Work Activity Inspection (LOTO)

• Audit Title

• Document No.

• Client / Site

• Conducted on

  Date

• Prepared by

• Location
  Address

• Personnel

Lock Out Tag Out (LOTO)

• Are safety lock out hasps, interlocking devices or lockable housings used for isolating equipment during maintenance and repair operations?

  Safe

  At Risk

  N/A

• Are all isolation devices capable to being locked in the isolation position?<br>

  Safe

  At Risk

  N/A

• Do all personal use and have there own lock and hasp?

  Safe

  At Risk

  N/A

• Are danger tags used as part of the isolation procedure?

  Safe

  At Risk

  N/A

• Are safe work procedures &/or permit to work systems used for isolation equipment?

  Safe

  At Risk

  N/A

AiGTS

• Is the work activity safe for the apprentice?

  Yes

  No

  N/A

• Have the findings been discussed with the Host Company?

  Yes

  No

  N/A

• Did the inspection result in any further action?

  Yes

  No

  N/A

Corrective Actions

• Comments: