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    Loto Program Self Audit

    Uploaded by

    Skariah Mathews
    This document provides a self-audit checklist for a company's lockout/tagout program. It includes criteria such as having written lockout/tagout policies and procedures, completing hazard assessments, providing training and authorization for employees, using energy isolating devices, defining responsibilities, and maintaining records. Respondents are asked to check boxes indicating whether criteria are met (Yes), not met (No), or still in development (DEV).

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    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd

    Loto Program Self Audit

    Uploaded by

    Skariah Mathews
    81 views2 pages
    This document provides a self-audit checklist for a company's lockout/tagout program. It includes criteria such as having written lockout/tagout policies and procedures, completing hazard assessments, providing training and authorization for employees, using energy isolating devices, defining responsibilities, and maintaining records. Respondents are asked to check boxes indicating whether criteria are met (Yes), not met (No), or still in development (DEV).

    Original Title

    Loto+Program+Self+Audit

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    This document provides a self-audit checklist for a company's lockout/tagout program. It includes criteria such as having written lockout/tagout policies and procedures, completing hazard assessments, providing training and authorization for employees, using energy isolating devices, defining responsibilities, and maintaining records. Respondents are asked to check boxes indicating whether criteria are met (Yes), not met (No), or still in development (DEV).

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    81 views2 pages

    Loto Program Self Audit

    Uploaded by

    Skariah Mathews
    This document provides a self-audit checklist for a company's lockout/tagout program. It includes criteria such as having written lockout/tagout policies and procedures, completing hazard assessments, providing training and authorization for employees, using energy isolating devices, defining responsibilities, and maintaining records. Respondents are asked to check boxes indicating whether criteria are met (Yes), not met (No), or still in development (DEV).

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Download as docx, pdf, or txt
    of 2

    Instructions:

    This self-audit was developed to provide a quick assessment of your company


    Lockout/Tagout program. Simply place a check mark in the appropriate column. The
    DEV column is included to capture activities which are in the development stage but not
    formally implemented. If you are unsure place a question mark (?) in the DEV column.

    LOCKOUT/TAGOUT PROGRAM CRITERIA YES NO DEV

    Is there a written Lockout/Tagout policy?   

    Is there a written Lockout/Tagout procedure(s)?   

    Is the LOTO procedure written in accordance with the   


    OH&S legislation and CSA Standard CAN/CSA Z-460-05?

    Are energy isolating devices used that physically prevent


    the transmission of or release of energy sources?
     disconnect switches
      
     circuit breakers
      
     line valves
      
     blocks
      
     other ____________________________________
      

    Have Hazards Assessments been completed for all


    identified hazardous energy sources?
     kinetic   
     chemical   
     potential   
     thermal   
     electrical   
     radiation   
     fluid (hydraulic) pressure   
     air (pneumatic) pressure   
    LOCKOUT/TAGOUT PROGRAM CRITERIA YES NO DEV

    Are there written Lockout/Tagout responsibilities for:


     employers   
     workers   
     contractors   
     others ___________________________________   

    Are employees using LOTO:


     trained?   
     authorized?   

    Are appropriate materials and hardware available?


     personal locks   
     warning tags   
     circuit breaker lockouts   
     multi-lock hasps   
     plug lockout   
     valve lockout   
     self-locking fasteners   
     other ____________________________________   

    Is there a written Emergency Lock Removal procedure?   

    Are accurate Lockout/Tagout records maintained?   

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