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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: Rudy Torres <br /> Permittee Company: Riverside Aggregates,LLC <br /> Address: 1750 County Road HH <br /> Lamar, CO 81052 <br /> Phone Number: (719)336-7361 <br /> Fax Number: <br /> Email Address: Jrudeinc@cminet.net <br /> Permitting Contact: Rudy Torres <br /> Company: Riverside Aggregates,LLC <br /> Address: 1750 County Road HH <br /> Lamar, CO 81052 <br /> Phone Number: (719)336-7361 <br /> Fax Number: <br /> Email Address: <br /> Inspection Contact: Rudy Torres <br /> Company: Riverside Aggregates,LLC <br /> Address: 1750 County Road HH <br /> Lamar,CO 81052 <br /> Phone Number: (719)336-7361 <br /> Fax Number: <br /> Email Address: <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 /> Signa ur'e of rmittee Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-01 L <br />