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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 print <br />current contact information: <br />Permittee Contact: Brian Wells <br />Permittee Company: Dirt Merchant, Inc. <br />Address: 638 1800 Road <br />Delta, CO 81416 <br />Phone Number: 970) 874-4151 <br />Fax Number: <br />Email Address: <br />o•^- <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 />of Permittee. Coraorate Officer. Owner, or Documented Desienee <br />a-/S- <br />Date