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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 />Anthony "Marshall" Miller <br />Permittee Company: <br />Lafarge West, Inc. c/o Lafarge <br />North America Inc. <br />Address: <br />8700 W. Bryn Mawr Ave., Ste. <br />300 <br />Chicago, IL 60631 <br />Phone Number: <br />(773) 372-1000 <br />Fax Number: <br />Email Address: <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 />�\ <br />Signature of Permit Cor <br />M -AF -01 <br />to/14115" <br />orate Officer, Owner, or Documented Designee Date <br />