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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: Carl F.Dismant <br /> Permittee Company: Bachelor Silver Mines Company <br /> Address: P.O.Box 965 <br /> Ouray,CO 81427 <br /> Phone Number: (970) 325-4665 <br /> Fax Number: <br /> Email Address: <br /> 1,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,Corporate Officer.Owner,or Documented Designee Date <br /> M-AF-02 <br />