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970-626-4439 <br />Division records indicate (lie fallowing permittee contact information. <br />current contact information: <br />03:08:06p.m. 08-11-2016 6)8 <br />Page 5 of 5 <br />If this information is not current, please type or print <br />Permittee Conlact: <br />Chris Miller <br />Permittee Company: <br />Ouray County <br />Address: <br />P.O. Box 456 <br />Ridgway, CO 81432 <br />Phone Number: <br />(970) 626-5391 <br />Fax Number: <br />(970) 6264439 <br />E-mail Address: <br />Cmiller(aDouraycounlyco.gov <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 Permittee. Cornorate Officer. Owner. or Documented Desitnee <br />Sl AV -04 <br />Date <br />