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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: Foster G. Scott <br /> Permittee Company: The Turquoise Connection, Inc. <br /> Address: 107 Wild Rose Dr. <br /> Canon City, CO 81212 <br /> Phone Number: (719)557-2846 <br /> Fax Number: <br /> Email Address: Fscott705@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 /> `*01114(7- (c— c -- z4 <br /> Signature of Per ittee, Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-02 <br />