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Lockout/Tagout Procedure Periodic Inspection

This procedure establishes the minimum requirements for the lockout of energy isolating devices whenever maintenance or servicing is done on machines or equipment. It shall be used to ensure that the machine or equipment is stopped, isolated from all potentially hazardous energy sources and locked out before employees perform any servicing or maintenance where the unexpected energizing or start-up of the machine or equipment or release of stored energy could cause injury.
Ergon - Lubbock 14842
08/12/2022

Lockout/Tagout Procedure Periodic Inspection

This procedure establishes the minimum requirements for the lockout of energy isolating devices whenever maintenance or servicing is done on machines or equipment. It shall be used to ensure that the machine or equipment is stopped, isolated from all potentially hazardous energy sources and locked out before employees perform any servicing or maintenance where the unexpected energizing or start-up of the machine or equipment or release of stored energy could cause injury.

    Lockout/Tagout Procedure Number

    Machine or Equipment

    Inspector

    Date of inspection

    This equipment, its energy isolating devices, involved personnel, and applicable energy control procedure have been inspected and evaluated. The conclusions are:

    Are the steps in the LOTO procedure being followed?

    • Yes
    • No
    • N / A

    Do the employees involved know their responsibilities under the procedure?

    • Yes
    • No
    • N / A

    Does the procedure provide the necessary protection?

    • Yes
    • No
    • N / A

    Are changes to the procedure needed?

    • Yes
    • No
    • N / A

    Note corrective actions and/or recommendations

Source: Ergon - Lubbock 14842 (Community Member)

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