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r <br /> 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: Jodi Ricker <br /> Steve Chisholm <br /> Permittee Company: ALL-RITE PAVING&REDI- <br /> MIX,INC. <br /> Address: P.O.Box 165 <br /> Canon City,CO 81215 <br /> Phone Number: (719)275-1280 <br /> Fax Number: <br /> Email Address: Jodi@arycorp.com <br /> steve. chisholm@arycorp. com <br /> I,the undersigned,hereby state that the information provided in this report is true and accurate,and that site operations are <br /> being conduc • accord. •,e with the Division approved mining and reclamation plans. <br /> ' .>C-e-4 )C(W'C- <br /> Signat of Per • t -Cor i orate G icer Owner,or Documented Designee Date <br /> M-AF-OI <br />