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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 />Rudy Torres <br />Permittee Company: <br />J -Rude Inc <br />Address: <br />1750 CR HH <br />Lamar, CO 81052 <br />Phone Number: <br />(719) 336-7361 <br />Fax Number: <br />Email Address: <br />Jrudeinc@cminet.net <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 />7 / <br />ignae of Permittee, Corporate Officer, Owner, or Documented Designee <br />M -AF -OI <br />/13 <br />Date <br />