Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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Procedure Number:
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Equipment Description:
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Was the LOTO procedure followed?
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Are switches permanently labeled?
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Have personnel received refresher training within the last 12 months?
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Date of last refresher training
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Does each employee have personal locks available for use?
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Are the hazardous energy control procedures available in the work area?
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Is the LOTO procedure being followed appropriately?
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I have discussed this LOTO procedure with the employee(s) involved with this observation and verified their understanding of this procedure.
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Note any deficiencies and corrective actions developed out of this observation.
