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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: George Glasier <br />Permittee Company: Pinon Ridge Mining LLC <br />Address: P O Box 825 <br />31161 Highway 90 <br />Nucla, CO 08142-4000 <br />Phone Number: 970) 864-2125 <br />Fax Number: <br />Email Address: Pinonridge.glasier@aol.com <br />Permitting Contact: George Glasier <br />Company: Pinon Ridge Mining LLC <br />Address: P O Box 825 <br />31161 Highway 90 <br />Nucla, CO 08142-4000 <br />Phone Number: 970) 864-2125 <br />Fax Number: <br />Email Address: Pinonridge.glasier@aol.com <br />c! <br />Inspection Contact: George Glasier <br />Company: Pinon Ridge Mining LLC <br />Address: P O Box 825 <br />33161 Highway 90 <br />Nucla, CO 81424 <br />Phone Number: 970) 864-2125 <br />Fax Number: <br />Email Address: Pinonridge.gIasier@aol.com a5ie e5fe/!—!J/7c7/1iU/?i. CD/J'I <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 />Signature of <br />Al -AF -02 <br />d/QiE;Oar <br />or Documented Designee Date