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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: <br />Connie N. Davis <br />Permittee Company: <br />Aggregate Industries - WCR, <br />Inc. <br />Address: <br />1687 Cole Blvd., Ste. 300 <br />Golden, CO 80401 <br />Phone Number: <br />(303) 716-5295 <br />Fax Number: <br />(303) 716-5340 <br />Email Address: <br />Connie.davis@aggregate-us.com <br />Permitting Contact: <br />Barb Brunk <br />Connie N. Davis <br />Company: <br />Tetra Tech RMC <br />Aggregate Industries-WCR, Inc. <br />Address: <br />1900 S. Sunset, Ste 1-F <br />Longmont, CO 80501 <br />1687 Cole Blvd., Suite 300 <br />Golden, CO 80401 <br />Phone Number: <br />(303) 772-5282 <br />(970) 396-5252 <br />Fax Number: <br />(303) 665-6959 <br />(303 716-5295 <br />Email Address: <br />connie.davis@aggregate-us.com <br />Inspection Contact: <br />Mike Refer <br />Connie N. Davis <br />Company: <br />Aggregate Industries - WCR, <br />Inc. <br />Address: <br />1687 Cole Blvd., Ste. 300 <br />Golden, CO 80401 <br />Phone Number: <br />(303) 985-1070 <br />(970) 396-5252 <br />Fax Number: <br />(303) 716-5209 <br />(303) 716-5295 <br />Email Address: <br />connie.davis@aggregate-us.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 />z;� 'o' / - 6? <br />Signature of Permittee, Corporate Officer, Owner, or Documented Designee Date <br />M -AF -o 1 <br />