Figure 3-5.DANGER/CAUTION Tag-Out Record Sheet NAVSEA 9210/9 (Back).
WORK NECESSARY TO CLEAR TAG(S):
Briefly describe any work that must be done
before the tag(s) can be cleared.
OPERATIONS/WORK ITEMS INCLUDED
IN TAG-OUT: Fill in this part of the form as
1. List the jobs to which this tag-out applies. If
the tag-out is for an outside repair activity,
list the job order number and title.
2. Record the tag numbers used and the date
and time they were issued.
3. You, as the petty officer in charge, sign in
the designated block. Then have a second
person sign after he or she verifies that (1)
you are using the right type and number of
tags, and (2) you are tagging out the correct
Only qualified ships force personnel shall
perform the second check of tag installation.
The second person shall not accompany the
person initially installing the tag(s).
Next, have the authorizing officer and the
repair activity representative, if applicable,
sign in the spaces provided.
After the work is completed and the tag-out
tags are removed, have the authorizing