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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 />Mark Johnson <br />Permittee Company: <br />Bestway Concrete Company <br />Address: <br />301 Centennial Dr. <br />Milliken, CO 80543 <br />Phone Number: <br />(970) 587-7277 <br />Fax Number: <br />(970) 587-7287 <br />Email Address: <br />v�.1p��� G� aES c_��re�e • c,�. <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 />V. P. <br />Signature of Permittee, Corporate Officer, Owner, or Documented Designee <br />U -.4F-01 <br />Date <br />fYA - (Q 49 -- (!:�)� 3 <br />RC'FIVED <br />v'SEP 2 '1 2015 <br />DIVISI%_'_ _ , I .. a4ATION, <br />MINING& TY -MINERALS <br />NS EPORT 1W -JW <br />aca <br />