• Document No.

  • Audit Title

  • Client / Site

  • Conducted on

  • Prepared by

  • Energy Isolation Certificate Number
  • Personnel

Energy Isolation Details

Isolation and lockout process

Static Plant

  • Identify equipment to be isolated.

  • Is Risk Assessment conducted and signed off?

  • General Permit to work issued.

  • Is the clearance book and filled and Isolation Certificate issued?

  • Is a qualified Industrial electrician performing the isolation process.

  • The main power supply disconnected at the isolation switch. Clearance book and isolation certificate issued

  • Do all employees involved have own lock.?

  • Test the lockout in order to verify that each energy source has been effectively locked out.

Mobile Plant

  • Was the park up principles followed as per procedure requirements ?

  • Is the ignition key removed and an isolation tag placed on controls and at isolation point (battery)

  • Only a qualified maintenance personnel to work on the mobile plant and also trained in site isolation procedure.

  • Was the plant properly locked out using the appropriate isolation locks and tags before any work commencement?

  • Is the work being conducted in a place in which it is safe to undertake maintenance activities.?

  • Other


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