My LIFE is at My LIFE is at My LIFE is at My LIFE is at

risk. LOTOTO risk. LOTOTO risk. LOTOTO risk. LOTOTO

shall be applied. shall be applied. shall be applied. shall be applied.
Owner of this Owner of this Owner of this Owner of this
lock/tag shall be lock/tag shall be lock/tag shall be lock/tag shall be
penalized in penalized in penalized in penalized in
accordance with accordance with accordance with accordance with
the existing the existing the existing the existing
company policy if company policy if company policy if company policy if
not removed after not removed after not removed after not removed after
the activity. the activity. the activity. the activity.
Contact #:0977835659 Contact: 09778359659 Contact #:09778359659 Contact #:09778359659
Contractor: ARCHON NELL INC. Contractor: ARCHON NELL INC. Contractor: ARCHON NELL INC. Contractor: ARCHON NELL INC.
Name: Junrey Manalo Name: ROMMEL DELA CRUZ Name: JONATHAN INTIA Name: EDWIN FINALLA
removed by: removed by: removed by: removed by:
This lock/tag may only be This lock/tag may only be This lock/tag may only be This lock/tag may only be
source has been LOCKED OUT! source has been LOCKED OUT! source has been LOCKED OUT! source has been LOCKED OUT!
This HAZARDOUS energy This HAZARDOUS energy This HAZARDOUS energy This HAZARDOUS energy
SAMPLE-BACK