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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 />int contact information: <br />Permittee Contact: <br />Kenneth L. Sitoglund <br />Permittee Company: <br />Skoglund Excavating Inc. <br />Address: <br />11 th and Broadway <br />P.O. Box 209 <br />Moffat, CO 81143 <br />Phone Number: <br />(719) 2564447 <br />Fax Number: <br />(719) 256.4447 <br />Email Address: <br />info (a lcenskoglund.cam <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 />Signature of Pamittm Corporo owae=. or <br />14."41 <br />Date <br />