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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 />Pennittee Contact: <br />Randal Arredondo <br />Permittee Company: <br />Saguache County <br />Address: <br />P.O. Box 476 <br />Saguache, CO 81149 <br />Phone Number: <br />(719) 655-2554 <br />Fax Number: <br />(719) 655-2543 <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 />beinWc ducted in accordance with the Division approved mining and reclamation plans. <br />Si nature of Permi ee,torporate Officer, Owner, or Documented Designee <br />M_ AH.o 1 <br />/ 6 — f <br />Date <br />