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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: Jacob D. Eisel <br /> Craig Howell <br /> Permittee Company: Nuvemco, LLC <br /> Nuvemco LLC <br /> Address: P.O. Box 1120 P.O. Box 297 <br /> Broomfield,CO 80038 Naturita, CO 81422 <br /> Phone Number: (303)666-7852 <br /> 505-350-5241 <br /> Fax Number: (303)666-6164 904-216-1041 <br /> Email Address: Jeisel@eiseloil.com okieatnuvemco@hotmail.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 cons cted in accordance with the Division approved mining and reclamation plans. <br /> i • <br /> �,i, moi' / �. _41.44 r 0V/2//40' <br /> Sig ature o mittee Cor orate Officer,,i wner,or Documented Desiree Date <br /> M-AF-0_' <br />