Title Page
-
Conducted on
-
Prepared by
-
Location
Machine Information
-
Name and/or number of machine
-
Add photo of machine
-
Date Created
-
Date Revised
-
How many LOTO points on the machine?
Lock Out Application Process
-
1. Notify affected personnel. 2. Properly shut down machine. 3. Isolate all affected energy sources. 4. Apply lock out devices, locks and tags. 5. Verify all affected sources are de-energized.
NOTE A qualified person must test the equipment to verify that all circuits have been de-energized before work is performed on electrical circuits or other components. The qualified person must comply with all aspects of NFPA 70 E while performing test procedures.
Lockout Steps
-
Step 1.
-
Add media
-
Step 2.
-
Add media
-
Step 3.
-
Add media
-
Step 4.
-
Add media
-
Step 5.
-
Add media
Lockout Removal Process
-
1. Ensure all tools and items have been removed. 2. Notify affected workers that lock out is being removed. 3. Verify that all controls are in neutral. 4. Remove lockout devices and reenergize machine. 5. Notify affected personnel that servicing is complete.
