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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: Sara A. Glinatsis <br /> Permittee Company: Sunrise Mining LLC <br /> Address: P.O. Box 160 <br /> Arvada, CO 80001 <br /> Phone Number: (308)760-8925 <br /> Fax Number: <br /> Email Address: Sglinatsis@diamondhillfarms.com <br /> Permitting Contact: Sara A. Glinatsis <br /> Company: Sunrise Mining LLC <br /> Address: PO Box 160 <br /> Arvada, CO 80001 <br /> Phone Number: (308)760-8925 <br /> Fax Number: <br /> Email Address: Sglinatsis@diamondhillfarms.com <br /> Inspection Contact: Sara A.Glinatsis <br /> Company: Sunrise Mining LLC <br /> Address: P.O. Box 160 <br /> Arvada, CO 80001 <br /> Phone Number: (308)760-8925 <br /> Fax Number: <br /> Email Address: Sglinatsis@diamondhillfarms.com <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 /> A�A, "'�/�") � I q <br /> Signature Permi ee Coro to Officer,Owner,or Documented Desiznee Date <br /> M-AF-02 <br />