Anonymous

Lockout Tagout Observation

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Information

Document No.
Audit Title
Client / Site
Conducted on
Prepared by
Location
Personnel

Procedure Number:
Equipment Description:
Was the LOTO procedure followed?
Are switches permanently labeled?
Have personnel received refresher training within the last 12 months?
Date of last refresher training
Does each employee have personal locks available for use?
Are the hazardous energy control procedures available in the work area?
Is the LOTO procedure being followed appropriately?
I have discussed this LOTO procedure with the employee(s) involved with this observation and verified their understanding of this procedure.
Note any deficiencies and corrective actions developed out of this observation.

Anonymous

Lockout Tagout Observation

Use this Template

Print as PDF

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