y,05 ss. County of sRt cNS If Corporation Attest (Seal) Signed: Corporate Secretary or Equivalent Town/City/County Clerk The foregoing ,instrument was acknowledged before me this 15� day of UPI U byahlzts e\Iss as NJ.P.os of la -1\AoLi.ftccii. BRYANNA ARROYO LOCKHART Notary ID #131701504 My Commission Expires August 28, 2022 Notary P My Commission expires: 1 2 (612 D22. SIGNATURES MUST BE IN BLUE INK You must post sufficient Notices at the location of the proposed mine site to clearly identify the site as the location of a Hello