Description

QUALIFIED PERSONS ONLY
Arc Flash and Shock Hazard
Appropriate PPE Required
Failure to Comply Can Result in Death or Injury
(Field A) inches Arc Flash Boundary
(Field B) Volt Shock Hazard
(Field C) inches Restricted Approach Boundary
PPE Level (Field D)
Equipment Name: (Field E)
Loc.: (Field F)
Fed From: (Field G)
ID#: (Field H)
Date: (Field I)