Lockout Tagout Procedure

Energy Control Program

LOTO Tag

This tag is part of OSHA's Lockout Tagout standard and is used in workplace safety procedures to warn employees not to operate equipment because it's undergoing maintenance or repair.

PadLock

Prevents accidental or unauthorized operation of machinery or electrical equipment during maintenance or servicing.

Circuit Breaker Lockout

Used to secure a circuit breaker in the OFF position so it can't be switched back on during maintenance or repairs.

Hasp Lockout

Allows multiple workers to lock out a single energy source. Operations cannot resume until all authorized users have removed their locks.

Plug Lockout

Used to prevent electrical plugs from being inserted into outlets while maintenance or servicing is being performed.

Circuit Breaker Handle Lockout

Designed to clamp over the handle of a large circuit breaker, preventing it from being turned back on while maintenance or servicing is being performed.

Will this be a Group Lockout?

• Yes
• No
• N / A

If Group Lockout is being initiated, please list ALL Authorized Technicians

FIRST AND LAST NAME

ALL REQUIRED TOOLS ARE TO BE PREPARED BEFORE LOTO IS INITIATED.

• All necessary tools have been prepared

Has all affected team members been notified? Please list below.

• Yes
• No
• N / A

How was affected team member notified?

• In Person

• Both email and in person

What piece of equipment are you initiating the LOTO?

What sources of energy are present? Please list below. (Electrical, Mechanical, Pneumatic, Thermal, Hydraulic or Chemical.)

Has equipment been shut down properly?

• Yes
• No
• N / A

Has all stored energy been released?

• Yes
• No
• N / A

Which lockout device will be used to control the hazards?

All lockout devices must be accompanied with an approved LOTO tag which displays the authorized team member's name.

• Padlock

• Plug Lockout + Padlock

• Circuit Breaker Lockout + Padlock

• Hasp Lockout (Group Lockout) + Padlocks

• Circuit Breaker Handle Lockout + Padlock

Where will the LOTO device be placed?

Time and Date LOTO was initiated

Are you transferring the authority of LOTO to another authorized team member?

• Yes
• No
• N / A

Who did you transfer authority to?

Date and Time authority was transferred

Reenergizing Checklist

• Inspect the machine and immediate area to ensure all tools and non-essential items have been removed, all guards are in place and that all essential operational components are intact.

• Check around machine and immediate areas to ensure no affected team members will be at risk during startup.

• Verify all controls and machine components are in a safe position

• Remove LOTO device

• Reconnect energy sources

• Confirm equipment is functioning properly

• Notify all affected team members that LOTO has been released and the machine is back in service