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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: Forrest V.Luke <br /> Permittee Company: Williams Fork Mining Company <br /> Address: P.O. Box 187 <br /> Craig,CO 81626 <br /> Phone Number: (970) 826-6140 <br /> Fax Number: (970) 824-6136 <br /> Email Address: Forrest@trappermine.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 /> Signature of Permittee, Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-01 <br />