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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 />Jason Burkey <br />Permittee Company: <br />Oldcastle SW Group, Inc. dba United <br />Companies of Mesa County <br />Address: <br />2273 River Road <br />P O Box 3609 <br />Grand Junction, CO 81502 <br />Phone Number: <br />(970) 243-4900 <br />Fax Number: <br />(970) 243-5945 <br />Email Address: <br />Jason.burkey@oldcastlematerials.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 conducted in accordance with the Division approved mining and reclamation plans. <br />Signature of Permit e, Corporate Officer, Owner, or Documented Designee Date <br />M -AF -04 <br />