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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: David A. Lincoln <br /> Permittee Company: Bennett Sand and Gravel,Inc. <br /> Address: 50500 E. 72nd Ave. <br /> Bennett, CO 80102 <br /> Phone Number: (303)644-3030 <br /> Fax Number: (303)644-4743 <br /> Email Address: BENNETTSAND@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 'th the Division approved mining and reclamation plans. <br /> C -7/,S //(O <br /> Signature of Permittee,Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-01 <br />