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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: <br />Todd A. Stockebrand <br />Permittee Company: <br />Asphalt Constructors, Inc. <br />Address: <br />7040 Highway 160 West <br />Alamosa, CO 81101 <br />Phone Number: <br />(719) 589-6671 <br />Fax Number: <br />(719) 589-0927 <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 />`. - u al,CLa bur) 5 e cX -a.fl <br />c <br />Si n a of ermittee, Corporate Officer, Owner, or Doc mented Designee Date <br />M -AF -01 <br />