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Page 6 of 6 <br />Division records indicate the following permittee/landowner contact information. If this information is not current, please <br />type or print current contact information: Rule 5.6.1(a, b). <br />Permittee Contact: <br />Mark E. Levin <br />Permittee Company: <br />Outlook Resources, Inc. <br />Address: <br />P.O. Box 1511 <br />Idaho Springs, CO 80452 <br />Phone Number: <br />(303) 567-4174 <br />Fax Number: <br />(303) 567-1006 <br />Email Address: <br />Landowner Contact: <br />d, , r- <br />Landowner Address: <br />Landowner Phone <br />Number: <br />Landowner Email <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 accorwith the Division approved NOI and reclamation plans. Rule 5.6.1(h). <br />(.� \// <br />1 <br />Signature of Permitteej, C}Sfporate Officer, Owner, or Documented Designee Date <br />P -AF -01 <br />