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t <br /> I Page 5 of 5 <br /> Division records indicate the following permittee/landowner contact information(blank fields indicate that we do not have <br /> j information on record). If this information is blank or not current,please type or print current contact information: <br /> i <br /> Permittee Contact: Donna Thompson <br /> Permittee Company: Donna Thompson <br /> Address: 34756 HWY 550 <br /> Durango, CO 81301 <br /> Phone Number: (970)247-QM <br /> Fax dumber: <br /> Email Address: Snooty@animas.net <br /> Permitting Contact: Donna Thompson <br /> Company: Donna Thompson <br /> Address: 34756 US Hwy 550 <br /> Durango, CO 81301 <br /> Phone Number: (970)247-4160 <br /> Fax Number: (970) <br /> 0 "- OR <br /> Email Address: <br /> Inspection Contact: G r✓ {°t <br /> OP- <br /> Company: <br /> Address: <br /> Phone Number: <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 /> „ <br /> Signature of Permittee,Corporate Officer,Owner,or Documented Designee Date <br /> M-AF-02 <br />