Lockout/Tagout Procedure for Work Orders
Lockout tagout (LOTO) is a safety procedure that prevents the accidental release of hazardous energy from electrical, mechanical, hydraulic, pneumatic, or other sources during maintenance or servicing of equipment. LOTO can protect workers from injuries such as electrocution, burns, cuts, crushes, or amputations.
Amoretti/
08/14/2024
Lockout/Tagout Procedure for Work Orders
Lockout tagout (LOTO) is a safety procedure that prevents the accidental release of hazardous energy from electrical, mechanical, hydraulic, pneumatic, or other sources during maintenance or servicing of equipment. LOTO can protect workers from injuries such as electrocution, burns, cuts, crushes, or amputations.
ASSET/EQUIPMENT:
DATE AND TIME ISSUED
WHERE IS LOTO PLACED? LOCATION:
Was lock placed on equipment or in other location (ex: electrical room)?
NOTIFICATION OF AFFECTED EMPLOYEES
Notify all affected employees that servicing or maintenance is required and that the equipment must be shut down and locked out to perform servicing or maintenance.
DID YOU NOTIFY AFFECTED EMPLOYEES/TEAM
SOURCES OF ENERGY
Select the type of energy sources associated with this equipment.
TYPE OF ENERGY
TYPE OF LOCKOUT DEVICES USED TO CONTROL THE HAZARDS
TRANSFER OF LOTO AUTHORITY
Are you transferring the authority of LOTO to another department/employee?
Date/Time
Who or what team did you transfer LOTO authority to?
RELEASE FROM LOCKOUT/TAGOUT
Operations
Inspect work area, remove non-essential items (tools), and replace equipment components (guards)
Notify all affected employees/teams that LOTO has been released.
Verify that controls are in a safe condition
Remove Each LOTO Device
Energy sources reconnected and equipment functioning properly?
Signature of Employee Removing LOTO Device
Click here to sign
Source: Amoretti/ (Community Member)