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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: Rob Mangone <br />Permittee Company: Rocky Mountain Materials & <br />Asphalt, Inc. <br />Address: 1910 Rand Ave <br />Colorado Springs, CO 80906 <br />Phone Number: 719) 473-3100 <br />Fax Number: 719) 473-3109 <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 />6tiet //RG,4ce r <br />Signature of Permittee, Corporate Officer, Owner, or Document Designee <br />M -AF -0 1 <br />o— w—/S----- <br />Date <br />ir' <br />Date