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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: Andy Weber p f <br /> �0.-tjtq (1)e be-r <br /> Permittee Company: Weber Sand&Gravel, Inc. <br /> Address: 2980 E. Hwy. 160 <br /> Pagosa Springs,CO 81147 <br /> Phone Number: (970)264-4568 <br /> Fax Number: (970)264-9089 <br /> Email Address: Webersandgravel@gmail.com <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 /> 4'atLo. �) ),1") 9-d - (Ro 16 <br /> Signatu a of P mittee Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-01 <br />