6 December 2006
Including change 1, 7 December 2006
6-1.6.5 Line/Equipment Involved. Give a brief description of the lines or equipment
on which work is to be performed. This information is prepared prior to issuance of the
6-1.6.6 Details of Blocking and Tagging. Step-by-step instructions and
supplemental information are provided relative to hanging tags and installing lockouts.
This information is prepared prior to issuance of the Safe Clearance.
6-1.6.7 Time Applied. Progressing downward in proper sequence of the form, fill in
the actual time each step of the details is performed.
6-1.6.8 Released By, Time Released, and Date Released. Provide the name and
signature of the person releasing the Safe Clearance. This is usually the authorized
individual-in-charge for the job. The person releasing a Safe Clearance is responsible
for making sure that all workers and temporary grounds are clear and that the line or
equipment is ready to return to service.
Note: Switching operations, and removal of lockouts and tagouts are not yet approved
or accomplished at this point.
6-1.6.9 Accepted By. Provide the name and signature of the person accepting the
release of the Safe Clearance. This is often the same person that issued the Safe
Clearance. If more than one Safe Clearance is issued for the same equipment or
location, this person is also responsible for ensuring all Safe Clearances are released
before any change is made in lockouts or tagouts. Once accepted, removal of lockouts
and tagouts may be authorized, and switching operations may be performed to restore
the line or equipment to service.
6-1.6.10 Time Removed. Beginning with the last detail of switching, lockout, and
tagout on the Safe Clearance, perform the reverse operation, progressing upward on
the form, and enter the time each operation is performed. For instance, if a detail of
switching, lockout, and tagout reads "Switch `A' open and hang danger tag" the opposite
operation is "remove danger tag and Switch `A' shut." Do not operate the equipment or
perform any switching operation after removing your danger tag if it is still tagged with
another danger tag.
Note: If lockouts and tagouts have been installed for more than one Safe Clearance on
the same equipment or line, perform no switching operations until releases have been
accepted for all Safe Clearances.
6-1.6.11 Notification. Return the completed Safe Clearance form to the office that
retains Safe Clearance records.
Lockout and Tagout Precautions.