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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: Bryce Romig <br /> Permittee Company: Climax Molybdenum Company <br /> Address: P.O.Box 68 <br /> Empire,CO 80438 <br /> Phone Number: (303)569-3221 <br /> Fax Number: (303)569-2830 <br /> Email Address: Bryce_romig@fini.com i�i I _ .� -�� <br /> ,. <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 /> Signa ure of Permittee,Corporate Officer,Owner,or Documented Designee Date <br /> i <br /> M-AP-02 <br />