Title Page

  • Conducted on

  • Prepared by

  • Location

Observe

  • Do workers have locks placed on appropriate lock out boxes according to their task?

  • Are all lock out boxes clearly marked and complete?

  • Are their locks tagged with their name and phone number?

Interview

  • Do the workers have lock out trainning?

  • Do workers know what system they have locked out to?

Observation/Comments

The templates available in our Public Library have been created by our customers and employees to help get you started using SafetyCulture's solutions. The templates are intended to be used as hypothetical examples only and should not be used as a substitute for professional advice. You should seek your own professional advice to determine if the use of a template is permissible in your workplace or jurisdiction. You should independently determine whether the template is suitable for your circumstances.