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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.

Lock Out/Tag Out Permit Checklist

by: audit-now
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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?

Select whether the procedures are being followed.

To ensure compliance with OSHA standards and mitigate hazardous energy risks.
2
Is there a verification process for energy isolation?

Indicate if the verification process exists.

To confirm that energy sources are effectively isolated to prevent accidental startup.
3
Is there documented LOTO procedure available?

Provide details about the documentation.

To ensure that written procedures are in place for reference and training.
4
How many LOTO incidents have occurred in the last year?

Enter the number of incidents.

To assess the effectiveness of LOTO procedures and identify areas for improvement.
Min: 0
Max: 100
5
Are training records for LOTO procedures up to date?

Provide details about the training records.

To ensure that all employees are adequately trained on LOTO procedures.
6
Are machines equipped with proper safeguarding mechanisms?

Select the status of machine safeguards.

To ensure that machines are safeguarded against accidental startup and other hazards.
7
What hazardous energies have been identified in the workplace?

List all identified hazardous energies.

To ensure that all potential hazards are recognized and documented for risk assessment.
8
On a scale of 1 to 10, how would you rate the risk level of identified hazards?

Enter a risk level from 1 (low) to 10 (high).

To evaluate the severity of risks associated with hazardous energies.
Min: 1
Max: 10
9
Have appropriate control measures been implemented for each identified hazard?

Select the status of control measures implementation.

To verify that necessary precautions are in place to mitigate identified risks.
10
Are control measures regularly reviewed and updated?

Indicate if there is a review process in place.

To ensure that control measures remain effective and relevant over time.
11
Please provide any additional comments or observations regarding hazardous energy control.

Enter any relevant comments.

To capture insights that may not be covered by other questions.
12
Is the inspection of LOTO equipment conducted at the required frequency?

Select the frequency compliance status.

To ensure inspections are performed as per regulatory requirements and company policy.
13
Is all LOTO equipment properly tagged during inspections?

Indicate if proper tagging is being followed.

To verify that all equipment is clearly marked to prevent accidental energization.
14
What was the date of the last inspection of LOTO equipment?

Enter the last inspection date.

To ensure that inspections are conducted within the required timelines.
15
How many deficiencies were found during the last inspection?

Enter the number of deficiencies found.

To evaluate the condition of LOTO equipment and identify areas needing improvement.
Min: 0
Max: 50
16
What corrective actions were taken for any deficiencies identified?

Provide details about the corrective actions taken.

To ensure that all identified issues are addressed promptly and effectively.
17
Have all employees received initial training on LOTO procedures?

Indicate if initial training has been completed by all employees.

To ensure that all employees are properly trained on the safety procedures related to hazardous energy control.
18
Is refresher training provided at the required frequency?

Select the frequency status of refresher training.

To ensure that employees are kept up-to-date with the latest safety practices and procedures.
19
How many employees have completed LOTO training in the last year?

Enter the number of employees trained.

To assess the reach of the training program and ensure all relevant employees are trained.
Min: 0
Max: 500
20
Are training materials and resources available for employees?

Provide details about the availability of training materials.

To ensure that employees have access to the necessary resources to understand LOTO procedures.
21
Have employees demonstrated understanding of LOTO procedures after training?

Select the assessment result for employee understanding.

To evaluate the effectiveness of the training program in instilling knowledge of safety procedures.
22
Is scheduled maintenance being performed on LOTO equipment?

Indicate if scheduled maintenance is being conducted as required.

To ensure that all equipment is properly maintained to prevent failures during energy control.
23
Is the maintenance log for LOTO equipment easily accessible to personnel?

Provide details on the accessibility of the maintenance log.

To ensure that all relevant personnel can review maintenance history and compliance.
24
How many equipment failures related to LOTO have occurred in the past year?

Enter the number of equipment failures.

To assess the reliability of LOTO equipment and identify potential issues in maintenance practices.
Min: 0
Max: 100
25
What corrective actions were taken in response to equipment failures?

Describe the corrective actions taken.

To ensure that appropriate measures are implemented to prevent future failures.
26
Are inspections of LOTO equipment conducted according to established frequency?

Select the adherence status for inspection frequency.

To ensure that equipment is regularly checked for safety and compliance.

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