Lockout and Tagout Policy for

[enter COMPANY NAME]

Purpose: This procedure establishes the minimum requirements for the lockout of energy isolating devices whenever
maintenance or servicing is done on machines or equipment. It shall be used to ensure that the machine or equipment is
stopped, isolated from all potentially hazardous energy sources and locked out before employees perform any servicing or
maintenance where the unexpected energizing or start-up of the machine or equipment or release of stored energy could cause
injury.

Who: All employees are required to comply with the restrictions and limitations imposed upon them during the use of lockout.
The authorized employees are required to perform the lockout in accordance with this procedure. All employees, upon observing
a machine or piece of equipment which is locked out to perform servicing or maintenance shall not attempt to start, energize, or
use that machine or equipment.

DEFINITIONS
Authorized employee: An employee who locks or tags machines or equipment in order to perform servicing or maintenance.

Affected employee: An employee who is required to use machines or equipment on which servicing is performed under the
Lockout and tagout standard or who performs other job responsibilities in an area where such servicing is performed.

1.0 POLICY
1.1 It is the policy of [Company name] that any individual engaged in maintaining, repairing, cleaning, servicing, or adjusting of
machinery, or equipment on [Company name] property will abide by the procedures outlined in this document and specific
procedures outlined in our injury prevention program. These procedures are designed to meet or exceed applicable OSHA
standards for safe work practices.

1.2 As part of this policy a Job Hazard Analysis (JHA) will be conducted for all major maintenance and repair operations within the
shop. JHA will be used to develop Standard Operating Procedures (SOPS) in order to help assure safe work practices.

1.3 Lockout is a first means of protection; warning tags only supplement the use of locks. Tags alone may be used only when the
application of a lock is not feasible and with approval of the appropriate supervisor.

2.0 PURPOSE
Lockout and tagout ensures that all employees are protected from the unexpected activation of mechanical and/or electrical
equipment during maintenance, repairing, cleaning, servicing, or adjusting of machinery, or equipment. It also assures that all
employees are protected against the release of residual (stored) energy in machines.
3.0 DEFINITIONS

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

3.2 TAGOUT
• The practice of using tags in conjunction with locks to increase the visibility and awareness that equipment is not to be
energized or activated until such devices are removed.
• Tagout devices will be of the non-reusable type, attachable by hand, self-locking, and non-releasable with a minimum
unlocking strength of no less than 50 pounds.

3.3 ACTIVATION/ENERGIZATION
• Energy that sets machinery into motion by starting, switching, pushing, moving, or otherwise engaging power sources for
such equipment. Completing a circuit that provides a flow of electricity that is the main or secondary power source for
machinery/equipment.

3.4 ENERGY CONTROL PROCEDURES

• Use of lock out/tag out equipment to ensure safe work practices.

3.5 HAZARDOUS MOTION AND ENERGY

• Hazardous motion may result even after power sources are disconnected. Examples are coiled springs, raised hydraulic
equipment, and any source energy (e.g., electricity, pressurized steam) that may cause injury. Hazards may be caused by
equipment under mechanical stress or gravity that may abruptly release and cause injury.

4.0 RESPONSIBILITIES

4.1 SAFETY LEADERSHIP TEAM

• Conduct a Job Safety Analysis for repair and maintenance processes.
• Provide annual training to employees affected by Lockout and tagout procedures.
• Inspect energy control procedures and practices at least annually to ensure that general and specific lockout and tagout
procedures are being followed.
• Inspections should be carried out by persons OTHER than those employees directly utilizing energy control procedures.
• Inspections will include a review between the inspector and each authorized employee, of that employee's responsibilities
under the energy control procedure being inspected.
• Certify that periodic inspections have been performed (see RECORDKEEPING and Appendix A, LOCK OUT/TAG OUT
INSPECTION FORM)
 • Maintain a file of equipment, machinery, and operations that require the use of lock out/tag out procedures. The file will
include the location, description, power source, and primary hazards of equipment/ machinery, a list of the primary
operators/maintenance personnel, and a list of lock out/tag out equipment that is used and maintained on site.

4.2 SUPERVISORS
• Ensure that each employee and contractor engaging in work requiring locking/tagging out 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 the necessary equipment and resources, including injury prevention signs, tags, padlocks, and seals.

4.3 EMPLOYEES
• Adhere to specific procedures as outlined in this document for all tasks that require the use of lockout and tagout
procedures.

5.0 SPECIFIC PROCEDURES

5.1 PREPARATION FOR LOCKOUT AND TAGOUT

• Make a survey to locate and identify all isolating devices to be certain which switch(es), valve(s), or other energy isolating
devices apply to the equipment to be locked or tagged out. More than one energy source (electrical, mechanical, hydraulic,
thermal, and chemical) may be present with a single piece of equipment.

5.2 SEQUENCE OF LOCKOUT OR TAGOUT SYSTEM PROCEDURE

• Notify affected employees that a lock out or tag out system is going to be utilized and the reason.
• The authorized employee shall know the type and magnitude of energy that the machine or equipment utilizes and shall
understand the hazards thereof.
• If the machine or equipment is operating, shut it down by the normal stopping procedure (depress stop button, open toggle
switch, etc.).
• Operate the switch, valve, or other energy isolating device(s) so that the equipment is isolated from it energy source(s).
Stored energy (such as that in 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 repositioning, blocking, bleeding down,
etc.
• Lock out/Tag out the energy isolating devices with assigned individual lock(s) or tag(s).
• After ensuring that no personnel are exposed, and as a check on having disconnected the energy sources, operate the push
button or other normal operating controls to make certain the equipment will not operate.
• CAUTION: Return operating control(s) to neutral or off position after the test.
• The equipment is now locked out or tagged out.

5.3 RESTORING MACHINES OR EQUIPMENT TO NORMAL OPERATIONS

• After the servicing and/or maintenance is complete and equipment is ready for normal production operations, check the
area around the machines or equipment to ensure that no one is exposed.
 • After all tools have been removed from the machine or equipment, guards have been reinstalled and employees are in the
clear, remove all lockout or tagout devices. Operate the energy isolating devices to restore energy to the machine or
equipment.

5.4 PROCEDURE INVOLVING MORE THAN ONE PERSON

• In the preceding steps, if more than one individual is required to lockout or tagout equipment, each shall place his/her own
personal lockout and 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 lockout the machine or equipment and the key placed in a lockout box or cabinet, which allows the use of multiple locks.
Each employee will then use his/her own lock to secure the box or cabinet. 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.

5.5 TEMPORARY REMOVAL OF LOCKOUT AND TAGOUT DEVICES

• In situations where lockout and 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:
• Remove non-essential items and ensure that machine or equipment components are operationally intact.
• Notify affected employees that lockout and tagout devices have been removed and ensure that all employees have been
safely positioned or removed from the area.
• Have employees who applied the lockout and tagout devices remove the lockout and tagout devices.
• Energize and proceed with testing or positioning.
• De-energize all systems and reapply energy control measures in accordance with section 5.2 of these procedures.

5.6 MAINTENANCE REQUIRING UNDISRUPTED ENERGY SUPPLY

• Where maintenance, repairing, cleaning, servicing, adjusting, or setting up operations cannot be accomplished with the
prime mover or energy source disconnected, such operations may only be performed under the following conditions:
• The operating station (e.g. external control panel) where the machine may be activated must be under the control of a
qualified operator at all times.
• All participants must be in clear view of the operator or in communication with each other.
• All participants must be beyond the reach of machine elements which may present a hazard.
• Where machine configuration or size requires that the operator leave the control station to install tools, and where there
are machine elements, which may move rapidly, if activated, such elements must be separately locked out.
• During repair procedures where mechanical components are being adjusted or replaced, the machine shall be de-energized
or disconnected from its power source.

6.0 EMPLOYEE TRAINING

• Designated employees will receive annual lock out/tag out training outlined in 29CFR [Specifically 1910.147 (c)(7)(i),(ii), &
(iii)]. During this training employees should be made aware of lockout and tagout procedures as well as how and why they
are being used.
 • Employees need to be trained to ensure that they know, understand, and follow the applicable provisions of the hazardous
energy control procedures. The training must cover at least three areas: aspects of the employer’s energy control program;
elements of the energy control procedure relevant to the employee’s duties or assignment; and the various requirements
of the OSHA standards related to lockout and Tagout.

7.0 RECORDKEEPING

7.1 INSPECTION RECORDS

• Maintain inspection records.
• Human Services will complete and maintain all LOCKOUT AND TAGOUT INSPECTION FORMS.

7.2 TRAINING RECORDS

• Training records will be maintained by [position]. Records will include an outline of topics covered and a sign in sheet of
those employees attending.
• Resources: Free lockout and tagout tutorial: www.osha.gov/dts/osta/lototraining/tutorial/tu-overvw.html
APPENDIX A

MODEL LOCKOUT AND TAGOUT INSPECTION FORM

1. Inspection date: _________________________________________________________________________________
2. Inspector: ______________________________________________________________________________________
3. Employee(s): ____________________________________________________________________________________

__________________________________________________________________________________________________

4. Machine/equipment on which the energy control procedure was being utilized:

__________________________________________________________________________________________________

Does employee have or have access to adequate lock out/tag out devices?  Yes  No
Has employee tested the effectiveness of his/her lock out/tag out devices?  Yes  No
Has employee received lockout and tagout training in the last year?  Yes  No
If this is an outside contractor, has a supervisor informed him/her of the  Yes  No
necessity for adhering to these procedures?
Have all procedures been followed?  Yes  No
Were tagouts legible and clearly displayed?  Yes  No
Comments/Observations:_____________________________________________________________________________

__________________________________________________________________________________________________