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Get Ardent Services Frm-0127 2014-2024

Acility: Project: Job No: Equipment ID: Sys / Service: Area: Lock / Tag / Device Placed By: Lock / Tag / Device Removal Requested By: Reason for Removal Request: Procedure Steps Confirmed 1. Verify need to remove isolation and energize equipment prior to employee s next scheduled shift. 2. Verify that employee in question is not on-site or at the facility. Comments If the above are confirmed Continue: 3. Confirm the employee in question has knowledge of the removal by one.

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