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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: Arthur A. Winter <br /> Permittee Company: Arthur A. Winter <br /> Address: 20157 C. R. 75.0 <br /> Trinidad,CO 81082 <br /> Phone Number: (719)846-6143 <br /> Fax Number: 'I I q_ f, f <br /> Email Address: Mckwl804@msn.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.-411 <br /> ' <br /> Signature of Permittee,Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-01 <br />