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F age 5 of 5 <br />g ivision records indicate the following permittee contact information. I this information is not current, please type or print <br />zur: ent contact information: <br />Permittee Contact: <br />Richard Coulson <br />Permittee Company: <br />Coulson Excavating Company, <br />Inc. <br />Address: <br />3609 North County Road 13 <br />Loveland, CO 80538 <br />Phone Number: <br />(970) 667-2178 <br />Fax Number: <br />(970) 667-2193 <br />Email Address: <br />Diana@coulsonex.com <br />I, the undersigned, hereby state that the info , ation provided in this report is true and accurate, and that site operations are <br />being conducted in accordan with <br />tIJ2,Tjl ' ' n approve ning and reclamation plans. <br />Sianat re f ttee, Corporate Officer, Owner, or Documented Designee Da e <br />M -AF -01 <br />