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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: Gina Nance S4VL AVIoeEZ <br /> Permittee Company: GCC Rio Grande,Inc. <br /> I <br /> Address: 3372 Lime Road <br /> Pueblo,CO 81004 16 <br /> Phone Number: (719)647-6800 V M L <br /> Fax Number: (719)566-7796 &.n E <br /> I <br /> Email Address: Salvidre@gcc.com gec.com <br /> skmc � <br /> Permitting Contact: EpwIN DUV4aE5 <br /> Company: 4CC Rto r4 r'4 U E� 1"C. <br /> Address: $pNr 6 <br /> i <br /> Phone Number: •}1q 6y3 , 66 61 <br /> Fax Number: ??1G <br /> Email Address: EOL t vAIZ a 3 00 CjC C. Corn <br /> Inspection Contact: Terry Tew J05eprt 30book <br /> Company: GCC Rio Grande,Inc. <br /> s�E <br /> Address: 3372 Lime Road <br /> Pueblo,CO 81004 <br /> Phone Number: (719)647-6800 5+M L <br /> Fax Number: (719)566-7796 SQ M E <br /> Email Address: J SOSF}Vok c� .C)CC . con. <br /> I,the undersigned,hereby state that the information provided in this report is true and accurate,and that site operations are <br /> being conducte in acc dance ith t Division approved mining and reclamation plans. <br /> T <br /> rZ �I '0! <br /> Signature of PeA mittee Cor or a Officer,Owner,or Documented Designee Date <br /> AI-AF-01 <br />