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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 />David A. Lincoln <br />Permittee Company: <br />Bennett Sand and Gravel, Inc. <br />Address: <br />50500 E. 72nd Ave. <br />Bennett, CO 80102 <br />Phone Number: <br />(303) 644-3030 <br />Fax Number: <br />(303) 644-4743 <br />Email Address: <br />BENNETTSAND@AOL.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 thq Division approved mining and reclamation plans. <br />Signature of Permittee, Corporate Officer, Owner, or Documented Designee <br />M -AF -01 <br />IS <br />Date <br />