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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 />LeonMoores <br />Permittee Company: <br />Moores Mining, LLC <br />Address: <br />32906 Highway 141 <br />Gateway, CO81522 <br />Phone Number: <br />(970) 931-2806 <br />q 3l - a a <br />lfo rh f - <br />Fax Number: <br />(970) 931-2805 <br />Email Address: <br />T <br />vim �r ; <br />I, the undersigned, hereby state that the information provided in this report is true and accurate, and that site operations are <br />being'qgnducted in accordance with the Division approved mining and reclamation plans. <br />ce,Owner, or Documented Designee <br />M -AF -0I <br />