Department: Maintenance

Responsible Personnel:

[Your Name], Maintenance Supervisor

[Your Name], LOTO Authorized Employee

Effective Date:  [Month Day, Year]

Review Date:  [Month Day, Year]

Affected Employees: Maintenance Team

Before Starting

Equipment Preparation

• Employee has received LOTO training.

• Confirm that the equipment to be worked on is properly identified and isolated.

• Review the equipment's lockout/tagout procedure documentation.

• Ensure all equipment is turned off.

• Identify all energy sources (e.g., electrical, hydraulic, pneumatic) and their locations.

• Gather necessary lockout/tagout devices and personal protective equipment (PPE).

Lockout/Tagout Procedure

• Notify affected employees and communicate the lockout/tagout procedure.

• Locate and identify the energy isolation points.

• Shut down the equipment using its normal stopping procedures.

• Isolate the energy sources by turning off switches, valves, or disconnecting power sources.

• Ensure that all stored energy (e.g., capacitors, springs) has been dissipated or relieved.

• Attempt to start the equipment to verify it's de-energized and locked out.

• Perform the required maintenance or servicing tasks.

• Ensure all tools and materials are removed from the equipment.

• Confirm that all employees are clear of the work area.

• Restore energy to the equipment and test its functionality.

• Remove tags and locks only by the authorized employee who applied them.

• Notify affected employees that the equipment is back in operation.

Post-Procedure Checks

• Conduct a post-job review with involved employees.

• Review the lockout/tagout procedure for any necessary updates or improvements.

• Ensure that all lockout/tagout devices are in good condition and ready for reuse.

Employee Sign-Off

Supervisor/Authorized Person Sign-Off