SAMPLE LOCKOUT/TAGOUT PROGRAM

POLICY

It is the policy of this company that any individual engaging in the maintenance, repairing, cleaning, servicing or adjusting of machinery or equipment will abide by the procedures outlined in this document and applicable Equipment-Specific Hazardous Energy Control Procedures.

The purpose of this policy is to ensure that all individuals in this company are protected from accidental or unexpected activation and release of stored energy of mechanical and/or electrical equipment during maintenance, repairing, cleaning, servicing or adjusting of machinery or equipment.

COMPLIANCE WITH THIS PROGRAM

Authorized employees are required to perform the lockout in accordance with this procedure. All employees, upon observing a machine or piece of equipment that is locked out to have servicing or maintenance performed, shall not attempt to start, energize or use that machine or equipment.

Any safety violation of this policy may lead to an employee's termination without prior instruction or warning. Management reserves the right to impose whatever disciplinary action it deems appropriate.

DEFINITIONS

Affected employee — An employee whose job requires him/her to operate or use a machine or equipment on which servicing or maintenance is being performed under lockout or tagout or whose job requires him/her to work in an area where such servicing or maintenance is being performed.

Authorized employee — A person who locks out or tags out machines or equipment in order to perform servicing or maintenance on that machine or equipment. An affected employee becomes an authorized employee when that employee's duties include performing servicing or maintenance covered under this section.

Lockout —The practice of using keyed or combination security devices ("locks") to prevent the unwanted activation of mechanical or electrical equipment.

Tagout—The practice of using tags in conjunction with locks to increase the visibility of and awareness that equipment is not to be energized or activated until such devices are removed.

Competent person – means one who is capable of identifying existing and predictable hazards in the surroundings or working conditions which are unsanitary, hazardous, or dangerous to employees, and who has authorization to take prompt corrective measures to eliminate them.

RESPONSIBILITIES

Safety Coordinator

  • Provides necessary training to employees authorized and/or affected by lockout/tagout procedures.
  • Inspects energy control procedures and practices at least annually to ensure that general and specific lockout/tagout procedures are being followed (See Lockout/Tagout Inspection Form).
  • Maintains a file of equipment, machinery and operations that require the use of an Equipment-Specific Energy Control Procedure.

NOTE: Similar machines and/or equipment (those using the same type and magnitude of energy) that have the same or similar type of controls can be covered with a single procedure. However, the procedure must be written in sufficient detail and provide enough direction so that employees can follow the procedure and determine how to safely perform servicing or maintenance work.

EXCEPTION: The safety coordinator need not document the required procedure for a particular machine or equipment when all of the following conditions exist:

  1. The machine or equipment has no potential for stored or residual energy or accumulation of stored energy after shut down that could endanger employees.
  2. The machine or equipment has a single energy source that can be readily identified and isolated.
  3. The isolation and locking out of that energy source will completely de-energize and deactivate the machine or equipment.
  4. The machine or equipment is isolated from that energy source and locked out during servicing or maintenance.
  5. A single lockout device will achieve a locked-out condition.
  6. The lockout device is under the exclusive control of the authorized employee performing the servicing or maintenance.
  7. The servicing or maintenance does not create hazards for other employees.
  8. The employer, in utilizing this exception, has had no accidents involving the unexpected activation or reenergization of the machine or equipment during servicing or maintenance.

Supervisors

  • Ensure that each employee and contractor engaging in work requiring lockout/tagout of energy sources understands and adheres to adopted procedures.
  • Assure that employees have received training in energy control procedures prior to operating the machinery or equipment.
  • Provide and maintain necessary equipment and resources including accident prevention signs, tags, padlocks, seals and/or other similarly effective means.
  • Notify safety coordinator of new or revised equipment, machinery or operations that require the use of lockout/tagout devices during servicing, maintenance or repair. Additional employee training may be required.

Employees

  • Adhere to specific procedures as outlined in this document and applicable Equipment-

Specific Energy Control Proceduresfor all tasks that require the use of lockout/tagout procedures.

  • Maintain appropriate lockout/tagout supplies.

LOCKOUT/TAGOUT PROCEDURES

Sequence of Lockout

  1. Notify all affected employees that servicing or maintenance is required on a machine or equipment and that the machine or equipment must be shut down and locked out to perform the servicing or maintenance.
  2. Refer to the appropriate Equipment-Specific Energy Control Procedure to identify the type and magnitude of the energy that the machine or equipment utilizes, understand the hazards of the energy and know the methods to control the energy.
  3. Shut down the machine or equipment by the normal stopping procedure (depress the stop button, open switch, close valve, etc.).
  4. Deactivate the energy isolating device(s) so that the machine or equipment is isolated from the energy source(s).
  5. Lock out and tag out the energy isolating device(s) with assigned individual lock(s).
  6. Stored or residual energy (such as that in capacitors, springs, elevated machine members, rotating flywheels, hydraulic systems and air, gas, steam or water pressure, etc.) must be dissipated or restrained by methods such as grounding, repositioning, blocking, bleeding down, etc.
  7. Ensure that the equipment is disconnected from the energy source(s) by first checking that no personnel are exposed and then verifying the isolation of the equipment by operating the push button or other normal operating control(s) or by testing to make certain that the equipment will not operate.

Restoring Equipment to Service

  1. Check the machine or equipment and the immediate area to ensure that nonessential items have been removed and that the machine or equipment components are intact.
  2. Check the work area to ensure that all employees have been safely positioned or removed from the area.
  3. Verify that the controls are in neutral.
  4. Remove the lockout devices and re-energize the machine or equipment. Each lockout or tagout device shall be removed only by the employee who applied the device.

Exception: If the authorized employee who applied the lockout or tagout device is not available to remove it, the following procedure shall be followed and documented (see Lockout/Tagout Device Removal Verification form):

  1. Verify that the authorized employee who applied the device is no longer in the facility.
  2. Make all reasonable efforts to contact the authorized employee to inform him/her that his/her lockout/tagout device has been removed.
  3. Ensure that the authorized employee has this knowledge before he/she resumes work at the facility.
  4. Notify affected employees that the servicing or maintenance is completed and the machine or equipment is ready for use.

Procedure Involving More Than One Person

In the preceding steps, if more than one individual is required to lock out or tag out equipment, each shall place his/her own personal lockout/tagout device on the energy isolating device(s). When an energy isolating device cannot accept multiple locks or tags, a multiple lockout or tagout device (hasp) may be used. If lockout is used, a single lock may be used to lock out the machine or equipment with the key being placed in a lockout box or cabinet that allows the use of multiple locks to secure it. Each employee will then use his/her own lock to secure the equipment from releasing stored energy or unintentional activation. As each person no longer needs to maintain his or her lockout protection, that person will remove his/her lock from the box or cabinet.

Temporary Removal of Lockout/Tagout Devices

In situations where lockout/tagout devices must be temporarily removed from the energy isolating device and the machine or equipment energized to test or position the machine, equipment or component thereof, the following sequence of actions will be followed:

  1. Clear the machine or equipment of tools, materials and debris and ensure that machine or equipment components are operationally intact.
  2. Notify affected employees that lockout/tagout devices have been removed and ensure that all employees have been safely positioned or removed from the area.
  3. Have employees who applied the lockout/tagout devices remove the lockout/tagout devices.
  4. Energize and proceed with testing or positioning.
  5. De-energize all systems and reapply energy control measures in accordance with the procedures above.

Contractors

Whenever outside contractors are to be engaged in activities covered by the scope and application of this standard, the on-site employer and the contractor shall inform each other of their respective lockout or tagout procedures.

EMPLOYEE TRAINING

  • The safety coordinator shall provide training to ensure that the purpose and function of the energy control program are understood by employees and that the knowledge and skills required for the safe application, usage and removal of the energy controls are acquired by employees.
  • Retraining shall be provided for all authorized and affected employees whenever there is a change in their job assignments or a change in machines, equipment or processes that present a new hazard or when there is a change in the energy control procedures.
  • Additional retraining shall also be conducted whenever a periodic inspection reveals, or whenever the employer has reason to believe, that there are deviations from or inadequacies in the employee's knowledge or use of the energy control procedures.
  • The safety coordinator shall certify that employee training has been accomplished and is being kept up to date through written documentation. The certification shall contain each employee's name and dates of training.

Note: Training requirements outlined in 29 CFR [Specifically 1910.147 (c)(7)(i) (ii) and (iii)].

For electrical reference NFPA 70E ANNEX G

LOCKOUT/TAGOUT INSPECTION FORM

Inspection Date:
Inspector (Printed Name/Signature):
Employee Inspected (Printed/Signature):
Employee Inspected (Printed/Signature):
Employee Inspected (Printed/Signature):
Employee Inspected (Printed/Signature):
Machine/Equipment which LO/TO was utilized:
Item / Yes / No
Do employees own, have company issued, or have access to adequate LO/TO devices?
Have employees tested the effectiveness of his/her LO/TO devices?
Have employees received CPR in the last year?
Have employees received LO/TO training?
If this is an outside contractor, has a supervisor informed contractor of the necessity for adhering to LO/TO procedures?
Have all LO/TO procedures been followed?
Were tags legible and clearly displayed?
Were tags written with current employee contact information?
Were tags written with the date of installation?
Comments/Observations

EQUIPMENT-SPECIFIC ENERGY CONTROL PROCEDURE

(To be used in conjunction with company Lockout/Tagout Procedure document)

Description of equipment:
Manufacturer:
Model:
Location:
AUTHORIZED EMPLOYEES/POSITIONS / AFFECTED EMPLOYEES/POSITIONS
HAZARDOUS ENERGY SOURCES PRESENT / HAZARD EXPLANATION
Electrical / Yes No
Pneumatic / Yes No
Steam / Yes No
Hydraulic / Yes No
Mechanical / Yes No
Other / Yes No

SHUTDOWN & LOCKOUT/TAGOUT PROCEDURE

List the steps to shut down and de-energize the equipment. Be specific regarding how any stored energy will be dissipated or restrained. Include procedures for testing the machine or equipment to verify the effectiveness of lockout devices, tagout devices and other energy control measures.
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ENERGY ISOLATION MEANS &
LOCATION / LO/TO DEVICES TO BE USED

START-UP PROCEDURE

List the steps necessary to re-activate or energize the equipment, insuring that all personnel are removed from the area where testing or activation procedures are being performed.
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