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Page 5 of 5 <br /> Division records indicate the following pennittee contact information. If this information is not current,please type or print <br /> current contact information: <br /> Permittee Contact: Michael D.Coleman <br /> Permittee Company: ACA Products,Inc. <br /> Address: P.O. Box 1887 <br /> Buena Vista,CO 81211 <br /> Phone Number: (719)395-3790 <br /> Fax Number: (719)395-3794 <br /> Email Address: <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 /> w M-- pR%ESl�A FEW T 0% 1141 Zotto <br /> Signature of Permittee, Corporate Officer,Owner,or Documented Designee Date <br /> N-AF-i)I <br />