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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: Chris Hanks <br /> Meg Burt <br /> Permittee Company: Cripple Creek&Victor Gold <br /> Mining Company <br /> Address: 100 N 3rd Street <br /> P O Box 191 <br /> Victor, CO 80860 <br /> Phone Number: (719)689-4055 <br /> Fax Number: (719)689-3254 <br /> Email Address: Meg.Burt@newmont.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 /> mil ly'-7 10(5L� <br /> ignature of Permittee.Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-02 <br />