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Page 5 of 5 <br /> Division records indicate the following permittee/landowner contact information(blank fields indicate that we do not have <br /> information on record). If this information is blank or not current,please type or print current contact information: <br /> Permittee Contact: Steve Chisolm <br /> Permittee Company: All-Rite Paving&Redi-Mix, <br /> Inc. <br /> Address: P.O. Box 165 <br /> Canon City, CO 81215 <br /> Phone Number: (719)275-1280 <br /> Fax Number: (719)275-1715 <br /> Email Address: Steve.chisolm@arycorp.com <br /> Permitting Contact: Angela Bellantoni <br /> Company: Environmental Alternatives, Inc. <br /> Address: 1107 Main Street <br /> Canon City, CO 81212 <br /> Phone Number: (719)275-8951 <br /> Fax Number: (719)275-1715 <br /> Disconnected <br /> Email Address: <br /> Inspection Contact: Jordan Sasser <br /> Steve Chisholm <br /> Company: All Rite Paving&Redi-Mix Inc. <br /> Address: P.O. Box 165 <br /> Canon City, CO 81215 <br /> Phone Number: (719)275-1280 <br /> Fax Number: (719)275-8897 <br /> Email Address: Jordan@arycorp.com <br /> steve. chisholm@arycorp. 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 /> 0 r P. Ar , 20 .2 - <br /> Signa a of Pernu ee,Corporate Officer,Owner,or Docume ted Designee Date <br /> M-AF-01 <br />