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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: Joseph C. Harden <br /> Permittee Company: Joseph Curtis Harden <br /> Address: P.O. Box 1207 <br /> Idaho Springs, CO 80452 <br /> Phone Number: (303) 567-2259 <br /> Fax Number: N/A <br /> Email Address: N/A <br /> 1, 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 /> to - 25— Z01 <br /> na re of Permittee, Corporate Officer, Owner,or Documented Designee Date <br /> M-AF-02 <br />