Workplace Lockout/Tagout Procedure Form
Please fill out the form with your information below.
Procedure Steps:
Notification: Notify all affected employees that a lockout/tagout procedure is going to be implemented and the reason for it.
Identification: Clearly identify the equipment or machinery to be locked out.
Shutdown: Turn off the equipment following the standard shutdown procedure.
Isolation: Isolate the equipment from its energy source(s).
Lockout/Tagout Application: Apply lockout/tagout devices to each energy isolation point.
Stored Energy: Ensure that any stored energy (electrical, mechanical, hydraulic, etc.) is released or restrained.
Verification: Verify that the equipment is isolated from its energy source by attempting to operate it.
[Authorized Employee Name]
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