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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: Randy DiLuzio <br /> Permittee Company: Tezak Heavy Equipment Co. Inc. <br /> Address: 205 Tunnel Dr. <br /> Canon City,CO 81212 <br /> Phone Number: (719)269-1173 <br /> Fax Number: (719)269-1148 <br /> Email Address: RDiLuzio@tezakheavyequipment.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 Div' !'9n approved mining and reclamation plans. <br /> �- <br /> Signature of Ni ttee,Corporate O ,Otivner,or Documented Designee Da e <br /> 111-AF-01 <br />