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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: Fred A.Duckels <br />Permittee Company: Duckels Construction,Inc. dba <br />Yampa Aggregates <br />Address: 3500 Duckels Court <br />Steamboat Springs, CO 80487 <br />Phone Number: 970)879-6072 <br />Fax Number:970)879-6748 <br />Email Address: Duckelscheryl@aol.com <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 />1" <br />4:41.4.41Ak <br />1 cz. <br />Sig•ature +f Per e,CO rporate Officer,Owner,or Documented Designee Date <br />M-AF-01