Energy isolation checklist per OSHA 29 CFR 1910.147
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| # | Procedure Item | Verified | Notes |
|---|---|---|---|
| Pre-Lockout Preparation | |||
| 1 | Equipment and all energy sources identified | ||
| 2 | Correct lockout procedure obtained for this equipment | ||
| 3 | Affected employees notified of lockout | ||
| 4 | Lock, tag, and isolation devices available | ||
| 5 | PPE selected and donned for energy isolation | ||
| Shutdown and Isolation | |||
| 6 | Equipment shut down using normal stopping procedure | ||
| 7 | Electrical energy source isolated (breaker, disconnect) | ||
| 8 | Pneumatic energy source isolated (valve closed, bled) | ||
| 9 | Hydraulic energy source isolated (valve closed, pressure relieved) | ||
| 10 | Mechanical energy source isolated (blocks, pins installed) | ||
| 11 | Other energy sources isolated (thermal, chemical, gravity) | ||
| Lockout Application | |||
| 12 | Personal lock applied to each isolation point | ||
| 13 | Danger tag attached to each lock with name, date, reason | ||
| 14 | Lockout hasp used where multiple workers involved | ||
| 15 | Valve lockout devices fitted where required | ||
| 16 | Each authorised employee has applied their own lock | ||
| Stored Energy Verification | |||
| 17 | Capacitors discharged or grounded | ||
| 18 | Springs released or blocked | ||
| 19 | Elevated components lowered or secured | ||
| 20 | Residual pressure in lines bled to zero | ||
| 21 | Temperature at safe level (if thermal energy present) | ||
| Zero Energy Confirmation | |||
| 22 | Attempted start-up to verify zero energy state | ||
| 23 | Voltage tester used to confirm zero electrical energy | ||
| 24 | Pressure gauges read zero on all isolated systems | ||
| 25 | Start control returned to off position after try-out | ||
| Restoration | |||
| 26 | Work completed and tools removed from equipment | ||
| 27 | Guards and safety devices reinstalled | ||
| 28 | All personnel clear of equipment and notified | ||
| 29 | Each authorised employee removes their own lock and tag | ||
| 30 | Equipment restarted and tested for normal operation | ||
I confirm that all items have been inspected/completed as indicated above. Any defects or concerns have been noted and reported.