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Pap 5 of3 <br />nada �.._._—L_ —AlR.J rise A.�_ _rtei a_ <br />u.i-y f� un�..uwwu�f�vu���fuiu,fur'.,uaa�Rwwi�Iisclwluus�AucthBiREtivxitrr@Ve <br />infarrnation on record). [f this information. is biank or not currentpleaselypeorpriaLgurma contud informdi= <br />'ParmsRirsllantat� �rtBtG%reeks � � <br />Andre Laroche , <br />PentitttneCompany- <br />Continenlatmaterinis <br />Corporation <br />Address: <br />444 E. Costilla St. <br />Colorado Springs, CO 80903 <br />Phone Number. <br />(719) 475-0700 <br />5719) 475-0700 x2448 <br />Fax Number: <br />(719) 475.0226 <br />Email Address: <br />Andre—laroche@tnansit.mix_com <br />Permitting Contact. <br />Andre Laroche <br />Company: <br />Transit Mix Concrete Co. <br />Address: <br />444 E. Costilla Street <br />Colorado Springs, CO 8D903 <br />Phone Number; <br />(719) 475-0700 x2048 <br />Fax Number. <br />(719) 475-0226 <br />Email Address: <br />andre_laroche@transitmix.com <br />Inspection Contact: <br />Andre Laroche <br />Company: <br />Transit Mix Concrete <br />Transit Mix Concrete Co. <br />Address: <br />444 E. Costilia Ave <br />Colorado Springs, CO 80901- <br />1030 <br />444 E. Costilla Street <br />Colorado Springs, CO 80903 <br />Phone Number: <br />(719) 475-0700 <br />(719) 475-0700 x2448 <br />Fax Number. <br />C7 19) 475-2607 <br />(719) 475-0226 <br />Email Address: <br />andre laroche@transilmixcom <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 accordance with the Division approved mining and reclamation plans. <br />(;�-2-1-- 11-08-2017 <br />Signature of Permittee, Corporate Officer. woer,or DocuMtnto Dellage Date <br />Y nr-0 <br />