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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: Regulatory Dept/Jason Eckman <br /> Permittee Company: EnCana Oil& Gas(USA), Inc. <br /> Address: 143 Diamond Ave <br /> Parachute, CO 81635 <br /> Phone Number: (970)285-2656 <br /> Fax Number: (970)285-2691 <br /> Email Address: Jason.eckman@encana.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 /> Icy/� 3/I(o <br /> Sig ure of Permittee, Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-01 <br />