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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: Daniel DiRezza <br /> Permittee Company: Direzza Limited Family <br /> Partnership <br /> Address: 4815 Hwy 194 <br /> Las Animas, CO 81054-9411 <br /> Phone Number: (719)469-5511 <br /> Fax Number: <br /> Email Address: Kat i.com ciji ZZ Q 3 pi. 0.'i C O M <br /> I,the undersigned, hereby state that th- • +rm. '. provided in this report is true and accurate, and that site operations are <br /> being conduct- • cordance wi • .iv. ion . ,prove•_ ning and reclamation plans. <br /> er <br /> y/20/&:•2& <br /> wow <br /> Signa a of Permittee, Corporat• I ffi er,Owner,or Documented Designee Date <br /> M-AF-O I <br />