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Page 5 of 5 <br /> livision records indicate the following permittee contact information. If this information is not current,please type or print <br /> urrent contact information: <br /> Permittee Contact: Randy Robins <br /> Permittee Company: Robins Construction,LLLP — <br /> Address: P.O. Box 212 <br /> i <br /> Antonito,CO 81120 <br /> Phone Number: (719)376-2351 <br /> Fax Number: (719)376-2231 <br /> Email Address: [nfo�+n_),robinscotrstruction.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 /> ParJG Robins 5 6 -20 6 <br /> Signature of Permittee,Corporate Officer,Owner.or Documented Designee Date <br /> M-.AF-01 <br />