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Page 5 of 5 <br />Landowner Phone 1 303 - 567 -4174 <br />Number: <br />Landowner Email ( mark.levin @minenv.com <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 NOI and reclamation plans. Rule 5.6.1(h). <br />17 <br />Signature of Permittee, Corporate Officer, Owner, or Documented Designee Date <br />