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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: Jerry Ritchey <br /> Permittee Company: Ritchey's Redi-Mix Concrete, <br /> Inc. <br /> Address: 509 S Idlewild St <br /> Yuma,CO 80759 <br /> Phone Number: (970)848-5451 <br /> Fax Number: (970)848-5453 <br /> Email Address: <br /> Ir <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 /> --3 -1 l <br /> Signatu erm' ee,torporate O er,Owner,or Documented Designee Date <br /> M-AF-01 <br /> la <br /> O <br /> o <br />