ROLLS COAX INDIA PRIVATE LIMITED

(Formally known as ROLLSCOAX)

OFFICE NO: 301 & 209, J-9 CENTER, OPPOSITE INCOME TAX OFFICE,
ADAJAN, SURAT, GUJARAT, 395009, TEL: 0261-4053706,
Mo: +91-9979760608

SITE VISIT REPORT

Report no: Date:
Name of Work Structural Stability Service-Utility Pipeline
PO Number WO NO: AM/NS-HAZ/SCC/4400176695
Client Arcelor Mittal Nippon Steel India Limited
Plant / Department Name
Name of AM/NS
Representative contacted

ROLLSCOAX
Representative Name
 ROLLS COAX INDIA PRIVATE LIMITED
(Formally known as ROLLSCOAX)

OFFICE NO: 301 & 209, J-9 CENTER, OPPOSITE INCOME TAX OFFICE,
ADAJAN, SURAT, GUJARAT, 395009, TEL: 0261-4053706,
Mo: +91-9979760608

ROLLSCOAX Representative Activity for the day:

Remark:

Signature, ROLLSCOAX Signature, AM/NS