Title Page

  • Location of vessel (drydock or berth)

  • Conducted on

  • Prepared by

  • Vessel / Facility Name

Forms Resources

  • MIDD-PRD-013 (REV-2) LOTO WAF Form07.24.2023

  • SWI-F-006 Lock Out Tag Out Instruction

MIDD LOTO WAF audit

Initial Request for LOTO

  • Is the WAF request filled out properly?

  • What was the discrepancy? (were false items entered to continue filling out WAF?)

  • Use this WAF form for reference.

  • What violation in SWI-F-006 Lock Out Tag Out Instruction MIDD LOTO was nonconforming?

  • Paragraph number?

  • 24 hours from the time the WAF was requested to the time the LOTO was applied reasonable? (within 48-72 hours depending on the type of LOTO)

  • Approximately how many days?

  • Were the affected employees notified that the LOTO will be taking place?

  • Who checked to ensure the control of Hazardous Energy?

  • Was it the same person on the WAF the Authorized Employee that checked the "Control of Hazardous Energy"?

  • Is this Group LOTO?

  • Did all Authorized Employees involved check in with WAFCOR prior to LOTO application?

  • What was the reason?

  • Was the Group LOTO form "MIDD-PRD-015 (REV-2) Group Record List" properly filled out in its entirety?

  • What was non-conforming?

  • After WAFCOR processed the group & assigned a PAE for each, how did the PAE verify equipment/device was safe?

  • Reference the WAFCOR log binder and verify by taking a pictures of the group LOTO application.

Tags & Locks

  • How many points of isolation was determined?

  • Was the lock(s) placed at the point of isolation?

  • If the lock was placed before the point of isolation, where was it placed?

  • Was the "Danger Tag" filled out in it's entirety?

  • Was the tag placed on the shackle of the lock?

  • Was this unlockable?

  • Was the "Tags+" method used according to MIDD-SWI-F-006 Lock Out Tag Out Instruction 8.4 Use of Tags+?

  • Refer to this section for clarification.

Testing & Positioning

  • Was this WAF removed temporarily for op testing?

  • Was WAFCOR notified 24 hours prior to testing?

  • What was the reason for not notifying WAFCOR prior testing?

  • Was there another authority giving direction to the Authorized Employee to remove LOTO?

  • Who was it?

  • Did the Authorized Employee remove the LOTO ?

  • What was the reason?

  • Was the MIDDPRD-016 Emergency Lock Removal Record properly filled out?

  • show evidence of non-conformance through media type (pic or vid)

  • Who was the Authorized Employee that temporarily removed the LOTO for op testing?

  • Were the criteria met according to MIDD-SWI-F-006 Lock Out Tag Out Instruction 8.2.1 before ships force energized their equipment/machinery?

  • What was non-conforming from MIDD-SWI-F-006 Lock Out Tag Out Instruction 8.2.1?

  • MIDD-SWI-F-006 Lock Out Tag Out Instruction 8.2.1

Completing LOTO Removal & Re-Energizing

  • When work was completed, did the AE/PAE initiate the removal for LOTO?

  • Why wasn't it the Authorized Employee on the WAF?

  • (if applicable) What was done in place of the Authorized Employee required participation?

  • Was the MIDDPRD-016 Emergency Lock Removal Record properly filled out?

  • Was LOTO ultimately removed?

  • What was the discrepancy?

  • What type of removal was it?

  • Was WAFCOR notified to clear the WAF?

  • What was the reason for not notifying WAFCOR prior to clearing the WAF?

  • Was there another authority giving direction to the Authorized Employee to remove LOTO?

  • Who was it?

  • Was the WAF signed off properly when work was completed?

  • What was done if work was completed but not signed off by the Authorized Employee?

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