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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: Robert W. Calder <br /> Permittee Company: Lockland, LLC <br /> Address: 902 East 6th Street <br /> Leadville, CO 80461 <br /> Phone Number: (719)486-7926 <br /> Fax Number: <br /> Email Address: <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 /> 7 ZJ I6 <br /> Sig ature of Permittee,Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-02 <br />