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Free electrical lockout-tagout checklist
Free electrical lockout-tagout checklist (PDF-ready). Covers isolation, verification, tagging, lock placement and re-energisation. Digitise with MapTrack.
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23 checks · 5 sections · Sign-off
23 checks
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- Circuit / Equipment
- Switchboard ID
- Voltage
- Location
- Date
- Licensed Electrician
- Licence No.
- Work Description
Circuit Identification
Isolation
Proving Dead
Work Completion
Re-energisation
Declaration
I confirm that safe isolation has been achieved following the prove-test-prove methodology. The circuit was confirmed dead before any electrical work commenced. Only a licensed electrician shall perform or supervise electrical lockout/tagout.
Licensed Electrician
Name / Licence No. · Signature · Date / Time
Responsible Person (Re-energisation Authorisation)
Name · Signature · Date / Time
The MapTrack electrical lockout-tagout checklist contains 23 checks across 5 sections.
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Key takeaways
- The MapTrack electrical lockout-tagout checklist contains 23 checks across 5 sections. Sections covered: Circuit Identification, Isolation, Proving Dead, Work Completion, Re-energisation.
- Work details: job number, equipment name and ID, description of work, planned start and finish time, authorised person name.
- Energy source identification: list of all electrical energy sources, circuit identifiers, voltage levels, isolation point locations.
- Notification: confirmation that affected personnel and areas have been notified of the planned isolation.
What is an electrical lockout-tagout checklist?
An electrical lockout-tagout (LOTO) checklist is a structured document used to ensure that electrical equipment and circuits are safely isolated, de-energised, locked and tagged before maintenance or repair work begins. The checklist guides workers through each step of the isolation process, from identifying energy sources and notifying affected personnel through to applying locks and tags, verifying zero energy and documenting the safe restoration of power after work is complete. It records who performed the isolation, which devices were locked, the work being done and the sign-off for re-energisation.
Lockout-tagout failures are a leading cause of electrical fatalities and serious injuries in Australian workplaces. AS 4024.1603:2006 (Safeguarding of machinery - Lockout/tagout) establishes the requirements for safe isolation of energy sources. The WHS Regulations 2011 prohibit electrical work on energised electrical equipment except in the limited cases regulation 157 allows (regulation 154), and require de-energised equipment to be kept from being inadvertently re-energised while the work is carried out (regulation 156). Skipping or shortcutting LOTO procedures can result in electrocution, arc flash, burns and equipment damage, with penalties under the WHS Act including fines exceeding $3 million for Category 1 offences where there is reckless conduct causing a risk of death or serious injury.
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Benefits of using this electrical lockout-tagout checklist
- Worker safety: ensures electrical circuits are confirmed dead before anyone works on or near them, preventing electrocution and arc flash.
- Regulatory compliance: satisfies AS 4024.1603:2006 lockout-tagout requirements and WHS Regulations 2011, regulations 154 and 156.
- Procedural consistency: a standardised checklist ensures every isolation follows the same steps regardless of the worker or shift.
- Accountability: personal lock and tag records create a clear chain of responsibility for each isolation point.
- Incident prevention: documented verification of zero energy catches missed isolation points before they cause injury.
- Audit readiness: completed LOTO checklists provide evidence of safe work practices during SafeWork inspections and audits.
What to include in an electrical lockout-tagout checklist
- Work details: job number, equipment name and ID, description of work, planned start and finish time, authorised person name.
- Energy source identification: list of all electrical energy sources, circuit identifiers, voltage levels, isolation point locations.
- Notification: confirmation that affected personnel and areas have been notified of the planned isolation.
- Isolation steps: isolator or breaker identification, position (open/closed), lock number, tag number, person who applied lock.
- Stored energy verification: capacitor discharge, UPS isolation, battery disconnection, generator lockout where applicable.
- Zero energy verification: voltage test results at the point of work using a proving unit-tested voltage detector.
- Danger tags and locks: tag details (name, date, reason, expected duration), personal lock serial numbers.
- Re-energisation procedure: confirmation all tools and personnel are clear, locks removed by their owners, test before energising.
- Sign-off: isolated by (name, signature, date/time), verified by (name, signature), re-energised by (name, signature, date/time).
How to use this electrical lockout-tagout checklist
Identify all energy sources and complete the pre-isolation checklist
Review the equipment single-line diagram or isolation procedure to identify every electrical energy source, including mains supply, backup generators, UPS systems, capacitors and battery banks. List each source on the checklist with its circuit identifier and voltage level.
Notify affected personnel and apply isolations
Inform all workers and supervisors in the affected area of the planned isolation. Open each isolator or circuit breaker listed on the checklist, confirm the device is in the open position and apply your personal lock and danger tag. Record the lock number and your name on the checklist.
Discharge stored energy and verify zero energy state
Discharge any capacitors, isolate UPS systems, disconnect batteries and lock out standby generators. Using a voltage detector that has been proved on a known live source, test at the point of work to confirm zero voltage on all phases and neutral. Record the test result on the checklist.
Perform the maintenance or repair work
Only commence work after the zero energy verification is complete and recorded. If the scope of work changes or additional circuits need isolation, stop work and repeat the isolation process for the new energy sources before continuing.
Complete the re-energisation procedure and sign off
Confirm all tools, test equipment and personnel are clear of the equipment. Each person removes their own lock and tag. The authorised person verifies all locks are removed, closes isolators in the correct sequence and re-energises the circuit. Record the re-energisation time and sign off the checklist.
How often should you complete this checklist?
A lockout-tagout checklist must be completed every time electrical equipment is isolated for maintenance, repair, testing or modification. There is no fixed calendar frequency because LOTO is triggered by the work activity, not by time. However, the LOTO procedure itself should be reviewed annually to ensure it reflects current equipment configurations. AS 4024.1603:2006 also requires that LOTO procedures be audited periodically to verify workers are following the documented process. In MapTrack, attach the LOTO checklist as a required form on every electrical maintenance work order to ensure it is never skipped.
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Frequently asked questions
Practical answers about the form, record keeping and using MapTrack.
A lockout-tagout checklist is used to document the safe isolation, de-energisation and re-energisation of electrical equipment before maintenance or repair work. It records every energy source, the isolation devices used, who applied each lock and tag, the zero energy verification result and the re-energisation sign-off. The completed checklist provides auditable evidence that the correct isolation procedure was followed.
Link to this answerAS 4024.1603:2006 (Safeguarding of machinery, Part 1603: Lockout/tagout) establishes the requirements for safe isolation of energy sources including electrical energy. Regulation 154 of the WHS Regulations 2011 requires electrical work to be carried out on de-energised equipment unless regulation 157 allows otherwise, and regulation 156 requires the equipment to be kept from being inadvertently re-energised while the work is done. Each state and territory may have additional codes of practice, such as the SafeWork NSW Code of Practice for Managing Electrical Risks in the Workplace, which provides practical guidance on implementing LOTO procedures.
Link to this answerOnly trained and authorised workers should perform electrical lockout-tagout. The authorised person must understand the equipment energy sources, the isolation procedure and the verification method. In Australia, electrical isolation of fixed wiring and equipment must be performed by or under the supervision of a licensed electrician. All workers in the affected area should understand the LOTO process and know not to remove another person's lock or tag.
Link to this answerFailure to follow lockout-tagout procedures can result in electrocution, arc flash burns, equipment damage and fatalities. Under the WHS Act 2011, a PCBU that fails to ensure safe isolation of electrical equipment faces the highest penalties if it commits a Category 1 offence (reckless conduct or gross negligence that exposes someone to a risk of death or serious injury): the model WHS Act sets up to $10,425,000 for a body corporate before indexation, and amounts differ by jurisdiction. Workers who bypass LOTO procedures also risk personal prosecution. Documented LOTO checklists are critical evidence during incident investigations and coronial inquiries.
Link to this answerYes. This electrical lockout-tagout checklist is completely free to download and use. It downloads as a ready-to-print PDF. The checklist references Australian standards including AS 4024.1603:2006 and the WHS Regulations 2011. If you want to digitise your LOTO process with mandatory photo evidence, real-time supervisor notifications and full audit trails, MapTrack can help.
Link to this answerApplicable regulatory standards
This form is a starting point. Check the current requirements that apply to your equipment, work and location. The form alone does not establish compliance.
- AS 4024.1603:2006 - Safeguarding of machinery, Lockout/tagout
- WHS Regulations 2011, regulations 154 to 157 - Electrical work on energised electrical equipment (prohibited unless permitted; de-energised equipment must not be inadvertently re-energised)
- Model WHS Regulations (Safe Work Australia)
- AS 4024 series, Safety of machinery (Standards Australia listing)
MapTrack publishes this template. The linked authorities publish their own guidance; they haven't endorsed this form.
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The MapTrack electrical lockout-tagout checklist contains 23 checks across 5 sections.
- Short attribution
- MapTrack Electrical lockout-tagout checklist, https://www.maptrack.com/templates/electrical-lockout-tagout-checklist
- Reference list
- MapTrack. (2026). Electrical lockout-tagout checklist [Checklist template]. Retrieved from https://www.maptrack.com/templates/electrical-lockout-tagout-checklist
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<div style="max-width:480px;font-family:system-ui,-apple-system,'Segoe UI',Roboto,sans-serif;border:1px solid #E5E7EB;border-radius:12px;padding:20px;background:#ffffff;">
<p style="font-size:12px;font-weight:700;letter-spacing:0.05em;text-transform:uppercase;color:#071D49;margin:0;">Free template</p>
<p style="font-size:18px;font-weight:700;color:#071D49;margin:6px 0 0;">Electrical lockout-tagout checklist</p>
<ul style="margin:12px 0 0;padding-left:18px;color:#374151;font-size:14px;line-height:1.6;">
<li style="margin:4px 0;">Work details: job number, equipment name and ID, description of work, planned start and finish time, authorised person name.</li>
<li style="margin:4px 0;">Energy source identification: list of all electrical energy sources, circuit identifiers, voltage levels, isolation point locations.</li>
<li style="margin:4px 0;">Notification: confirmation that affected personnel and areas have been notified of the planned isolation.</li>
<li style="margin:4px 0;">Isolation steps: isolator or breaker identification, position (open/closed), lock number, tag number, person who applied lock.</li>
<li style="margin:4px 0;">Stored energy verification: capacitor discharge, UPS isolation, battery disconnection, generator lockout where applicable.</li>
<li style="margin:4px 0;">Zero energy verification: voltage test results at the point of work using a proving unit-tested voltage detector.</li>
</ul>
<p style="font-size:13px;color:#6B7280;margin:14px 0 0;padding-top:12px;border-top:1px solid #E5E7EB;">Free <a href="https://www.maptrack.com/templates/electrical-lockout-tagout-checklist" style="color:#071D49;font-weight:600;text-decoration:none;">Electrical lockout-tagout checklist</a> by MapTrack</p>
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About the author
Co-Founder & Commercial Director
Jarrod has spent over a decade in technology consulting and asset management, including roles at Accenture (mining and heavy industry) and CGI as an Asset Management Consultant. He co-founded MapTrack and built and scaled its original platform, then rebuilt it with Lachlan and Alex from thousands of customer conversations and 300+ user research sessions with field teams. His consulting background gives him deep insight into the operational and compliance challenges facing asset-intensive Australian businesses.
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