• Audit Title

  • Squadron

  • Conducted on

  • Inspector

  • Location
  • Supervisor

21.9 Hazardous Energy Control (Lockout and Tagout) Checklist

  • Are procedures developed and documented for safe and proper use of locks and tags? AFI 91-203 para.

  • Has a training plan been developed for initial and recurring training on lockout and tagout procedures? AFI 91-203 para.

  • Are LOTO devices (typically locks) used as a positive means of isolating energy sources and preventing unexpected start-up of machines and equipment? AFI 91-203 para.

  • Is an inspection of the lockout and tagout program conducted annually? AFI 91-203 para.

  • Is an adequate supply of safety tags and locks available for use? AFi 91-203 para. 21.3.3

  • Are all workers responsible for recognizing when LOTO is used, the general reasons for LOTO and the importance of not tampering with or removing LOTO devices? AFI 91-203 para.

  • Have equipment-specific, written procedures been developed for use when equipment or machinery undergoes servicing, modification or maintenance? AFI 91-203 para. 21.3.8

  • Are affected personnel in the area notified before and after lockout or tagout controls are used? AFI 91-203 para. 21.4

  • Does the supervisor, authorized worker and operator responsible for the equipment or machinery know the type, magnitude and hazards of the energy source(s)? AFI 91-203 para.

  • Are lockout devices attached in a manner that will hold the energy isolating devices in a―safe‖ or ―off‖ position? AFI 91-203 para.

  • Are service/administrative locks and tags replaced when maintenance on equipment and machinery starts? AFI 91-203 para.

  • Are specific, written procedures utilized during shift or personnel changes to ensure the continuity of lockout or tagout protection? AFI 91-203 para. 21.4.10

  • Is initial and recurring lockout and tagout program job training current and documented? AFI 91-203 para. 21.5.5

  • Are periodic self-inspections conducted and documented by the unit? AFI 91-203 para. 21.6.1


  • Report Routing

  • Supervisor Signature:

  • Notification

  • Superintendent Signature:

  • Notification

  • Commander Signature:

  • Notification

  • Safety Office Signature:

  • Notification

  • Wing Commander Signature:

  • Notification

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