Figure 3-4.—DANGER/CAUTION Tag-Out Record Sheet NAVSEA 9210/9 (Front).
you a log serial number from the DANGER
CAUTION Tag-Out Index and Record of
Audit sheet.
(B) SYSTEM OR COMPONENT: Enter the
official nomenclature of the system or
equipment you are tagging-out (example,
AN/WSC-3[V]).
(C) LOG SERIAL NO.: Enter the number assigned
by the authorizing officer.
(D) REASON FOR TAG-OUT: Briefly describe
the reason for the tag-out (example, “Pre-
ventive maintenance”).
(E) PERSONNEL/EQUIPMENT HAZARDS
INVOLVED: Briefly describe any hazards
that may exist (examples, “Shock hazard” or
“Operation would damage equipment”).
(F) AMPLIFYING INSTRUCTIONS: Briefly
describe any other instructions that may apply.
3-9
