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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 />Douglas Sessions <br />Permittee Company: <br />Douglas & Patricia Sessions <br />Address: <br />32416 Hwy 34 <br />PO Box 385 <br />Wray, CO 80758 <br />Phone Number: <br />(970) 332-4657 <br />Fax Number: <br />(970) 33246+-7- <br />et7 D — 3.3 <br />- Og J <br />Email Address: <br />gtSS itYnS @ p\c «151' <br />-1, <br />t (rev\ <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 />41 <br />Signa ure of Permitt e, Corpor a Officer, Owner, or Documented Designee <br />M -AF -OI <br />to <br />