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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: Louis P.Vezzani <br /> Permittee Company: Walsenburg Sand and Gravel <br /> Company <br /> Address: P.O. Drawer 352 <br /> Walsenburg, CO 81089 <br /> Phone Number: (719)738-1883 <br /> Fax Number: (719)738-1883 <br /> Email Address: <br /> Permitting Contact: Steve O'Brian <br /> Company: Environment, Inc. <br /> Address: 7985 Vance Dr Ste 205A <br /> Arvada, CO 80003 <br /> Phone Number: (303)423-7297 <br /> Fax Number: (303)423-7599 <br /> Email Address: <br /> Inspection Contact: Gary Vezzani <br /> Company: Walsenburg Sand and Gravel <br /> Company <br /> Address: P.O. Drawer 352 <br /> Walsenburg,CO 81089 <br /> Phone Number: (719)738-1883 <br /> Fax Number: (719)738-1883 <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 /> Signature of Permittee,Corporate Officer; ner,or Documented Designee Date <br /> M-AF-01 <br />