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Page 5 of S <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: Todd E. Hammerlund <br /> Permittee Company: Granby Sand&Gravel, LLC <br /> Address: P O Box 1838 <br /> Granby,CO 80446 <br /> Phone Number: (970)627-8834 <br /> Fax Number: <br /> Email Address: Athspecialties(a)live.com <br /> 1,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 /> �21 -/� <br /> Signature of Permittee.Corporate O rcer,Owner.or Documented Designee Date <br /> WAF-W <br /> See attached page for additional information <br />