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Tags<br />
<strong>Facility</strong> Identifi<strong>cat</strong>ion Products<br />
Health <strong>and</strong> <strong>Safety</strong> Tags (cont.)<br />
See page 85 for information on part number sizes <strong>and</strong> materials. Unless legend for back side of tag is shown, it is<br />
indi<strong>cat</strong>ed below tag part numbers. Legends for Style A, B or C backs are shown on page 85.<br />
GAS<br />
Signed By:<br />
Date:<br />
DANGER<br />
KEEP OUT<br />
PANDUIT<br />
PVT-33-Q<br />
Styl e C<br />
PVT-33<br />
DANGER<br />
KEEP<br />
OUT<br />
Signed By:<br />
Date:<br />
PCT-55 PANDUIT PVT-55<br />
PVT-55-Q<br />
PCT-55-Q<br />
Style A<br />
DANGER<br />
LIVE<br />
WIRE<br />
Signed By:<br />
Date:<br />
PCT-56 PANDUIT PVT-56<br />
PVT-56-Q<br />
PCT-56-Q<br />
Style A<br />
NO SMOKING<br />
MATCHES<br />
OR OPEN<br />
LIGHTS<br />
Signed By:<br />
Date:<br />
DANGER<br />
PANDUIT<br />
PVT-11-Q<br />
Style C<br />
PVT-11<br />
RADIATION<br />
HAZARD IDENTITY<br />
Signed By:<br />
Date:<br />
PCT-215F<br />
PANDUIT<br />
PCT-215F-Q<br />
Same as Front<br />
Regulatory <strong>Safety</strong> Tags<br />
See page 85 for information on part number sizes <strong>and</strong> materials.<br />
CONFINED SPACE<br />
ENTRY PERMIT<br />
DATE & TIME OF ISSUE<br />
EQUIPMENT I.D.<br />
EQUIPMENT LOCATION<br />
EXPIRATION<br />
WORK TO BE DONE<br />
CONFINED SPACE APPROVAL<br />
QUALIFIED<br />
PERSON<br />
OTHER QUALIFIED<br />
PERSON<br />
EMPLOYEE(S) TO ENTER<br />
SUPERVISOR<br />
CHECKLIST ON OTHER SIDE<br />
MUST BE COMPLETED<br />
BEFORE APPROVAL<br />
CHECKLIST<br />
SPECIAL REQUIREMENTS Yes No<br />
Lockout—De-energize<br />
Lines Broken—Capped or Blanked<br />
Purge—Flush <strong>and</strong> Vent<br />
Ventilation<br />
Secure Area<br />
Breathing Apparatus<br />
Resuscitator—Inhalator<br />
Escape Harness<br />
Tripod Emergency Escape Unit<br />
Lifelines<br />
Fire Extinguishers<br />
Lighting<br />
Protective Clothing<br />
Respirator<br />
TEST(S) TO BE TAKEN<br />
(Valid for one 8-hour turn only) Yes No<br />
P.E.L.<br />
% of Oxygen 19.5% – 23.5%<br />
% of L.E.L. Any % over 10<br />
Carbon Monoxide<br />
35 ppm<br />
Hydrogen Sulfide<br />
10 ppm<br />
CONFINED SPACE<br />
INSPECTION TAG<br />
This space was checked:<br />
DATE<br />
TIME<br />
FLAMMABLE<br />
VAPOR<br />
%LEL<br />
OXYGEN %<br />
H 2S<br />
ppm<br />
CO<br />
ppm<br />
OTHER<br />
SIGNED BY<br />
CONFINED SPACE<br />
INSPECTION TAG<br />
Comments:<br />
Signed<br />
Date<br />
HEALTH<br />
SPECIAL NOTICE<br />
Chemical Name<br />
Common Name<br />
Manufacturer<br />
FLAMMABILITY<br />
SEE OTHER SIDE<br />
REACTIVITY<br />
CHEMICAL NAME<br />
(CHECK OFF APPROPRIATE BOXES)<br />
ROUTE OF ENTRY<br />
INHALATION<br />
INGESTION<br />
SKIN ABSORPTION<br />
SKIN OR EYE CONTACT<br />
HEALTH HAZARDS<br />
NO HEALTH HAZARDS<br />
TOXIC<br />
HIGHLY TOXIC<br />
REPRODUCTIVE TOXIN<br />
IRRITANT<br />
CORROSIVE<br />
SENSITIZER<br />
CARCINOGEN<br />
PHYSICAL HAZARDS<br />
NO PHYSICAL HAZARDS<br />
COMBUSTIBLE LIQUID<br />
COMPRESSED GAS<br />
OXIDIZER<br />
FLAMMABLE GAS<br />
EXPLOSIVE<br />
FLAMMABLE LIQUID / SOLID<br />
PYROPHORIC<br />
ORGANIC PEROXIDE<br />
WATER REACTIVE<br />
UNSTABLE (REACTIVE)<br />
TARGET ORGANS & EFFECTS<br />
LUNGS<br />
CENTRAL NERVOUS SYSTEM<br />
HEART<br />
CARDIOVASCULAR SYSTEM<br />
KIDNEY<br />
MUCOUS MEMBRANES<br />
EYES<br />
AUTONOMIC NERVOUS SYSTEM<br />
SKIN<br />
RESPIRATORY SYSTEM<br />
PROSTATE<br />
MUTAGEN<br />
BLOOD<br />
TERATOGEN<br />
LIVER<br />
SEE OTHER SIDE<br />
PCT-218 PANDUIT PVT-218<br />
PCT-218 PANDUIT PVT-218<br />
PCT-219 PANDUIT PVT-219<br />
PCT-219 PANDUIT PVT-219<br />
PCT-220 PANDUIT PVT-220<br />
PCT-220 PANDUIT PVT-220<br />
Front<br />
PVT-218-Q<br />
PCT-218-Q<br />
Back<br />
Front<br />
PVT-219-Q<br />
PCT-219-Q<br />
Back<br />
Front<br />
PVT-220-Q<br />
PCT-220-Q<br />
Back<br />
Chemical Name<br />
Common Name<br />
Manufacturer<br />
HEALTH FLAMMABILITY<br />
REACTIVITY<br />
SEE OTHER SIDE<br />
REACTIVITY FLAMMABILITY HEALTH<br />
Can cause death or major injury despite<br />
4 medical treatment.<br />
Can cause serious injury despite medical<br />
3 treatment.<br />
Can cause injury. Requires prompt<br />
2 treatment.<br />
1 Can cause irritation if not treated.<br />
0 No hazard.<br />
Very Flammable gases or very volatile<br />
4 flammable liquids.<br />
3 Can be ignited at all normal temperatures.<br />
2 Ignites if moderately heated.<br />
1 Ignites after considerable preheating.<br />
0 Will not burn.<br />
4 Readily detonates or explodes.<br />
Can detonate or explode but requires strong<br />
3 initiating force or heating under confinement.<br />
2 Normally unstable but will not detonate.<br />
Normally stable. Unstable at high temperature<br />
<strong>and</strong> pressure. Reacts with water.<br />
1<br />
0 Normally stable. Not reactive with water.<br />
SPECIAL<br />
NOTICE<br />
W Water Reactive OX Oxidizing Agent<br />
HEALTH<br />
FLAMMABILITY<br />
REACTIVITY<br />
PROTECTIVE<br />
EQUIPMENT<br />
SEE OTHER SIDE<br />
CHEMICAL NAME<br />
(CHECK OFF APPROPRIATE BOXES)<br />
ROUTE OF ENTRY<br />
INHALATION<br />
INGESTION<br />
SKIN ABSORPTION<br />
SKIN OR EYE CONTACT<br />
HEALTH HAZARDS<br />
NO HEALTH HAZARD<br />
TOXIC<br />
HIGHLY TOXIC<br />
REPRODUCTIVE TOXIN<br />
IRRITANT<br />
CORROSIVE<br />
SENSITIZER<br />
CARCINOGEN<br />
PHYSICAL HAZARDS<br />
NO PHYSICAL HAZARDS<br />
COMBUSTIBLE LIQUID<br />
COMPRESSED GAS<br />
OXIDIZER<br />
FLAMMABLE GAS<br />
EXPLOSIVE<br />
FLAMMABLE LIQUID / SOLID<br />
PYROPHORIC<br />
ORGANIC PEROXIDE<br />
WATER REACTIVE<br />
UNSTABLE (REACTIVE)<br />
TARGET ORGANS & EFFECTS<br />
LUNGS<br />
CENTRAL NERVOUS SYSTEM<br />
HEART<br />
CARDIOVASCULAR SYSTEM<br />
KIDNEY<br />
MUCOUS MEMBRANES<br />
EYES<br />
AUTONOMIC NERVOUS SYSTEM<br />
SKIN<br />
RESPIRATORY SYSTEM<br />
PROSTATE<br />
BLOOD<br />
BLOOD<br />
MUTAGEN<br />
LIVER<br />
TERATOGEN<br />
SEE OTHER SIDE<br />
See pages 39-44 for Lockout/Tagout<br />
legends <strong>and</strong> pages 58-61 for<br />
Electrical legends.<br />
To order custom legend tags, refer<br />
to Custom Tag Order Forms<br />
on pages 60-61.<br />
PCT-236 PANDUIT PVT-236<br />
PCT-237 PANDUIT PVT-237<br />
Front<br />
PVT-236-Q<br />
PCT-236-Q<br />
Back<br />
Front<br />
PVT-237-Q<br />
PCT-237-Q<br />
Back<br />
86<br />
Most commonly used parts appear in BOLD.
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