Information
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Document No.
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Audit Title
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Client / Site
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Conducted on
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Prepared by
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Location
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Personnel
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List authorized employees using this procedure.
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Employee name: Employee name: Employee name:
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Has the employees been trained in the procedure?
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Do authorized employees know the location of the written procedure?
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Do authorized employees have access to the procedure?
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Are affected employees notified when the procedure is being used?
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Have affected employees been trained to recognize when the procedure is being used and instructed not to remove lockout/tagout devices or start de-energized equipment.
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Can energy-isolating devices be locked out?
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NOTE: When you replace, renovate, or modify machines and equipment, ensure that the energy-isolating devices will accept lockout devices. New equipment and equipment renovated or modified after January 2,1990, must be capable of being locked out.
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Did each authorized employee lock out all energy sources?
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Does this procedure involve group lockout/tagout?
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Did the authorized employees verify that the equipment was de-energized?
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Did the authorized employees follow the lock/tagout procedure?
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Does the lock/tagout procedure adequately protect employees? If not, list and describe the deficiencies requiring corrective action.
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If this is a lockout procedure, did the inspector review with all authorized and employees their responsibilities under the procedure? NOTE: A review can be accomplished by meeting with employees individually or in a group.
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If this is a tagout procedure, did the inspector review with all authorized and affected employees their responsibilities under the procedure? NOTE: A review can be accomplished by meeting with employees individually or in a group.
