Държавен вестник, бр. 34, 2013 г., стр. 22

СТР.  22	
Д Ъ Р Ж А В Е Н  В Е С Т Н И К 	
БРОЙ  34
Приложение № 5  
към чл. 34, ал. 2, т. 1
ОСЪЩЕСТВЕН КОНТРОЛ
                                  
       ИНФОРМАЦИОННА КАРТА НА НАРЯДА        A 00000001
                                                                        Състав на наряда:
         Дата........... 20...... г.                   1. ..............................................................................
                                                    (име, фамилия и длъжност на старшия на наряда)
        Смяна: от ......ч. до ....... ч.             2. ...............................................................................
        Служебно МПС рег. №:                 (име, фамилия и длъжност  на водача на сл. МПС)
        ..........................................              3. ................................................................................
                                                               (име, фамилия и длъжност)
        Участък за обслужване:               4. ...............................................................................
        ...........................................                             (име, фамилия и длъжност)
        Провел инструктажа:	
	
        .......................................................... 
        (име, фамилия, длъжност, подпис)
        Провел отвода:
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        (име, фамилия, длъжност, подпис)
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ХАРАКТЕРНИ СЛУЧАИ
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стр. 4
ИНФОРМАЦИОННО ОБЕЗПЕЧАВАНЕ/РАЗПОРЕДЕНИ ЗАДАЧИ
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стр. 1
В ИНФОРМАЦИОННАТА КАРТА НЕ СЕ ПОПЪЛВАТ ЛИЧНИ ДАННИ НА ЛИЦА!