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Pagc 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: James MacDonald <br /> Permittee Company: APC Southern Construction Co., <br /> LLC <br /> Address: 14802 W 44th Avenue <br /> Golden,CO 80403 <br /> Phone Number: (303)279-6611 <br /> Fax Number: (303)279-6216 <br /> Email Address: Jmacdonaldrrapcsouthern.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 /> gnature o Permittee.Corporate Officer,Owner,or Documented Designee Date <br /> Al At-CI <br />