Annual Program Review - Hazardous Energy Control (LOTO)

• Audit Title

• Site Name

• Conducted on

  Date

• Auditor

• Location
  Address

• Site EHS Manager

Applicable Standards

• Select those standards that apply.

  Select 29CFR1910.147, Hazardous Energy Control EHS&S Standard 22, Machine Safety ANSI Z244

  • 29CFR1910.147, Hazardous Energy Control
  • EHS&S Standard 22, Machine Safety
  • ANSI Z244

Documents Reviewed

• Written Program

• HECPS

• Authorized Inspections

• Training Program

• Training Records

• Annual HECP Review Process

• List of Authorized Employees

Program Execution

• Is there an IOSS program leader on site?

  Yes

  No

  N/A

• How many authorized employees are on site?

  0 to 5

  6 to 10

  10 to 50

  50+

• Notes

Employee Discussions

• Discussions were held with the following groups or employees on site. List number of people when applicable.

Training

• What is the frequency of authorized, affected and other employee training?

• Does the training program cover the required elements for Authorized, Affected and Other employees?

Tagout

• Does the site use tag out?

  Yes

  No

  N/A

• Why is tagout used instead of Lockout?

• How is tagout managed?

• Does tagout require EHS permission to execute?

LOTO Hardware

• How is LOTO standardized for the site (size, shape or color). Provide specifics of site standard.

• Add picture of standard lock if available.

  Media

• How many locks are provided to each Authorized employee?

• How many keys does each lock have?

• Is there identification of the authorized employee on the lock?

  Yes

  No

  N/A

• Are tags used with locks? What information is provided on the tags?

HECP's

• Does the site utilize equipment specific HECP's?

  Yes

  No

  N/A

• Do they include the following information? (Check off those items found on the HECP's.)

• Energy source

• Magnitude of energy

• Location of energy isolation device

• How to dissipate stored energy

• How to verify energy isolation

• How to verify energy isolation for exposed electrical parts

• Is there an annual review of equipment specific HECP's used?

  Yes

  No

  N/A

• How is the annual review of the HECP's accomplished?

• If no equipment specific HECP exists, is a permit used?

  Yes

  No

  N/A

• Review completed permit and provide any comments.

• What is done when no equipment specific HECP exists?

Group Lockout

• Describe how group lockout is managed.

Periodic Inspections of Authorized Employees

• Are inspections of Authorized employees completed?

  Yes

  No

  N/A

• What percent or how many Authorized employees are covered?

• Are the inspections documented? (Review completed inspections)

  Yes

  No

  N/A

• Are the outcomes of the inspections shared with all Authorized employees?

  Yes

  No

  N/A

Variance for Removal of Locks

• Is there a documented process for removal of LOTO locks by persons other than the authorized employee who owns the lock?

  Yes

  No

  N/A

• Are all such lock removals documented? (review examples)

  Yes

  No

  N/A

Out of Service Program

• Does the site have an out of service program?

  Yes

  No

  N/A

• Briefly describe program including color coding of lock and or tags.

Plant Tour

• Were any active lock outs occurring during site tour?

  Yes

  No

  N/A

• Was lockout being performed consistent with the site program and the equipment specific HECP?

  Yes

  No

  N/A

• Were all LOTO locks seen in the field consistent with the site standard?

  Yes

  No

  N/A