(b) The following certification must carry the operator's original signature or be submitted to the BLM using the BLM's electronic reporting system:

I hereby certify that I, or someone under my direct supervision, have inspected the drill site and access route proposed herein; that I am familiar with the conditions which currently exist; that I have full knowledge of state and Federal laws applicable to this operation; that the statements made in this APD package are, to the best of my knowledge, true and correct; and that the work associated with the operations proposed herein will be performed in conformity with this APD package and the terms and conditions under which it is approved. I also certify that I, or the company I represent, am responsible for the operations conducted under this application. These statements are subject to the provisions of 18 U.S.C. 1001 for the filing of false statements. Executed this _ day of _____, 20____. Name Position Title Address Telephone Field representative (if not above signatory) Address (if different from above) Telephone (if different from above) Email (optional)