Lockout Tagout Inspection Form Template
Streamline Your Safety Inspections with Our Easy Template
Ensuring workplace safety during machinery maintenance is crucial, and missing a step can lead to serious accidents. This Lockout Tagout Inspection Form Template helps safety managers and employees document and verify that all safety measures are in place before beginning work. With this template, you can efficiently track device status, ensure compliance with safety standards, and promote a culture of safety in your organization, reducing risks and improving protection for your team. Explore our live template to start optimizing your inspection process.
When to use this form
Use this form when you audit energy control before maintenance, after repairs, during shift changes, or during annual reviews. Safety managers, supervisors, electricians, mechanics, and contractors benefit by following the same steps every time. Typical scenarios include isolating a pump, locking a breaker, bleeding hydraulics, venting air lines, or confirming stored energy on conveyors. The checklist helps you verify devices and tags, record test-try results, attach photos, and note fixes. It produces consistent, documented evidence you can share with crews and leadership. If you are reviewing broader programs on the same visit, pair it with the Workplace safety inspection checklist form. For multi-asset walkdowns across a site, add the Field inspection form.
Must Ask Lockout Tagout Inspection Questions
- Are all energy sources identified and are isolation points clearly labeled?
This prevents missed secondary or stored energy that could cause injury. Clear labels help any authorized worker find the correct switch, valve, or block without guesswork.
- Were the correct lock and tag applied by an authorized person, with name, date, and contact on the tag?
Attribution creates accountability and makes coordination easy if conditions change. It also confirms that only trained staff control the isolation.
- Did you verify a zero energy state using test-try and, where needed, meter readings or bleed-down?
A positive test is the only proof that isolation works; paperwork alone is not enough. Recording the method and results improves traceability and reveals gaps in procedures.
- For group work, has every worker placed a personal lock, and is a lockbox controlled by the lead?
Personal locks prevent re-energizing while anyone is still exposed. A lockbox log shows who is protected and supports safe shift handoffs.
- Are shift change, handoff, and contractor controls defined and documented before work starts?
Clear steps prevent removed locks or lost tags when crews rotate. Contractor coordination avoids conflicting procedures and keeps your rules in force on shared sites.
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