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PamPamS off <br /> Division records indicate the following permittee/iandowner 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 infonnatioc: <br /> 11Se a e tima■r. i GIIIIIIIIr <br /> 1 ' <br /> Address: P O Box 825 <br /> 31161 Highway 90 <br /> Nucla, CO 81424 <br /> Phone Number: (970)864-2125 <br /> Fax Number: <br /> Email Address: Pinonridge.glasier@aol.com <br /> Permitting Contact: George Glasier <br /> Company: Pinon Ridge Mining LLC <br /> Address: P 0 Box 825 <br /> 31161 Highway 90 <br /> Nucla,CO 81424 <br /> Phone Number: (97)086-4212 <br /> Fax Number: <br /> Email Address: Pinonridge.glasier@aol.com <br /> Inspection Contact: George Glasier <br /> Company: Pinon Ridge Mining LLC <br /> Address: P 0 Box 825 <br /> 31161 Highway 90 <br /> Nucla,CO 81424 <br /> Phone Number: (97)086-4212 <br /> Fax Number: <br /> Email Address: Pinonridge.glasier@aol.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 /> Signature of Per ttee,Corporate Officer,Owner,or Documented Desinnee Date <br /> M-AF-02 <br />