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Division records indicate the following permittee contact information. If this information is not current lease Page 5 5 <br /> current contact information: p type or prrint <br /> Permittee Contact: Frank L.Leone Jr <br /> Permittee Company: Leone Sand&Gravel LLC <br /> Address: 2400 E Main Street <br /> Trinidad,CO 81082 <br /> Phone Number: (719) 846-4170 <br /> Fax Number: (719) 845-0605 <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 /> Signature of Permittee.Co orate icer Owner.or Documented Designee Date <br /> M-AF-01 <br />