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Page S ofS <br /> Division records indicate the following permitteeilandowner contact information(blank fields indicate that wee do not have <br /> information on record). if this information is blank or not current,please type or print tumid.contact information: <br /> l er mittee toatact: i Christiumee e <br /> l Yermiteee Company: 'k.a1<arie'kiiesr.arc_cte iuivage <br /> North America inc. <br /> Address 1687 Cole Blvd <br /> Suite 300 <br /> Golden,CO 80401 <br /> Phone Number: (303)809-7231 <br /> Fax Number: <br /> Email Address: Christine.felz@lafargeholcim.com <br /> Permitting Contact: " <br /> Company: Lafarge North America Inc. <br /> Address: -840O-V Bryn Mawr Ave.,Ste. 7 <br /> 300- \ ) ' ( k r�l v c k-P 2w <br /> �w c lit <br /> '73(.) I C I <br /> Phone Number: (1733112-1000 1 j ' <br /> Fax Number: <br /> Email Address: <br /> Inspection Contact: _AnthetirlvtalrghlrICIllter <br /> - CA-'°(\9 <br /> Company: <br /> Address: ., <br /> 300 <br /> Phone Number: (7,7-3)172-I 000 <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 /> L11 �"� • �" 11 .5 11 <br /> Signature of Permittee,Cornorate Officer, wner,or Documented Designee ate <br /> M-AF-01 --(� <br />