You can either print out the Sign Survey to fill it in by hand, or work within the electronic version on your computer, laptop, tablet or mobile device. The electronic version is easy to navigate. All editable fields (“Qty,” “Location/Comments” and most of the Quote/Order form) have blue shading.
On a computer or laptop: Either type a number in the “Qty” field or use the dropdown list by clicking on the arrow. Use the tab key to move to the “Location/Comments” field where you can type text. Hitting tab again will move you to the “Qty” field one row down. Use the right scroll bar to move to the next page.
On a tablet or mobile device: Tap into the desired field. Use the dropdown list to enter values in the “Qty” field. Tapping into the “Location/Comments” field will bring up a keyboard to type text. To clear values, tap into the field and then use the “Reset Field” button on the keyboard that pops up.
If you need other products not listed in the Sign Survey, or if you need custom signs or safety identification products, simply add them to the Quote/Order form on the last page of the survey.
Turning the USABlueBook Sign Survey into a Quote or Order
Once you have completed your survey, consolidate your notes on the Quote/Order form. Check the box next to “Quote” or “Order” and fill in your contact information, USABlueBook account number, PO number (if applicable) and shipping information. Please be sure all contact information is accurate in case we have questions about your quote or order.
Fax a copy of the Quote/Order form page to 847-‐689-‐3030, or email the entire file or a scan of the Quote/Order form page to [email protected].
www.usabluebook.com3
ELECTRICALSAFETY
Electrical Safety Signs:Alert personnel to potentially dangerous energy sources with signs, centers, and tags. Reg: 29 CFR 1910.303Lockout devices must be standardized within the facility in at least one of the following areas: color, shape or size. Tagout devices must also be standardized in print format.
EQUIPMENTBEING
SERVICEDDO NOTOPERATE
CU-116924
C190A
THIS MACHINE MUSTBE LOCKED OUT
PRIOR TO SERVICING
C115A
AREA IN FRONT OF THISELECTRICAL PANEL MUST BEKEPT CLEAR FOR 36 INCHES
OSHA-NEC REGULATIONS
D49A
HIGHVOLTAGE
STOCK # MATERIAL SIZE (IN.) QTY LOCATION/COMMENTS
51419 Magnetic 7 x 5
51420 Vinyl Adhesive 21/4 x 41/2
5142151422
Vinyl AdhesiveRigid Plastic
7 x 107 x 10
5143951440514415144251443
Vinyl AdhesiveVinyl Adhesive
Rigid PlasticRigid PlasticAluminum
7 x 1010 x 147 x 10
10 x 147 x 10
514235142451425514265142751428
Vinyl AdhesiveVinyl Adhesive
Rigid PlasticRigid PlasticAluminumAluminum
7x 1010 x 147 x 10
10 x 147 x 10
10 x 14
514295143051431514325143351434
Vinyl AdhesiveVinyl Adhesive
Rigid PlasticRigid PlasticAluminumAluminum
7 x 1010 x 147 x 10
10 x 147 x 10
10 x 14D466A
THIS EQUIPMENTSTARTS
AUTOMATICALLY
STOCK # MATERIAL SIZE (IN.) QTY LOCATION/COMMENTS
57192Lockout StationBoard, Wire Rack, 3 Ring Binder
14w x 20h x 4½d
Lockout Procedures Station:Locate your facility’s established program procedures close to the area(s) in which they will be used. Reg: 29 CFR 1910.147 (c)(4)
Electrical Safety Labels, Pack of 5:Help protect workers from potential danger and avoid injury or even death.
D100AP
220 VOLTSD101AP
480 VOLTSD225AP
AREA IN FRONT OF THISELECTRICAL PANEL MUST
BE KEPT CLEAR FOR 36 INCHESOSHA-NEC REGULATIONS
C115AP
AREA IN FRONT OF THISELECTRICAL PANEL MUST BEKEPT CLEAR FOR 36 INCHES
OSHA-NEC REGULATIONS
EMERGENCYSHUT-OFF
STOCK # 92486
MATERIAL Vinyl
SIZE (IN.) 3 x 5
QUANTITY
STOCK # 92487
MATERIAL Vinyl
SIZE (IN.) 3 x 5
QUANTITY
STOCK # 92488
MATERIAL Vinyl
SIZE (IN.) 3 x 5
QUANTITY
STOCK # 92489
MATERIAL Vinyl
SIZE (IN.) 3 x 5
QUANTITY
STOCK # 92490
MATERIAL Vinyl
SIZE (IN.) 3 x 5
QUANTITY
Location/Comments
Location/Comments
Location/Comments
Location/Comments
Location/Comments
www.usabluebook.com 4
Lockout Tags, Pack of 25:
CU-95047
This energy source hasbeen LOCKED OUT!
Unauthorized removal ofthis lock/tag may resultin possible discharge.
DO NOTOPERATE
www.nationalmarker.com
This lock/tag mayonly be removed by:
NAME:
DEPT:
EXPECTED COMPLETION:
REMARKS
CU-95052
DO
NOTO
PERATEThis lock/tag m
ayonly be rem
oved by:
NAME:DEPT:
EXPECTED COMPLETION:
front back
CU-95047
This energy source hasbeen LOCKED OUT!
Unauthorized removal ofthis lock/tag may resultin possible discharge.
DO NOTOPERATE
www.nationalmarker.com
This lock/tag mayonly be removed by:
NAME:
DEPT:
EXPECTED COMPLETION:
REMARKS
CU-95052
DO
NOTO
PERATEThis lock/tag m
ayonly be rem
oved by:
NAME:DEPT:
EXPECTED COMPLETION:
front back
RPT90
DO NOTOPERATE
NO OPERAR
DO NOT REMOVETHIS TAG
SEE OTHER SIDE
NO REMOVERESTA TARJETA
DE ADVERTENCIAVER EL OTRO LADODATE/FECHA
SIGNED BY/FIRMADO POR
STOCK # 51688
MATERIAL Plastic
SIZE (IN.) 3 x 6
QUANTITY
Location/Comments
STOCK # 51689
MATERIAL Vinyl
SIZE (IN.) 3 x 6
QUANTITY
Location/Comments
STOCK # 92497
MATERIAL Vinyl
SIZE (IN.) 3 x 6
QUANTITY
Location/Comments
Polytags Lockout Tags, Pack of 100:Boxes of 100 tags on Perforated Rolls.
STOCK # 51691
MATERIAL Synthetic Paper
SIZE (IN.) 3 x 6
QUANTITY
Location/Comments
STOCK # 51692
MATERIAL Synthetic Paper
SIZE (IN.) 3 x 6
QUANTITY
Location/Comments
CU-95053
This energy source hasbeen LOCKED OUT!
Unauthorized removal ofthis lock/tag may resultin possible discharge.
www.nationalmarker.com
This lock/tag mayonly be removed by:
NAME:
DEPT:
EXPECTED COMPLETION:
REMARKS
front back
CU-95053
This lock/tag may
only be removed by:
NAME:DEPT:
EXPECTED COMPLETION:
CU-95054
This energy source hasbeen LOCKED OUT!
Unauthorized removal ofthis lock/tag may resultin possible discharge.
www.nationalmarker.com
This lock/tag mayonly be removed by:
NAME:
DEPT:
EXPECTED COMPLETION:
REMARKS
front back
CU-95053
This lock/tag may
only be removed by:
NAME:DEPT:
EXPECTED COMPLETION:
STOCK # 51690
MATERIAL Synthetic Paper
SIZE (IN.) 3 x 6
QUANTITY
Location/Comments
STOCK # 51694
MATERIAL Synthetic Paper
SIZE (IN.) 3 x 6
QUANTITY
Location/Comments
STOCK # 51693
MATERIAL Synthetic Paper
SIZE (IN.) 3 x 6
QUANTITY
Location/Comments
CU-95056
This energy source hasbeen LOCKED OUT!
Unauthorized removal ofthis lock/tag may resultin possible discharge.
DO NOTOPERATE
www.nationalmarker.com
EQUIPMENT LOCKED OUT
NAME:
DEPT:
EXPECTED COMPLETION:
REMARKS
CU-95052
DO
NOTO
PERATEEQUIPMENT LOCKED OUT
NAME:DEPT:
EXPECTED COMPLETION:
front back
CU-95065
This energy source hasbeen LOCKED OUT!
Unauthorized removal ofthis lock/tag may resultin possible discharge.
www.nationalmarker.com
This lock/tag mayonly be removed by:
NAME:
DEPT:
EXPECTED COMPLETION:
REMARKS
front back
CU-95065
This lock/tag may
only be removed by:
NAME:
DEPT:EXPECTED COM
PLETION:
CU-95052
This energy source hasbeen LOCKED OUT!
Unauthorized removal ofthis lock/tag may resultin possible discharge.
DO NOTOPERATE
www.nationalmarker.com
This lock/tag mayonly be removed by:
NAME:
DEPT:
EXPECTED COMPLETION:
REMARKS
CU-95052
DO
NO
TO
PERATEThis lock/tag m
ayonly be rem
oved by:
NAME:DEPT:
EXPECTED COMPLETION:
front back
ELECTRICAL
SAFETY
STOCK # 51435
MATERIAL Vinyl
SIZE (IN.) 3 x 5
QUANTITY
Location/Comments
STOCK # 51436
MATERIAL Vinyl
SIZE (IN.) 3 x 5
QUANTITY
Location/Comments
STOCK # 51437
MATERIAL Vinyl
SIZE (IN.) 5 x 7
QUANTITY
Location/Comments
Arc Flash and Shock HazardAppropriate PPE Required
Refer to NFPA 79E for minimum PPE requirements.
Do not operate controls or open coverswithout appropriate personal protectionequipment.Failure to comply may result in injury ordeath!
WARNINGArc Flash and Shock HazardAppropriate PPE Required
Refer to NFPA 79E for minimum PPE requirements.
Do not operate controls or open coverswithout appropriate personal protectionequipment.Failure to comply may result in injury ordeath!
Arc Flash & Shock HazardAppropriate PPE Required
Arc-rated balaclavaArc-rated hard hat linerArc-rated glovesLong-sleeve shirtLong pants
Arc-rated shirtArc-rated pantsArc-rated coverallFlash suitFlash hoodHard hat
Face shieldHearing protectionSafety glassesSafety gogglesLeather glovesLeather shoes
Incident Energy (cal/cm2)Corresponding Work DistanceNominal System VoltageLimited Approach BoundaryRestricted Approach BoundaryProhibited Approach Boundary
Equipment ID:CU-94796
WARNINGArc Flash & Shock Hazard
Appropriate PPE Required
Arc-rated balaclavaArc-rated hard hat linerArc-rated glovesLong-sleeve shirtLong pants
Arc-rated shirtArc-rated pantsArc-rated coverallFlash suitFlash hoodHard hat
Face shieldHearing protectionSafety glassesSafety gogglesLeather glovesLeather shoes
Incident Energy (cal/cm2)Corresponding Work DistanceNominal System VoltageLimited Approach BoundaryRestricted Approach BoundaryProhibited Approach Boundary
Equipment ID:CU-94799
STOCK # 51438
MATERIAL Vinyl
SIZ (IN.) 5 x 7
QUANTITY
Location/Comments
Arc Flash Labels, Pack of 5:Protect employees from electric shock, burns, and other hazards by posting warning labels near switchboards, control panels, or other conductor sources. Reg: NFPA 70E
www.usabluebook.com 26
CUSTOM PRODUCTS
This is a general guide designed to assist customers in identifying available USABlueBook identification products in support of their safety programs. This guide is not a list of all legally required products; and USABlueBook makes no warranty, express or implied, that the guide or the products are suitable for a particular customer’s use. Each party using this guide should assess the specifics of its own business operations and make its own determination, or seek independent professional advice, regarding the use of this guide and products and compliance with applicable laws.
Date Completed: USABlueBook Sales Representative: Quote Order PO# This Facility Sign Survey was prepared for: Shipping information: Company Name: Company Name: Contact Name: Address: Contact Phone: City, State, Zip: Contact Email: Attention (if needed): USABlueBook Account #:
Use this form to consolidate your selections throughout the Sign Survey into a convenient ordering list. Also include any other stock, or custom products needed on this list. Call us at 1-800-548-1234 to place your order.*
*You can also fax a copy of this page to 847-689-3030 or scan and email this completed form to us at [email protected] to request a quote or place your order
