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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 />Preston L. Niesen <br />LE,4z' <br />Permittee Company: <br />Golden Eagle Uranium LLC <br />ENGmNErK'146, if,c. <br />6—Arfre4Y <br />GA4,4pJuL(ilc u. CO 815b3 <br />Address: <br />13263 W. Utah Cir. <br />Lakewood, CO 80228 <br />Phone Number: <br />(303) 985-4689 <br />ov <br />Fax Number: <br />WaNt <br />Email Address: <br />e c is 4o rt , Wase, @ 1 p *c: a <br />, A e t <br />Landowner Contact: <br />L d Co /der <br />URgNIL" I,E7/S/N6 P2oGRznh <br />LE,4z' <br />Landowner Address: <br />n/Av4KRo REseAgcN ANo <br />Ll. S. V EPARTMemr of <br />2.5-97 LEGAcy WAY, <br />ENGmNErK'146, if,c. <br />6—Arfre4Y <br />GA4,4pJuL(ilc u. CO 815b3 <br />Landowner Phone <br />Number: <br />( 19 70 > z 4-8 - 4. 6-6O � <br />Landowner Email <br />Ed ,Coffer a 1m. doe. 9 <br />ov <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 NOI and reclamation plans. Rule 5.6.1(h). <br />t�-112.0,. <br />Signature of Permitte , Corporate Officer, Owner, o Documented Designee <br />P -AF -01 <br />I z- B - zO/S <br />Date <br />