Lock Out/Tag Out Permit Checklist

A comprehensive checklist for ensuring proper implementation of Lock Out/Tag Out procedures to control hazardous energy sources during equipment maintenance and servicing.

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About This Checklist

The Lock Out/Tag Out Permit Checklist is a crucial tool for ensuring workplace safety and compliance with OSHA regulations. This comprehensive checklist helps prevent accidents, injuries, and fatalities associated with the unexpected energization or startup of machinery and equipment during maintenance or servicing. By systematically verifying that all energy sources are properly isolated and controlled, this checklist safeguards workers from hazardous energy release. Implementing this checklist not only enhances safety protocols but also improves operational efficiency, reduces downtime, and demonstrates a commitment to employee well-being.

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Industry

Manufacturing

Standard

OSHA 1910.147 - Lockout/Tagout

Workspaces

Power Plants
Factory
Industrial Facilities
Manufacturing Facilities
Construction Sites

Occupations

Safety Manager
Maintenance Technician
Industrial Electrician
Plant Engineer
Occupational Health and Safety Specialist
1
Are Lock Out/Tag Out (LOTO) procedures being followed?
2
Is there a verification process for energy isolation?
3
Is there documented LOTO procedure available?
4
How many LOTO incidents have occurred in the last year?
Min: 0
Max: 100
5
Are training records for LOTO procedures up to date?
6
Are machines equipped with proper safeguarding mechanisms?
7
What hazardous energies have been identified in the workplace?
8
On a scale of 1 to 10, how would you rate the risk level of identified hazards?
Min: 1
Max: 10
9
Have appropriate control measures been implemented for each identified hazard?
10
Are control measures regularly reviewed and updated?
11
Please provide any additional comments or observations regarding hazardous energy control.
12
Is the inspection of LOTO equipment conducted at the required frequency?
13
Is all LOTO equipment properly tagged during inspections?
14
What was the date of the last inspection of LOTO equipment?
15
How many deficiencies were found during the last inspection?
Min: 0
Max: 50
16
What corrective actions were taken for any deficiencies identified?
17
Have all employees received initial training on LOTO procedures?
18
Is refresher training provided at the required frequency?
19
How many employees have completed LOTO training in the last year?
Min: 0
Max: 500
20
Are training materials and resources available for employees?
21
Have employees demonstrated understanding of LOTO procedures after training?
22
Is scheduled maintenance being performed on LOTO equipment?
23
Is the maintenance log for LOTO equipment easily accessible to personnel?
24
How many equipment failures related to LOTO have occurred in the past year?
Min: 0
Max: 100
25
What corrective actions were taken in response to equipment failures?
26
Are inspections of LOTO equipment conducted according to established frequency?

FAQs

The primary purpose is to ensure that all hazardous energy sources are properly identified, isolated, and controlled before maintenance or servicing work begins on machinery or equipment.

Typically, the authorized employee performing the maintenance or servicing work is responsible for completing the checklist, with oversight from a supervisor or safety manager.

The checklist should be reviewed at least annually or whenever there are changes in equipment, processes, or energy control procedures. It should also be updated after any incidents or near-misses related to Lock Out/Tag Out procedures.

Key components include identification of energy sources, verification of isolation, application of locks and tags, testing for zero energy state, and steps for removing Lock Out/Tag Out devices and restoring equipment to service.

The checklist ensures a systematic approach to controlling hazardous energy, reducing the risk of accidents and injuries during maintenance and servicing activities. It also promotes a culture of safety awareness and compliance with established procedures.

Benefits of Lock Out/Tag Out Permit Checklist

Ensures compliance with OSHA Lock Out/Tag Out standards

Reduces the risk of workplace accidents and injuries

Improves communication and coordination among workers during maintenance procedures

Provides a systematic approach to hazardous energy control

Serves as documentation for safety audits and inspections