1. DANGER UNSAFE DO NOT USE EQUIPMENT NEEDS REPAIRS UNSAFE DO NOT USE EQUIPMENT NEEDS REPAIRS LOCKED OUT BY: Name: _______________________ Dept: ________________________ Date: ________________________ Time: _______________________ Reason: ______________________ _____________________________ _____________________________ _____________________________ FrontBack

2. DANGER UNSAFE DO NOT USE Name: _______________________ Date: ________________________ Reason: ______________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ DANGER FrontBack

3. DANGER UNSAFE DO NOT USE Name: _______________________ Date: ________________________ Reason: ______________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ _____________________________ DANGER FrontBack

4. DANGER UNSAFE DO NOT USE EQUIPMENT NEEDS REPAIRS UNSAFE DO NOT USE EQUIPMENT NEEDS REPAIRS LOCKED OUT BY: Name: _______________________ Dept: ________________________ Date: ________________________ Time: _______________________ Reason: ______________________ _____________________________ _____________________________ _____________________________ FrontBack

5. DANGER UNSAFE DO NOT USE EQUIPMENT NEEDS REPAIRS UNSAFE DO NOT USE EQUIPMENT NEEDS REPAIRS LOCKED OUT BY: Name: _______________________ Dept: ________________________ Date: ________________________ Time: _______________________ Reason: ______________________ _____________________________ _____________________________ _____________________________ FrontBack