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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: J Pat Greer <br /> Permittee Company: The Greer Family Trust <br /> Address: 8097 County Road 100 <br /> Hesperus, CO 81326 <br /> Phone Number: (970)588-3325 <br /> Fax Number: <br /> Email Address: Dnr—drmsminadmin@state.co.us <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 /> Sign re of Permittee,Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-0I <br />