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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: Joe Kozimor <br /> Permittee Company: Consolidated Constructors, Inc. <br /> Address: P.O. Box 629 <br /> Farmington,NM 87499 <br /> Phone Number: (505)326-7771 <br /> Fax Number: (505)326-7774 <br /> Email Address: <br /> Permitting Contact: Joe Kozimor <br /> Company: Consolidated Constructors,Inc. <br /> Address: P.O. Box 629 <br /> Farmington,NM 87499 <br /> Phone Number: (505)326-7771 <br /> Fax Number: (505)326-7774 <br /> Email Address: <br /> Inspection Contact: Joe Kozimor <br /> Company: Consolidated Constructors,Inc. <br /> Address: P.O. Box 629 <br /> Farmington,NM 87499 <br /> Phone Number: (505)326-7771 <br /> Fax Number: (505)326-7774 <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 /> C -i _ C S l <br /> Si a of Permittee,j2otporaj Officer,Owner,or Documented DesiEnee Date <br /> M-AF-01 <br />