Lockout Tagout Periodic Inspection Form

Author Sienna 29 Apr 2024

Lockout Tagout Periodic Inspection Form - Loto will follow the specific instructions for each piece of equipment/machinery to identify, disconnect, isolate, lock out and verify the lock out of the appropriate energy sources. Inspections should be carried out by an authorized employee, other than. Use this form to document an inspection of a written lockout or tagout procedure. Identify an area and task where lockout / tagout procedures are being applied.

Lockout Tagout Periodic Inspection Form (Annual, Monthly Etc.)

This lockout tagout (loto) inspection form is free and customisable for any of your periodic inspections. New equipment and equipment renovated or modified after january 2, 1990, must be capable of being locked out. All employees authorized to implement the procedure but not present for this inspection must review the results.

Inspection Questions Yes No* 1.

Lockout tagouts are a key area for site and worker safety, and companies create strong and reliable loto programs for. In accordance with the occupational safety and health administration (osha) standard, niosh recommends best practices for conducting an annual periodic inspection of each energy control procedure, as part of. Do employees have adequate lo/to devices for the work occurring?

First, The Inspector Must Observe A Representative Sample Of Authorized Employees Performing The Servicing And Maintenance Operation Using The Lockout/Tagout Procedure.

Equipment type and serial number: This can be accomplished for example by a meeting or. This form must be used to document periodic inspection of compliance with lockout/tagout (loto) procedures.

[29 Cfr 1910.147 (C) (6) (I) (B)].

Explains the standard in a question/answer format. The lockout/tagout authorized person(s) periodic review (word) is used to inspect the authorized person’s role and responsibility established in the hazardous energy control program and confirm that the authorized person has sufficient knowledge of hazardous energy control procedures and their application to lockout/tagout and tagout. Use this form to conduct inspections of energy control procedures to ensure that equipment adequately satisifies lockout/tagout procedures.

You Can Go Through These Components At Your Own Pace And In Any Sequence:

If more than one energy source was isolated, was the lock placement. Environmental health & safety has reviewed this document and approved the control of hazardous energy (hasp, cable lock, circuit breaker lockout, equipment locks, etc) 3.

Have All Affected Personnel Been Notified Of The Lo/To Activities And The Equipment That Will Be Involved?

The program has three major components. The inspector must be trained in lockout / tagout procedures and be an authorized employee as defined in the lockout / tagout procedures. The employer must identify any deficiencies or deviations and correct them.

Each Loto Will Follow The General Process Listed Below.

The periodic inspection consists of two requirements. What does the periodic inspection entail? I hereby certify the periodic inspection for compliance with lockout/tagout standards on this machine/equipment have been satisfactory completed with the employee identified above authorized inspector: