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Overview
Complete
Lockout Tagout Checklist
HYD47852GH / Wellington Industrial Works / 9 May 2018 / Robbie McPhee
Inspection score
100%
Failed items
0
Created actions
0
Equipment Serial #
HYD47852GH
Site
Wellington Industrial Works
Conducted on

9th May, 2018

9:33 AM AEST

Prepared by
Robbie McPhee
Audit
100%
General Information
Nature of work
Steel Manufacturing
Take a photo of the equipment/machinery
Photos
Hazardous energy sources
Electrical
Mechanical
Thermal
Purpose of Lockout Tagout procedure
Servicing or equipment maintenance
Employees involved in the LOTO
1. Mark Philips 2. Steve Rogers 3. Alvin Peters
Area Inspection
100%
Have nonessential items (e.g., tools, spare parts) been removed from the work area?
Yes
Notes
Area is clean with no unnecessary tools present.
Are all of the machine or equipment components operationally intact?
Yes
Are all employees safely positioned or have cleared the area?
Yes
Notes
Billy Smith, the supervisor, ensured that all employees have cleared off the area.
Have all affected employees been notified that the lockout or tagout devices have been removed before the equipment started?
Yes
Have lockout or tagout devices been removed from the energy-isolating device by the employee who applied them?
Yes
Employees
100%
Are the employees knowledgeable about the Lockout/Tagout Procedures and their responsibilities?
Yes
Are affected employees notified when the procedure is being used?
Yes
Have affected employees been trained to recognize when the procedure is being used and instructed not to remove lockout/tagout devices or start de-energized equipment?
Yes
Lockout/Tagout Devices
100%
Are LOTO devices manufactured from durable materials to stand the industrial environment of their use?
Yes
Are they substantial enough to prevent removal without the use of excessive force?
Yes
Applying LOTO devices
100%
Have all sources of power been checked before shutting down the equipment?
Yes
Are all effective employees notified that you are ready to start a LOTO procedure?
Yes
Is the equipment stopped by following its normal shutdown procedure?
Yes
Is the equipment isolated by turning off the energy at the main power source?
Yes
Are lock and appropriate lockout device (tags) applied to each energy isolating device?
Yes
Notes
Great locking device.
Photos
REFERENCE: Proper lockout and tagout device attached to the power source of the isolated device. [This is an example of how you can use iAuditor to include best practice reference images in your templates to assist with inspections]
Has the power been shut off and verified?
Yes
Removing LOTO devices
100%
Are all tools removed and machine guards replaced?
Yes
Are all employees cleared off the machine?
Yes
Are the LOTO devices removed by the person who applied them?
Yes
Are all affected employees notified that LOTO devices have been removed?
Yes
Is energy restored properly?
Yes
Completion
Recommendations
1. Ensure that lockout or tagout devices are only used to control energy. 2. Do not forget to write the name of the person who applied the LOTO device. 3. Test the power source twice to make sure it is turned off properly. 4. Always conduct an inspection whenever servicing and maintenance are to be conducted. 5. Be knowledgeable about the LOTO procedure and the hazardous energy present in your area.
Full name and Signature of the Inspector
Robbie McPhee
9th May, 2018 9:42 AM AEST
Media summary
3 Media files