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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: Ray Anderson <br /> Permittee Company: Puckett Land Company <br /> Address: 5460 S. Quebec St., Suite 250 <br /> Greenwood Village, CO 80111 <br /> Phone Number: (303) 763-1000 <br /> Fax Number: (303) 763-1040 <br /> Email Address: <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-Al-U 1 <br />