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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 orprint <br /> current contact information: <br /> Permittee Contact: Julie Sevier <br /> Permittee Company: Pioneer Sand Company, Inc. <br /> Address: 5-6 0c) <br /> Colorado Springs,CO 80933- <br /> 7650 <br /> Phone Number: (719)550-5383 Iva5 <br /> Fax Number: <br /> Email Address: 1 Jsevier@pioneersaild.com <br /> pioneersand.com <br /> 1,the undersigned,hereby state that the information provided in this report is true and accurate, and that site operations are <br /> bei"I)conducted in accordance ith the Division approved mining and reclamation plans. <br /> Si sture of PermitteP Coraorate Officer,Owner,or Documented Designee Date <br /> M-AFA1 <br />