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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 <br />print current contact information: <br />Permittee Contact: <br />Byron Weathers <br />Permittee <br />Company: <br />Byron J. & LaLani R. <br />Weathers <br />Address: <br />11955 CR 37 <br />Yuma, CO 80759 <br />Phone Number: <br />(970) 848-2912 <br />Fax Number: <br />(970) 848-2912 <br />Email Address: <br />byron@weathersfarms.net <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 />?--/5 <br />Signature orate icer, Owner, or Documented Designee Date <br />