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Division records indicate the following permittee/landowner contact information. If this information is not current, please <br />type or print current contact information: Rule 5.6.1(a, b). <br />Permittee Contact: <br />Mark A. Steen <br />Permittee Company: <br />AGC Resources, LLC <br />Address: <br />P.O. Box 1523 <br />Longmont, CO 80502 <br />Phone Number: <br />(303) 651-2985 <br />Fax Number: <br />Email Address: <br />Goldtontine@gmail.com <br />Landowner Contact: <br />Landowner Address: <br />Landowner Phone <br />Number: <br />Landowner Email <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 NOI and reclamation plans. Rule 5.6.1(h). <br />Signature of Permittee, Corporate Officer, Owner, or Documented Designee Date <br />P -AF -01 <br />