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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: Ferd&Matt Mueller <br /> Permittee Company: Siloam Stone, Inc. <br /> Address: 315 N. 7th St. <br /> Canon City,CO 81212 <br /> Phone Number: (719)275-4275 <br /> Fax Number: (719)275-9050 <br /> Email Address: Siloam@ris.net <br /> Permitting Contact: Stevan L.O'Brian <br /> Company: Environment, Inc. <br /> Address: 7985 Vance Dr Ste 205A <br /> Arvada,CO 80003 <br /> Phone Number: (303)423-7297 <br /> Fax Number: (303)423-7599 <br /> Email Address: <br /> Environment-inc©outdrs.net <br /> Inspection Contact: Ferd&Matt Mueller <br /> Company: Siloam Stone <br /> Address: 1360 Rudd Ave <br /> Canon City,CO 81212 <br /> Phone Number: (970)275-4275 <br /> Fax Number: (970)269-1033 <br /> Email Address: Siloam@ris.net <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 Perm' ee. oraorate Officer,Owner,or Documented Designee Date <br /> M-AF.OI <br />