Free lockout tagout procedure template

• The MapTrack lockout tagout procedure template contains 22 checks across 4 sections. Sections covered: Energy Sources, Lockout Steps, Verification, Removal Procedure.
• Scope and purpose: define which plant, equipment and energy types the procedure covers. State the objective of preventing uncontrolled energy release during maintenance, servicing and inspection.
• Roles and responsibilities: define the authorised person (approves isolation), competent person (performs isolation) and affected person (works on isolated plant). Include training and competency requirements.
• Energy source identification: provide a table listing all energy types (electrical, hydraulic, pneumatic, mechanical, gravitational, thermal, chemical, stored energy), the specific isolation points for each and the isolation method.

Learn more about compliance and inspections in MapTrack.

• Injury prevention: ensures all hazardous energy sources are identified, isolated and verified as zero energy before any hands-on work begins, protecting workers from electrocution, crushing, burns and entanglement.
• Legal compliance: a documented LOTO procedure demonstrates the PCBU has met their obligations under AS/NZS 4024.1603 and WHS Regulations for managing risks associated with plant.
• Consistency: every worker follows the same isolation sequence regardless of the energy type, equipment complexity or time of day, eliminating reliance on memory.
• Clear accountability: defined roles for authorised person, competent person and affected person ensure everyone knows who approves, who performs and who is protected by the isolation.
• Group lockout coverage: the procedure addresses multi-person and multi-trade scenarios where several workers need simultaneous protection on the same equipment.
• Audit trail: completed LOTO procedures with referenced checklists provide documented evidence for regulator enquiries, insurer audits and incident investigations.

• Scope and purpose: define which plant, equipment and energy types the procedure covers. State the objective of preventing uncontrolled energy release during maintenance, servicing and inspection.
• Roles and responsibilities: define the authorised person (approves isolation), competent person (performs isolation) and affected person (works on isolated plant). Include training and competency requirements.
• Energy source identification: provide a table listing all energy types (electrical, hydraulic, pneumatic, mechanical, gravitational, thermal, chemical, stored energy), the specific isolation points for each and the isolation method.
• Shutdown sequence: describe the normal operating shutdown steps that must be completed before isolation points are secured.
• Lock and tag application: specify the types of personal danger locks and tags, the rule that each worker applies their own lock, and the use of multi-lock hasps for group isolation.
• Stored energy dissipation: describe how to bleed hydraulic and pneumatic lines, discharge capacitors, block raised loads and restrain spring-loaded mechanisms.
• Try-out verification: define the zero-energy verification process, including attempting to start the equipment (try test) and testing with instruments where applicable.
• Group lockout: describe the procedure for multi-person work, including the group lockout box, the requirement for each worker to apply a personal lock, and the communication protocol.
• Re-energisation procedure: define the steps for removing locks, replacing guards, confirming personnel are clear, notifying affected persons and restarting equipment.
• Record keeping: specify the documentation requirements, including the isolation register, completed LOTO checklists and retention periods.

1. Identify all energy sources for the specific item of plant by reviewing the equipment isolation register, manufacturer documentation and isolation diagrams.

   Conduct an energy source audit for the equipment. List every energy type: electrical (mains, batteries, capacitors), hydraulic (pressurised lines, rams, accumulators), pneumatic (compressed air, gas lines), mechanical (moving parts, springs, flywheels, conveyors), gravitational (raised loads, counterweights), thermal (steam, heated surfaces), chemical (process chemicals, pipelines) and stored energy. Record each source in the energy identification table with its isolation point and method.

2. Notify all affected personnel that the equipment is being isolated and why.

   Inform every worker, operator and contractor who may be affected by the equipment being taken out of service. Use a verbal briefing, toolbox talk or written notification. Obtain acknowledgement that they understand the isolation is in effect and the expected duration. This prevents anyone from attempting to operate equipment that is under isolation.

3. Shut down the equipment following the normal operating shutdown sequence before applying isolation devices.

   Follow the manufacturer or site procedure for normal shutdown. Do not simply switch off at the isolator, as this may leave stored energy in the system or cause damage. Allow the equipment to come to a complete stop. Verify that all moving parts have ceased and all process flows have stopped before proceeding to isolation.

4. Apply personal danger locks and tags to every isolation point. Each worker applies their own lock so the equipment cannot be re-energised until every lock is removed.

   Use a personal danger lock (uniquely keyed or combination) and a danger tag for each isolation point. Each worker who will be exposed to the energy hazard applies their own lock. Use a multi-lock hasp where more than one person needs to lock the same point. Do not use improvised locking devices. Ensure an adequate supply of locks, tags and hasps is available before work begins.

5. Dissipate all stored and residual energy: bleed hydraulic and pneumatic lines, discharge capacitors, block raised loads and restrain spring-loaded mechanisms.

   After all isolation devices are applied, stored energy may still remain. Bleed hydraulic and pneumatic lines to zero pressure and verify with gauges. Discharge capacitors using approved procedures. Block or pin raised loads, spring-loaded mechanisms and counterweights so they cannot move under gravity. Verify that all stored energy has been safely dissipated or mechanically restrained.

6. Perform zero-energy verification by attempting to start the equipment (try test) and testing with instruments where required.

   Press the start button or operate the controls to verify the equipment does not start. This try test confirms all energy sources have been effectively isolated. For electrical isolation, use a voltage tester to confirm zero volts at the equipment terminals. For hydraulic and pneumatic systems, check pressure gauges read zero. Return all controls to the off position after the try test.

7. When work is complete, follow the re-energisation procedure: remove tools, replace guards, confirm all personnel are clear, remove locks and restart.

   Before removing any lock, confirm all tools and materials have been removed from the equipment. Replace all guards, covers and safety devices. Conduct a head count or roll call to confirm every worker is clear of the equipment. Each worker removes their own lock only. Notify all affected personnel that the equipment is being re-energised. Start the equipment and verify normal operation before releasing it back to service.

Practical answers about the form, record keeping and using MapTrack.

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/NZS 4024.1603 - Control of hazardous energy (Lockout/tagout)
• WHS Regulations 2011 - Chapter 5 Part 5.1 (Plant and structures)
• OSHA 29 CFR 1910.147 - The control of hazardous energy (Lockout/tagout)
• Safe Work Australia - Code of Practice: Managing risks of plant in the workplace

• Model Code of Practice: Managing risks of plant in the workplace (Safe Work Australia)
• Model WHS Regulations (Safe Work Australia)
• OSHA 29 CFR Part 1910, Occupational Safety and Health Standards
• 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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