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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: Matt R. Carnahan <br /> Permittee Company: Oldcastle SW Group, Inc. dba Four <br /> Corners Materials <br /> Address: P.O. Box 1969 <br /> Bayfield, CO 81122-1969 <br /> Phone Number: (970)247-2172 <br /> Fax Number: (970)259-3631 <br /> Email Address: Mcamahan@4comersmaterials.com <br /> Permitting Contact: Matt Carnahan <br /> Company: Oldcastle SW Group, Inc. dba Four <br /> Corners Materials <br /> Address: P.O. Box 1969 <br /> Bayfield, CO 81122-1969 <br /> Phone Number: (970)247-2172 <br /> Fax Number: (970)259-3631 <br /> Email Address: <br /> Inspection Contact: Matt Carnahan <br /> Company: Oldcastle SW Group, Inc. dba Four <br /> Corners Materials <br /> Address: P.O. Box 1969 <br /> Bayfield, CO 81122-1969 <br /> Phone Number: (970)247-2172 <br /> Fax Number: (970)259-3631 <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 /> -4&t' au Gn v t-Al r. V 7 2 S 2017 <br /> Signature of Per ittee Corporate Offficer,Owner,or Documented Designee Date <br /> M-AF-01 <br />