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Page Sof5 <br /> Division records indicate the following permitteeilandowner 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: Bernard Frei <br /> Permittee Company: Albert Frei&Sons Inc. <br /> Address: P.O. Box 700 <br /> Henderson,CO 80640 <br /> Phone Number: (303)289-1837 <br /> Fax Number: (303)289-2865 <br /> Email Address: bfrei@albertfreiandsons.com <br /> Permitting Contact: Steve O'Brian <br /> Company: Environment, Inc. <br /> Address: 7985 Vance Dr.,#205A <br /> Arvada,CO 80003 <br /> Phone Number: (303)423-7297 <br /> Fax Number: (303)423-7599 <br /> Email Address: Environment-inc@outdrs.net <br /> Inspection Contact: Bernard Frei <br /> Company: Albert Frei and Sons,Inc. <br /> Address: P.O. Box 700 <br /> Henderson,CO 80640 <br /> Phone Number: (303)289-1837 <br /> Fax Number: (303)289-3865 <br /> Email Address: bfrei@atbertfreiandsons.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 /> Secretary /0 3i <br /> Signature of Permittee,Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-01 <br /> Albert Frei and Sons,Inc-Hatchery Pit 2017 <br />