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Page 5 of 5 <br />Division records indicate the following permittee contact information. If this information is not current, please type or <br />print current contact information: <br />Permittee Contact: <br />GordonBrocker <br />Permittee Company: <br />Glenn E Sessions & Sons, Inc. <br />Address: <br />33492 Hwy 125 <br />P.O. Box 1076 <br />Walden, CO80480 <br />Phone Number: <br />(970) 723-4944 <br />Fax Number: <br />(970) 723-8344 <br />Email Address: <br />►G�X1C���SeSSic�nS!„►--v��Sf�� c0� <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 />Signature ofPermittee`, Corporate Officer, Owner, or Documented Designee <br />71 <br />Date <br />