Simplified Lockout Job Audit

• Site conducted

  Select

• Conducted on

  Date

• Prepared by

• Location

  Cascades Sonoco Birmingham

• Who are you auditing today?

• What is the employee position?

• Which machine are you auditing?

• The employee knows where to find the appropriate specification sheet that corresponds to the equipment to lock out?

  Yes

  No

• The employee marks the task to be completed on the specification sheet?

  Yes

  No

  N/A

• The employee asks the operator to shut the equipment down and dissipate any residual energy?

  Yes

  No

  N/A

• The employee walks to the element to be locking out and affixes his personal lock?

  Yes

  No

• The employee uses a hasp?

  Yes

  No

• The employee asks the operator to validate the lock out by trying to start the equipment in his presence?

  Yes

  No

  N/A

• The employee and the operator jointly sign the LOTO specification sheet to attest that the validation was completed?

  Yes

  No

Maintenance Job Completed - Unlocking Process

• Before reenergizing equipment: the employee conducts tests and visual inspections, as necessary, to verify that all tools and employees are absent from work area?

  Yes

  No

• The employee removes personal lock?

  Yes

  No

• The employee reenergizes equipment?

  Yes

  No

  N/A

• The employee returns the used specification sheet into the LOTO register once the job is completed?

  Yes

  No