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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 Lamanna <br /> Permittee Company: Holcim(US)Inc. <br /> Address: 3500 Highway 120 <br /> Florence, CO 81226 <br /> Phone Number: (719)288-1420 -7 /Q -o2$$ _ I H I g <br /> Fax Number: (719)784-2205 <br /> Email Address: Joe.lamanna@holcim.com daw►; n'. t I A-At'Z3, o(c;m .toy+► <br /> Permitting Contact: Michael A.Toelle <br /> Company: Holcim(US)Inc. <br /> Address: 3500 Highway 120 <br /> Florence, CO 81226 <br /> Phone Number: (719)784-6325 <br /> Fax Number: (719)784-3470 <br /> Email Address: M)Ke .-tpe Ile@ 10-6nyt helc;',co--" <br /> Inspection Contact: Michael A.Toelle <br /> Company: Holcim(US)Inc. <br /> Address: 3500 Highway 120 <br /> Florence, CO 81226 <br /> Phone Number: (719)784-6325 <br /> Fax Number: (719)784-3470 <br /> Email Address: <br /> 1,the undersigned,hereby state that the information provided in this report is true and accurate, and that site operations are <br /> being conducted in a cordance with the Division approved mining and reclamation plans. <br /> Signature of Permittee,Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-01 <br />