Specific Energy Control for Machine or Equipment during Lock Out/Tag Out Procedures

PROCEDURE NUMBER:

DATE:

COMPLETED BY:

MACHINES OR EQUIPMENT UTILIZING THIS PROCEDURE:

SOURCES OF HAZARDOUS ENERGY

• Electrical

• Counter Weight

• Pneumatic

• Engine

• Flywheel

• Spring

• Hydraulic

• Thermal

• Chemical

• Other

Notify affected employees that the machine is about to be shut down and locked out. (Specific Instructions)

Shut down the machine using normal stopping procedures. Specific Instructions:

Isolate all energy sources listed above. Specific Instructions:

Apply locks to all isolation devices operated in step four. Specific Instructions:

If a tag is used in lieu of a lock when the energy- isolating device is incapable of lockout (see Appendix A), the following additional safety precaution(s) shall be taken:

Block or dissipate all stored energy in rams, flywheels, springs, pneumatic or hydraulic systems, etc. Specific Instructions:

Verify that the machine is locked out by testing the machine operating controls. RETURN ALL CONTROLS TO THE “NEUTRAL” OR “OFF” POSITION AFTER TESTING. Specific Instructions:

Check the machine to be sure it is operationally intact, tools have been removed, and guards have been replaced. Specific Instructions:

Check to be sure all employees are safely positioned. Specific Instructions:

Notify all affected employees that locks / tags are going to be removed and the machine is ready for operation. Specific Instructions:

Remove all locks, blocks, or other energy restraints. Specific Instructions:

Restore all energy to the machine. Specific Instructions:

OTHER COMMENTS: