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Page 5 of 5 <br /> Division records indicate the following permittce contact information. If this information is not current,please type or print <br /> current contact information: <br /> Permittee Contact: Daren Palizzi <br /> Permittee Company: Jones Fine Sand <br /> Address: 5400 Forest St. <br /> Commerce City,CO 80022 <br /> Phone Number: (303)289-1428 <br /> Fax Number: 303-289-6990 <br /> Email Address: jonesfinesnnd@q.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 /> (, 8g�2- P.,1. ^ zf 6 <br /> Signature of Permittee,Corporate Officer,Owner,or Documented Designee Date <br /> W AU-01 <br />