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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: <br />Regulatory Dept / Jason Eckman <br />Permittee Company: <br />EnCana Oil & Gas (USA), Inc. <br />Address: <br />143 Diamond Ave <br />Parachute, CO 81635 <br />Phone Number: <br />(970) 285-2656 <br />Fax Number: <br />(970) 285-2691 <br />Email Address: <br />Jason.eckman@encana.com <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 />t <br />Signatuf a of Permittee, Corporate Officer, Owner, or Documented Designee <br />'J <br />M -AF -01 <br />�U <br />Date <br />