General Information

  • Nature of work

  • Take a photo of the equipment/machinery

  • Hazardous energy sources

  • Enter other energy source

  • Purpose of Lockout Tagout procedure

  • Employees involved in the LOTO

Area Inspection

  • Have nonessential items (e.g., tools, spare parts) been removed from the work area?

  • Are all of the machine or equipment components operationally intact?

  • Are all employees safely positioned or have cleared the area?

  • Have all affected employees been notified that the lockout or tagout devices have been removed before the equipment started?

  • Have lockout or tagout devices been removed from the energy-isolating device by the employee who applied them?

Employees

  • Are the employees knowledgeable about the Lockout/Tagout Procedures and their responsibilities?

  • Are affected employees notified when the procedure is being used?

  • Have affected employees been trained to recognize when the procedure is being used and instructed not to remove lockout/tagout devices or start de-energized equipment?

Lockout/Tagout Devices

  • Are LOTO devices manufactured from durable materials to stand the industrial environment of their use?

  • Are they substantial enough to prevent removal without the use of excessive force?

  • Do they clearly identify the employee who installed the device?

Applying LOTO devices

  • Have all sources of power been checked before shutting down the equipment?

  • Are all effective employees notified that you are ready to start a LOTO procedure?

  • Is the equipment stopped by following its normal shutdown procedure?

  • Is the equipment isolated by turning off the energy at the main power source?

  • Are lock and appropriate lockout device (tags) applied to each energy isolating device?

  • REFERENCE: Proper lockout and tagout device attached to the power source of the isolated device.
    [This is an example of how you can use iAuditor to include best practice reference images in your templates to assist with inspections]

    lockout_tagout_device2.jpg
  • Has the power been shut off and verified?

Removing LOTO devices

  • Are all tools removed and machine guards replaced?

  • Are all employees cleared off the machine?

  • Are the LOTO devices removed by the person who applied them?

  • Are all affected employees notified that LOTO devices have been removed?

  • Is energy restored properly?

Completion

  • Recommendations

  • Full name and Signature of the Inspector

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