Professional Documents
Culture Documents
PM/OHS/010
UNTILL THE FOLLOWING CONDITIONS HAVE UNTILL ALL CHECKOUTS BELOW ARE COMPLETE
BEEN COMPLIED WITH: AND SIGNED FOR AND FINAL AUTHORITY GIVE
1. ALL CHECKOUTS LISTED ON THE REVERSE BY OPERATOR'S SIGNATURE ON REVERSE SIDE
SIDE OF THIS CARD ARE COMPLETED AND
SIGNED FOR.
EQUIPMENT NO. ……………………………….
2. FINAL AUTHORITY TO START UP OR OPERATE
THIS EQUIPMENT HAS BEEN GIVEN BY ALL MILL WRIGHT ALIGNMENT:………………………
THE SIGNATURES BELOW. ROTATION………………LUBRICATION.……………
SIGNED……………………….APP………………….
DATE……………………………………
CONTRACTOR: ………………………………………
REP……………………………………………………. OTHER………………………………………………….
DATE………………………………………………….. SIGNED……………………….APP………………….
DATE……………………………………
CLIENT:……………………………………………….
SIGNED……………………….APP………………….
OPERATING CHECK………………………………….
CHARTS……………………….INK…………………..
SIGNED……………………….DATE…………………
SEE REVERSE SIDE SEE REVERSE SIDE