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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: Bradley S.Wilson <br /> Permittee Company: CEMEX, Inc. <br /> Address: PO Box 529 <br /> Lyons, Co 80540 <br /> Phone Number: (303)823-2100 <br /> Fax Number: (303)823-2199 <br /> Email Address: Bradleys.wilsonacemex.com <br /> 1,the undersigned,hereby state th information provided in this report is true and accurate, and that site operations are <br /> being conducted in accordance w' h t e Division approved ning and reclamation plans. <br /> C►- -�-�► <br /> Sign<ure of Per ' ee Cor orate Officer,Ohar,or Documented Designee Date <br />