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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: Rob Quint <br /> Permittee Company: Logan County <br /> Address: 315 Main St., Ste. 2 <br /> Sterling, CO 80751 <br /> Phone Number: (970)522-7879 <br /> Fax Number: (970)522-4018 <br /> Email Address: Quintr@logancountyco.gov <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 Division approved mining and reclamation plans. <br /> a <br /> ,'—'� / 0 //f-/?0 q, <br /> Signature of Permittee,Corporate Officer,Owner,or Documented Desiznee Date <br /> M-AF-04 <br />