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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: Kirk Daehling <br /> Permittee Company: Natural Soda LLC <br /> Address: 3200 CR 31 <br /> Rifle, CO 81650 <br /> Phone Number: (970)878-3674 Ext. 114 <br /> Fax Number: (970)878-5866 <br /> Email Address: Kdaehling@enirgi.com <br /> Permitting Contact: Kirk Daehling Gerald Daub <br /> Company: Natural Soda LLC Daub & Associates, Inc. <br /> Address: 3200 CR 31 2241 S Broadway <br /> Rifle,CO 81650 Grand Junction, CO. 81507 <br /> Phone Number: (970) 878-3674 <br /> (970) 254-1224 <br /> Fax Number: (970)878-5866 (9 7 0) 2 4 2-8 4 3 8 <br /> Email Address: Kdaehling@enirgi.com gjdaub@daubandassociates.com <br /> Inspection Contact: Kirk Daehling <br /> Company: Natural Soda LLC <br /> Address: 3200 CR 31 <br /> Rifle,CO 81650 <br /> Phone Number: (970) 878-3674 Ext. 114 <br /> Fax Number: (970)878-5866 <br /> Email Address: Kdaehling@enirgi.com <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 /> z�- 0, O-zz� /--/,?-/ l <br /> Signature of Per ee Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-02 <br />