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Page 6 of 6 <br /> Division records indicate the following permittee/landowner contact information. If this information is not current, please <br /> type or print current contact information: Rule 5.6.1(a,b). <br /> Permittee Contact: Preston L.Niesen <br /> Permittee Company: Golden Eagle Uranium LLC <br /> Address: 6767 S. Spruce Street, Suite 100 <br /> Centennial, CO 80112 <br /> Phone Number: (720)259-1534 <br /> Fax Number: (720)228-2838 <br /> Email Address: <br /> Landowner Contact: <br /> Landowner Address: <br /> Landowner Phone <br /> Number: <br /> Landowner Email <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 NOI and reclamation plans. Rule 5.6.1(h). <br /> Signature of Permittee, Corporate Officer,Owner,or Documented Designee Date <br /> P-AF-01 <br />