Държавен вестник, бр. 83, 2015 г., стр. 74

СТР.  74	
Д Ъ Р Ж А В Е Н  В Е С Т Н И К 	
БРОЙ  83
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IV. Взаимодействие със съседни наряди: ............................................................................................
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Забележки
V. Мерки за безопасност: ........................................................................................................................
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VI. Контролни въпроси: .........................................................................................................................
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Забележка. При необходимост един инструктиращ може да използва и повече от една бланка. 
Дата ............................ 
ИНСТРУКТИРАЩИ СЛУЖИТЕЛИ: 
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(длъжност, подпис, фамилия)
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(длъжност, подпис, фамилия)
3. .......................................(..........................)
(длъжност, подпис, фамилия)
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(длъжност, подпис, фамилия)