Lockout tagout log form

Record each energy source separately in your log, noting the specific isolation method for each one (disconnect switch, valve, block, etc.). For each source, document verification steps taken to confirm zero energy state and any special procedures required. This comprehensive approach ensures no potential hazard is missed during maintenance.

At minimum, collect signatures from the authorized employee performing the lockout, their supervisor, and any affected employees working on the equipment. For group lockouts, document the primary authorized employee and all participants. During periodic inspections, include the inspector’s signature to verify compliance.

If you identify issues like missing isolation points, damaged lockout devices, or procedural gaps while completing the log, stop work immediately and notify your supervisor. Document the concern in the log’s notes section. This creates a record of the issue and ensures safety protocols are properly followed before work resumes.

Create a new log entry whenever work is completed and equipment is returned to service. If maintenance spans multiple days but remains continuous with the same lockout devices in place, you can continue the existing entry with daily verification signatures. This maintains clear documentation of ongoing work while preventing redundant entries.