Lockout / Tagout - Ohio Bureau of Workers' Compensation

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(iv) Prior to lockout device removal, the management representative and the immediate supervisor shall reinspect the work area to ensure that the employee has not returned. If employee absence is again verified, and no other employee is exposed to a hazard, lockout device(s) may be removed, and the remaining steps of the established lockout removal and reenergization procedure followed. 16. Signature of Management Representative ________________________________________________________ [name] ________________________________________________________ [plant manager, plant safety director]. ________________________________________________________ [date] 10
TO BE COMPLETED UPON INITIAL ASSIGNMENT AND CHANGED WHENEVER THE IDENTITY/IDENTITIES OF THE PERSON(S) CHANGE 1. The management lockout coordinator for this facility is: (fill in name and/or title) ________________________________________________________________________________ 2. The management members of the lockout committee are: a. _________________________________________________________________________ (fill in name and/or title of management lockout coordinator) b. _________________________________________________________________________ (fill in name and/or title of skilled trades supervisor) c. _________________________________________________________________________ (fill in name of plant safety director, if different from (a) above. 3. The union members of the lockout committee are: a. _________________________________________________________________________ (fill in name of Health and Safety or other appropriate union representative) b. _________________________________________________________________________ (fill in name of Skilled Trades representative) c. Additional members (fill in names and/or titles as necessary) _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ 4. a. INITIAL TRAINING instructors are: (fill in name and/or title) _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ b. REPEAT TRAINING, instructors are: (fill in name and/or title) _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ 5. AUTHORIZED INSPECTOR are: a. Management: (fill in name and/or title) _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ b. Union observers are: (fill in name and/or title) _________________________________________________________________________ _________________________________________________________________________ _________________________________________________________________________ 6. Qualified management representatives for Lockout Device Removal Permit (Appendix A - Form #6) are: Shift 1 ____________________________________________________________(name and/or title) Shift 2 ____________________________________________________________(name and/or title) Shift 3 ____________________________________________________________(name and/or title) 11
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Lockout / Tagout Class Agenda and O
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Lockout / Tagout Course Objectives
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Activity Plan q Activity Other peop
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The following accidents, taken from
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V. Identify Different Personnel u A
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XI. Miscellaneous Items in Your Pro
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OSHA Regulations (Standards - 29 CF
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(a)(3) "Purpose." (a)(3)(i) This se
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(c)(2) "Lockout/tagout." (c)(2)(i)
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(c)(5)(ii) Lockout devices and tago
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(c)(7)(i)(A) Each authorized employ
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(d)(2) (d)(3) (d)(4) "Machine or eq
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(e)(3)(ii) Making all reasonable ef
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OSHA Regulations (Standards - 29 CF
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(7) Ensure that the equipment is di
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III. Definitions Authorized employe
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D. Lockout Device Application. 1. A
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3. Ensure that our employees unders
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APPENDIX A TAGOUT PROCEDURES A. Whe
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DATE: _____/_____/_____ APPENDIX C
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APPENDIX E ENERGY SOURCE EVALUATION
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2 of 3 APPENDIX F 5. A. Apply locks
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APPENDIX G-1 “Authorized” Emplo
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APPENDIX G-3 “Other” Employee T
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HAZARDOUS ENERGY CONTROL PROCEDURES
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Appendix I Audit Checklist Review t
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Yes No Before the machinery is acti
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Additional Training for Qualified P
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Employer Responsibilities (continue
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Preventing Shock • Safety Plannin
Page 79 and 80: OSHA Regulations (Standards - 29 CF
Page 81 and 82: (c)(2) (c)(3) (c)(4) Communications
Page 83 and 84: (b)(3)(ii) The skills and technique
Page 85 and 86: The work practices that are used sh
Page 87 and 88: equivalent to that obtained by use
Page 89 and 90: Note: The work practices used by qu
Page 91 and 92: (c)(3)(iii)(B)(2) The equipment is
Page 94 and 95: OSHA Standards Interpretation and C
Page 96 and 97: [01/07/1992] Electrical safety rela
Page 98 and 99: guards and/or devices assure employ
Page 106 and 107: contradict the guidance provided in
Page 108 and 109: • Verification is provided by a s
Page 110 and 111: Question: Reply: Would interlocking
Page 113 and 114: The following document is reproduce
Page 116 and 117: WHY THIS LOCKOUT IMPLEMENTATION KIT
Page 118 and 119: LOCKOUT STANDARD CHRONOLOGY Februar
Page 120 and 121: 6. Industry sectors, such as constr
Page 122 and 123: f. Each element of this program wil
Page 124 and 125: h. Locks shall be attached to each
Page 126 and 127: Training records such as attendance
Page 128 and 129: (b) (c) (d) (e) (f) Machinery equip
Page 132 and 133: APPENDIX A - SAMPLE FORMS Form No.
Page 134 and 135: Form No.2 WRITTEN PROCEDURE ELEMENT
Page 136 and 137: Are alternate energy control method
Page 138 and 139: Is procedure adequate? ____________
Page 140 and 141: Is job procedure for removal being
Page 142 and 143: 11. Have attempts been made to cont
Page 144 and 145: Document No- 1 PLANNING FOR TRAININ
Page 146 and 147: 8. The retraining must reestablish
Page 148: appropriate, to determine whether e
Page 152: One Hour Safety Presentation The ma
Page 156: Elements of a Lockout/Tagout Progra
Page 160: Identify Different Personnel u Auth
Page 164: List & Identify all Sources Of Ener
Page 168: Procedures For Each Piece Of u Writ
Page 172: Training Affected & Other Employees
Page 176: Develop Procedures On How You Will
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Miscellaneous Items in Your Program
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Other Things To Consider u When do
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Elements of a Lockout/Tagout Progra
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Identify Different Personnel u Auth
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List & Identify all Sources Of Ener
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Procedures For Each Piece Of Equipm
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Training Affected & Other Employees
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Develop Procedures on how you will
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Miscellaneous Items in Your Program
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Other Things To Consider u When do
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If an energy isolating device is ca
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Student Handouts
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Training Of Authorized Employees. u
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Shift & Personnel Changes u How to
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Resources Available from the Divisi
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Saving You Time and Research Reques
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The CDC is always a good resource f
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http://www.fmcsa.dot.gov/safetyprog
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Lockout / Tagout - Ohio Bureau of Workers' Compensation

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