LOTO audit

• Document No.

• Audit Title

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

LOTO box

• Are padlocks applied to the correct isolation points (refer to padlock stamp and isolation map)

  Yes

  No

  N/A

• Are all the padlocks removed and only their keys remain in the box

  Yes

  No

  N/A

• Does the number of isolation points on isolation map align with the number of isolation padlocks available in the LOTO box

  Yes

  No

  N/A

• Is the shift manager green padlock fitted to the LOTO box

  Yes

  No

  N/A

• Are all persons working on the tasks under LOTO locked onto the box

  Yes

  No

  N/A

Isolation and lock off sheet

• Are all padlocks correctly identified in the "Key ID number" on the isolation and lock off sheet

  Yes

  No

  N/A

• Are all verification boxes tick to confirm padlocks are applied

  Yes

  No

  N/A

• Is the reason for isolation detailed on the sheet

  Yes

  No

  N/A

• Have the shift manager and competent person signed to authorise the isolations

  Yes

  No

  N/A

• Has the reinstatement section been fully completed

  Yes

  No

  N/A

Isolation maps

• Does the isolation map detail stored energy sources

  Yes

  No

  N/A

• Do all LOTO boxes have an isolation map

  Yes

  No

  N/A

LOTO board

• Are all departmental locks available on their pegs. If not, are they signed out on the "Departmental lock sign out/in" form

  Yes

  No

  N/A

• Are all engineering padlocks present on their pegs if they are not in use

  Yes

  No

  N/A

• Are all hasps in place on their pegs if they are not in use

  Yes

  No

  N/A

• Is there a LOTO specific risk prediction tool available for use

  Yes

  No

  N/A

LOTO RPT

• Has a LOTO RPT been used by all people working on the equipment

  Yes

  No

  N/A

• Have the hazards been correctly identified

  Yes

  No

  N/A

• Has the individual printed and signed their name

  Yes

  No

  N/A

• Have all other sections been correctly completed

  Yes

  No

  N/A