Lockout and Tagout Audit

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Program

• Has the contractor established a LOTO program?

  Yes

  No

  N/A

Definitions

• Does the procedure define the following items?1910.147(b)<br> 1. Affected employees<br> 2. Authorized employees<br> 3. Energized<br> 4. Capable of being locked out<br> 5. Energy isolating device<br> 6. Energy source<br> 7. Lockout<br> 8. Lockout device<br> 9. Tagout<br> 10. Tagout device

  Yes

  No

  N/A

Content

• Does the program contain energy control procedures or methods to determine energy control periods? 1910.147(c)(1)

  Yes

  No

  N/A

• Does the program contain employee training requirements for authorized and affected individuals? 1910.147(c)(1)

  Yes

  No

  N/A

• Does the program contain periodic inspection requirements? 1910.147(c)(1)

  Yes

  No

  N/A

• Does the procedure identify methods to be used when an energy isolating device cannot be used? 1910.147(c)(2)(i)

  Yes

  No

  N/A

• Does the program identify pracatuions and limitiations of using tagout only? 1910.147(c)(2)(ii)

  Yes

  No

  N/A

• Does the program identify LOTO design criteria for new equipment? 1910.147(c)(2)(iii)

  Yes

  No

  N/A

• Does the program contain the following sections? 1910.147(c)(4)(ii)<br> 1. Scope of the program<br> 2. Purpose of the program<br> 3. Authorization<br> 4. Rules and techniques for LOTO<br> 5. A specific statement for the use of the procedure<br> 6. Specific procedural steps for shutting down, isolating, blocking and securing machines or equipment to control hazardous energy<br> 7. Specific procedural steps for the placement, removal and transfer of lockout devices or tagout devices and the responsibility for them<br> 8. Specific requirements for verifying the effectiveness of lockout devices, tagout devices, and other energy controlling measures<br>

  Yes

  No

  N/A

• Are materials provided by the employer for use as LOTO devices? 1910.147(c)(5)(i)

  Yes

  No

  N/A

Equipment

• Do LOTO devices meet the following criteria? 1910.147(c)(5)(ii)

• Do LOTO devices meet the following criteria? 1910.147(c)(5)(ii)<br> 1. Singularly identified<br> 2. Used on on LOTO<br> 3. Durable<br> 4. Capable of withstanding the environment<br> 5. Capable of becoming wet without deterioration<br> 6. Capable of withstanding acidic or basic environments where acids or bases are stored<br> 7. Standardized - Same color, design, shape, etc. Must meet one criteria<br> 8. Substantial/Heavy Duty<br> 9. Identifiable<br> 10. Provide a warning to employees

  Yes

  No

  N/A

Inspections

• Does the employer conduct a periodic inspection of the energy control procedure at least annually to ensure that the procedure and the requirements of this standard are being followed? 1910.147(c)(6)(i)(A)

  Yes

  No

  N/A

• Does the employer conduct a periodic inspection that includes a review of each authorized employee's responsibilities under the program? 1910.147(c)(6)(i)(C)

  Yes

  No

  N/A

• Does the employer conduct a periodic inspection that includes the identification of the machine, the date of the inspection, the employees included in the inspection, and the person performing the inspection? 1910.147(c)(6)(ii)

  Yes

  No

  N/A

Training

• Does the employer provide training to authorized and affected employees? 1910.147(c)(7)(i)

  Yes

  No

  N/A

• Does the employer provide training that includes the understanding of the knowledge and skills required for safe use of LOTO? 1910.147(c)(7)(i)

  Yes

  No

  N/A

• Does the employer provide training that includes recognition of hazardous energy sources, types and magnitude of energy available in the workplace, and the methods of isolation? 1910.147(c)(7)(i)(A)

  Yes

  No

  N/A

• Does the employer provide training to affected individuals that includes the purpose and use of energy control procedures? 1910.147(c)(7)(i)(b)

  Yes

  No

  N/A

• Where tagout systems are used, does the employer provide training to the limitations of tagout only? 1910.147(c)(7)(ii)

  Yes

  No

  N/A

• Does the employer address address LOTO retraining and the conditions that retraining is required? 1910.147(c)(7)(iii)(A)

  Yes

  No

  N/A

• Does the employer track LOTO training including employees name and dates of training? 1910.147(c)(7)(iv)

  Yes

  No

  N/A

LOTO Steps

• Is lockout or tagout performed only by the authorized employee who is performing the maintenance? 1910.147(c)(8)

  Yes

  No

  N/A

• Do authorized employees follow the step-by-step process for LOTO? 1910.147(d)<br> 1. Application of control<br> 2. Preparation for shutdown<br> 3. Machine shutdown<br> 4. Machine isolation<br> 5. LOTO application<br> 6. Release of stored energy<br> 7. Verification of isolation<br> 8. Completion of maintenance<br> 9. Release from LOTO<br> 10. LOTO device removal

  Yes

  No

  N/A

• Does the program provide guidance for the testing or repositioning of machinery during LOTO? 1910.147(f)(1)

  Yes

  No

  N/A

• Does the program provide instructions for interactions with contractors? 1910.147(f)(2)

  Yes

  No

  N/A

• Does the program provide guidance for group LOTO? 1910.147(f)(3)

  Yes

  No

  N/A

• Does the program provide devices for group LOTO? 1910.147(f)(3)

  Yes

  No

  N/A

• Does the program provide instructions for shift change? 1910.147(f)(4)

  Yes

  No

  N/A

Audit Score

• 90 - 100 Excellent: 1 or 2 minor deficiencies only

• 80 - 90 Average: No major, more than 2 minor deficiencies

• 70 - 80 Poor: Any major deficiency

• < 70 Fail: More than 2 major deficiencies

• Audit Score