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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 />Gina Nance <br />Permittee Company: <br />GCC Rio Grande, Inc. <br />Address: <br />3372 Lime Road <br />Pueblo, CO 81004 <br />Phone Number: <br />(719) 647-6800 <br />Fax Number: <br />(719) 647-6899 <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 />Owner, or Documented Designee <br />F- 27�v'.r <br />ate <br />