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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 />Sean Mello <br />Permittee Company: <br />Western Slope Aggregates, Inc. <br />Address: <br />P O Box 1319 <br />Carbondale, CO 81623 <br />Phone Number: <br />(970) 963-9424 <br />Fax Number: <br />(970) 963-1454— 2' <br />CI -1 O 91. <br />3- <br />2 <br />41 x-' <br />Email Address: <br />Smello@ws-materials.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 conducted in accordance with the Division approved mining and reclamation plans. <br />if S�,4n1 <br />$46_4.0 C-e+.+c..AL- itGcr4- <br />Signature of Permittee, Crporate Officer, Owner, or Documented Designee <br />M -AF -01 <br />3/7 /i , <br />Date <br />