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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: Tony Bohling <br /> Permittee Company: City of Delta <br /> Address: 360 Main Street <br /> Delta, CO 81416 <br /> Phone Number: (970)874-7973 <br /> Fax Number: (970)874-1353 <br /> Email Address: Tony@cityofdelta.net <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 /> it 4 <br /> Signatu a of Per i ee Cor ,orat `Of cer,Owner,or Documented Designee D e <br /> M-AF-04 <br />