Reliance Industries Limited Reliance Project Management System Dahej Manufacturing Division- Expansion Project Equipment Operator Certification Record 10087-2-HSEF-CHK-GE-034 0 | 19.02.14 Issued for Implementation | BK Rev | Date Revision Details Prepared | “Checked By by Approved ByReliance Project Management System _Equipment Operator Certification Record Date RECORD OF REVISIONS Revision Details 10087-2-HSEF-CHK-GE-034 Date: 19/02/2014, Rev. 0 Number _| 19.02.2014 Issued for ImplementationReliance Project Management System 10087-2-HSEF-CHK-GE-034 Equipment Operator Certification Record a Date: 19/02/2014, Rev. 0 | Name Date 7 Job Title Personnel ID No. Permanent Address (street/city/state/pin/country) Phone No. | Project Name Project Location Project No,/Contract No Phone No Date of Birth Sex Hair Eye Color Height Weight color Male_| Female Restrictions |Yes_| No | it Yes, explain Wear rx | Yes | No Glasses? Equipment License Record Equipment | Capacty/atin. | Name/Tite | Training Date | Eval. Dato | Expir. Date Type Licensing Official | Comments: Note: This form is referenced in 10087-2-HSEF-DWP-GE-046 and 10087-2-HSEF- DWP-GE-048 Equipment Operator Certification Record (10087-2-HSEF-CHK-GE-034) Page 3 of 3 © 2014 Reliance Industries Ltd.