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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 />Alan Chiles <br />Permittee Company: <br />Rimrock Exploration & <br />Development, Inc. <br />Address: <br />P.O. Box 430 <br />Nucla, CO 81424 <br />Phone Number: <br />(970) 417-1239 <br />Fax Number: <br />Email Address: <br />r(L %; 5-0 2 % <br />C <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 />Signature of Permittee, Corporate Officer, Owner, or Documented Designee <br />M -AF -02 <br />0 2o/ <br />Date <br />