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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: Kevin Dodson <br /> Permittee Company: Pinneo Feedlot, LTD. Liability <br /> Company <br /> Address: 32295 Hwy 34 <br /> P.O. Box 384 <br /> Brush, CO 80723 <br /> Phone Number: (970)842-0701 <br /> Fax Number: <br /> Email Address: <br /> Permitting Contact: Joel Chisum <br /> ,a.V 0 �t� e) <br /> Company: Pinneo Feedlot, LTD. Liability i, yi ��, I p L`T ( t <br /> Company <br /> Address: 32295 Hwy 34 <br /> P.O. Box 384 Q .� 'u �. 3 �-eJ <br /> Brush, CO 80723 1 <br /> Phone Number: (970)842-0701 9-10 <br /> Fax Number: <br /> Email Address: <br /> Inspection Contact: Joel Chisum ( V l ►'� �,6 p '`► <br /> Company: Pinneo Feedlot, LTD. Liability <br /> Com an n ' <br /> Address: 32295 Hwy 34 <br /> P.O. Box 384 <br /> Brush, CO 80723 <br /> Phone Number: (970)842-0701 <br /> Fax Number: <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,Owner,or Documented Designee Date <br /> M-AF-01 <br />