• 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.

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