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Permittee Contact: <br />Mickey E. Fouts <br />/7g 1/ <br />Permittee Company: <br />COAG Corporation <br />Address: <br />200 South Wilcox Street <br />P.O. Box 402 <br />Castle Rock, CO 80104 <br />Phone Number: <br />(303) 814 -8251 <br />� s CG , <br />Fax Number: <br />3 O ) _ g ,_ J 3 2 C' <br />Email Address: <br />CF.PR.email <br />Landowner Contact: <br />c 0 /* 6- c ,, /'t'/1. <br />/7g 1/ <br />Landowner Address: <br />Landowner Phone <br />Number: <br />O'' S ' — c3 z <br />Landowner Email <br />,y <br />L.. ,62- Q � � & AL <br />� s CG , <br />19. As required by rule 5.6.1(t), attach a map to this report that accurately depicts the NOI boundary, current affected <br />area, location of all previously listed featured, and all acreages listed in items 6 through 12 and item 20. These <br />activities must be identified on a site map of adequate scale to field locate these areas, and may include coordinates in <br />latitude and longitude to at least 5 decimal places, or UTM coordinates with the datum and zone specified. <br />rrO C / ' - 4"6 5 <br />UPDATED MAP ATTACHED: <br />20. Rule 5.7 requires submittal of final abandonment reports within 60 days for any drill hole(s) with artesian flows and <br />no later than 12 months for all other completed drill holes. <br />ABANDONMENT REPORTS ATTACHED: or. <br />Division records indicate the following permittee /landowner contact information. If this information is not current, please <br />type or print current contact information: Rule 5.6.1(a, b). <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 NOI and reclamation plans. Rule 5.6.1(h). <br />ature of Permittee, Corporate Officer, Owner, or Documented Designee <br />Date <br />Page 4 of 4 <br />