Lockout tagout (loto) procedure checklist
Assess compliance with loto procedures
What does this form include?
This form contains 8 sections:
Instructions-------------------1. Answer "Yes", "No", "N/A" for the questions below2. Add any photos
PROCESS
- The Lock Out - Tag Out process is systematically applied when working on energized equipment
- There is evidence / examples of recent LOTO
- LOTO Procedure is well understood by Managers and Supervisors
- LOTO Procedure is well understood by the crewmembers
- A list of activities subjected to LOTO is visibly posted, the personnel are aware and understand the list
- All LOTO certificates are formally authorized by the Person In Charge
- Contractors follow the LOTO procedure for services related to Saxon
- LOTO always completed with conjunction to Permit to Work
LOTO DEVICES
- LOTO equipment (board) is readily available at all times? General conditions (how many, where, etc)
- Tags are waterproof to prevent tag from deteriorating or becoming illegible due to wet conditions and weather
- Tags include legend such as Do Not Start, Do Not Open, Do Not Close, Do Not Energize, Do Not Operate
- All isolation points are able to be isolated by positive means of locking
TRAINING
- Personnel know the purpose and the use of the LOTO procedure
- Energy isolation incidents / lessons learned are commonly distributed to the rigs
- All personnel are familiar with the PTW process and LOTO supplemental checklists
- Personnel recognize all type of energy sources requiring isolation through LOTO
Additional comments
Add relevant photos
Auditor
Site Manager
Use this template