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?
Please note that this checklist template is a hypothetical appuses-hero example and provides only standard information. The template does not aim to replace, among other things, workplace, health and safety advice, medical advice, diagnosis or treatment, or any other applicable law. You should seek your professional advice to determine whether the use of such a checklist is appropriate in your workplace or jurisdiction.
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