OSHA Lockout Tagout Checklist – Free PDF Template

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OSHA lockout tagout checklist

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Use this template with Lumiform

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Get reports and analyse your data

Prices start from ░░░ per month

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This OSHA lockout tagout checklist is for verifying if your facility complies with the Control of Hazardous Energy standard (29 CFR 1910.147). You can evaluate your lockout procedures step by step, from proper equipment de-energization to employee safety lock protocols. For example, if you experience near-misses during equipment maintenance, this comprehensive checklist allows you to identify critical gaps in lockout procedures before accidents occur.

Research shows that in 70% of workplace energy-related fatalities, there was no attempt at lockout procedures, while properly implemented procedures have proven highly effective at preventing deaths. This checklist serves as your compliance safeguard, helping protect workers from unexpected equipment startup during maintenance activities.

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Preview of the template

Audit

LOCKOUT/TAGOUT PROCEDURES

Are all machinery or equipment capable of movement, required to be de-energized or disengaged and locked-out during cleaning, servicing, adjusting or setting up operations, whenever required?

Where the power disconnecting means for equipment does not also disconnect the electrical control circuit.

Are the appropriate electrical enclosures identified?

Are means provided to assure the control circuit can also be disconnected and locked-out?

Is the locking-out of control circuits in lieu of locking-out main power disconnects prohibited?

Are all equipment control valve handles provided with a means for locking-out?

Does the lockout procedure require that stored energy (mechanical, hydraulic, air, etc.) be released or blocked before equipment is locked-out for repairs?

Are appropriate employees provided with individually keyed personal safety locks?

Are employees required to keep personal control of their key(s) while they have safety locks in use?

Is it required that only the employee exposed to the hazard, place or remove the safety lock?

Is it required that employees check the safety of the lock-out by attempting a startup after making sure no one is exposed?

Are employees instructed to always push the control circuit stop button immediately after checking the safety of the lock-out?

Are there a means provided to identify any or all employees who are working on locked-out equipment by their locks or accompanying tags?

Are a sufficient number of accident preventive signs or tags and safety padlocks provided for any reasonably foreseeable repair emergency?

When machine operations, configuration or size requires the operator to leave his or her control station to install tools or perform other operations, and that part of the machine could move if accidentally activated, is such element required to be separately locked or blocked out?

In the event that equipment or lines cannot be shut down, locked-out and tagged, is a safe job the procedure established and rigidly followed?

Recommendation

Write your recommedations here

Completion

Full Name and Signature of the Inspector

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Frequently asked questions

How do I implement this OSHA lockout tagout checklist in my workplace?

Begin by reviewing your current lockout procedures against this checklist during a scheduled maintenance activity. Have a safety manager observe the process, answer each question honestly, and document findings. Address any “NO” responses immediately by updating your written procedures, providing additional training, or purchasing necessary equipment. Repeat this audit quarterly to ensure ongoing compliance.

What’s the difference between lockout and tagout procedures?

Lockout procedures physically prevent equipment reactivation using locks on energy isolation devices, while tagout uses prominent warning tags when locks can’t be applied. This checklist addresses both approaches but emphasizes lockout as the preferred method since it provides physical protection. Remember that tagout alone requires additional safety measures to be OSHA-compliant.

How can I address the recommendation section of this lockout tagout checklist effectively?

Focus your recommendations on specific, actionable improvements with clear ownership and deadlines. Rather than writing “improve training,” specify “Schedule refresher training on proper lock removal procedures for maintenance team by June 15th.” Prioritize recommendations addressing imminent safety hazards, OSHA compliance issues, and recurring problems identified in previous audits.

What should I do if our equipment can’t be completely de-energized as required in the checklist?

Document alternative protective measures in your recommendation section, including detailed work procedures, additional PPE requirements, and enhanced training. OSHA allows for alternative methods when complete de-energization is impossible, but you must demonstrate these methods provide equivalent worker protection. Consider consulting a safety professional to develop appropriate alternative procedures.

This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.