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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 />Pablo Vasquez <br />P t <br />I <br />Permittee Company: <br />Bad Boy Stone <br />Address: <br />P.O. Box 946 <br />Lyons, CO 80540 <br />Phone Number: <br />(303) 823-9625 <br />Fax Number: <br />(303) 823-6888 <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 />M -AF -01 <br />It_ Vis c)cz [310( kh,s11-7( ZZ g. <br />y <br />e of Permittee, Corporate Officer, wner, or Documented Designee <br />Date <br />