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Division records indicate the following permittee/landowner contact information. If this information is not current, please <br />type or print current contact information: Rule 5.6.1(a, b). <br />Permittee Contact: <br />Al Dowdy <br />a Ad <br />17 <br />Permittee Company: <br />Al Dowdy <br />�� A+-e— <br />Address: <br />15725 Ramrod Dr. <br />g.A M <br />Peyton, CO 80831 <br />SAS <br />Phone Number: <br />(719) 749-9860 <br />gi mfi' <br />Fax Number: <br />(719) 683-3731 <br />5A/,7#1-11 - <br />NDi►-.t_ <br />Email Address:�,� <br />IY0 oVe— <br />"/Y<'- <br />Landowner Contact: <br />Landowner Address: <br />157ZT-RaoM 4 OR <br />pey?'V'*' (f& go43( <br />SAS <br />Landowner Phone <br />7l � <br />Number: <br />5A/,7#1-11 - <br />Landowner Email <br />IY0 oVe— <br />"/Y<'- <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 />Signature of Permittee, Corporate Officer, Owner, or Documented Designee <br />P -AF -01 <br />�j } I <br />20/j�� /r <br />Date <br />