Lockout/Tagout Log Sheet Page Number: Station Number: Released Lock/Tag Describe in detail where the lock is applied and where Phone/ Date L/T Number the equipment or machinery being locked is located. Name/Badge Page Applied Date Initials Remarks Completely filled forms must be retained by the lockout/tagout station custodian for future audit purposes. ANL-496 (03/21/2011) Use ink only to fill out log sheet (nonerasable pen or marker).
Lockout/Tagout Log Sheet Page Number: Station Number: Lock/Tag Number Describe in detail where the lock is applied and where the equipment or machinery being locked is located. Name/Badge Phone/ Page Date L/T Applied Released Remarks Date Initials ANL-496 (03/21/2011) Completely filled forms must be retained by the lockout/tagout station custodian for future audit purposes. Use ink only to fill out log sheet (nonerasable pen or marker).