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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: Kerry Halde <br /> Permittee Company: Halde Sand&Gravel,Inc. <br /> Address: 46321 US Highway 24 <br /> Burlington, CO 80807 <br /> Phone Number: (719)346-0352 <br /> Fax Number: (719)346-8945 <br /> Email Address: h44d25014 1401ryin tt <br /> I,the undersigned,hereby state that the information provided in this report is true and accurate,and that site operations are <br /> being cond cte ' accordance with the Division approved mining and reclamation plans. <br /> 51y/R, <br /> Signa e o Permittee,Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-01 <br />