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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: Richard Thomas <br /> Permittee Company: RWT Excavating and <br /> Demolition LLC <br /> Address: 3771 Road P <br /> Wiggins, CO 80654 <br /> Phone Number: 970-396-4941 <br /> Fax Number: 970-483-6115 <br /> Email Address: rwtexcavating0hotmail.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 /> Sign a of Permittee,Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-01 <br />