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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: Kenneth Winkler <br />Permittee Company: Montrose County <br />Address: 949 N. 2nd Street <br />Montrose, CO 81401 <br />Phone Number: 970) 252-7000 <br />Fax Number: <br />Email Address: <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 df Permittee, Corporate Officer, Owner, or Documented Designee <br />M -AF -04 <br />lv l <br />ate