Lockout / Tagout - Ohio Bureau of Workers' Compensation

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Is job procedure for removal being followed? (If not state elements not followed) __________________ ______________________________________________________________________________________ Is procedure posted? ____________________ Is procedure In diagram form? ____________________ Is procedure adequate? __________________________________________________________________ Have all personnel, tools, equipment/supplies been removed from task/work area? ________________ Is this Tryout/Release to Production? _______________________________________________________ Have guards etc. been replaced? __________________________________________________________ Have all other safety devices been reactivated? ______________________________________________ Have all repairs etc. been effected? ______________________ Is machine/equipment process ready to be released from lockout? ________________________________________________________________ If so, by whom, and when ________________________________________________________________ Have those employees who applied lockout devices removed ONLY their own devices? ____________ ______________________________________________________________________________________ Are there any other lockout devices requiring removal (if so specify), for example contractor's devices? ______________________________________________________________________________________ Who has been contacted to remove these devices? (name) ____________________________________ ___________________________________ By whom and when _______________________________ ______________________________________________________________________________________ What action is required to correct any deficiencies noted? _____________________________________ ______________________________________________________________________________________ Who has been notified to correct deficiencies? _______________________________________________ ______________________________________________________________________________________ Date of notification ______________________________________________________________________ INSPECTION PERFORMED BY __________________________________________________________ DATE AND TIME OF INSPECTION ________________________________________________________ (THIS FORM MUST BE RETAINED BY THE LOCAL JOINT HEALTH AND SAFETY COMMITTEE FOR A PERIOD OF ONE YEAR FROM DATE OF COMPLETION)
Form No.6 ABANDONED LOCKOUT DEVICE REMQVAL PERMIT This permit shall be completed for each abandoned lockout device removal requirement. Removal of abandoned lockout devices SHALL only be undertaken after all procedural requirements have been followed. and all sections of the permit form completed. 1. Name of employee whose lockout device is to be removed __________________________________ ______________________________________________________________________________________ 2. Clock number: badge number-, department number: _______________________________________ ______________________________________________________________________________________ 3. Name/number/identification of machine, process or equipment involved in lockout _______________ ______________________________________________________________________________________ 4. Number of lockout devices to be removed ________________________________________________ 5. Location and types of lockout devices to be removed _______________________________________ ______________________________________________________________________________________ 6. Has task requiring lockout been completed? _____________________________Yes _____ No _____ 7. If task has been completed, can machine, process or equipment be operated without hazard? _____ ______________________________________________________________________________________ 8. Has machine, equipment or process been visually inspected to ensure employee has left work area? ______________________________________________________________________________________ 9. If employee not in work area, has time card (other record) been checked? _____________________ Left facility __________________ Not left facility ____________________ 10. Have coworkers been asked whether employee still in facility? ______________________________ Paged _____________Yes _________ No _________ - over -
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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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(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
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(c)(2) (c)(3) (c)(4) Communications
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(b)(3)(ii) The skills and technique
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The work practices that are used sh
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equivalent to that obtained by use
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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
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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 130 and 131: (iv) Prior to lockout device remova
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 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
Page 180: Miscellaneous Items in Your Program
Page 184: Other Things To Consider u When do
Page 188: 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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