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:


Superintendent Signature:


Commander Signature:


Safety Office Signature:


Wing Commander Signature:


Please note that this checklist is a hypothetical example and provides basic information only. It is not intended to take the place of, among other things, workplace, health and safety advice; medical advice, diagnosis, or treatment; or other applicable laws. You should also seek your own professional advice to determine if the use of such checklist is permissible in your workplace or jurisdiction.