Lockout tagout procedure template (LOTO form)
Updated · Reviewed by Israel Margulies, founder and CEO of High Point GPS
A machine-specific lockout/tagout procedure form: the machine, each energy source with its isolation device and location, the steps to shut down, isolate and lock out, how to release stored energy, how to verify it's dead, and how to restart, with the authorized employees' sign-off.
OSHA's rule 29 CFR 1910.147(c)(4)(ii) says energy control procedures must include a specific statement of their intended use; specific steps for shutting down, isolating, blocking and securing the machine; specific steps for placing, removing and transferring lockout or tagout devices and who is responsible; and specific requirements for testing to verify the controls work.
Write one procedure per machine, because every machine has its own energy sources and isolation points. This form follows the federal text; it isn't legal advice, and your energy control program, training and periodic inspections are separate requirements.
Energy control procedure (LOTO)
Fields: Machine / equipment · Location · Procedure no. · Intended use (when this procedure applies) · Written by · Date
Log columns: Energy source and magnitude · Isolation device · Location of the device · Lock / tag method · Verification
Lockout steps
- Notify affected employees
- Shut down the machine by its normal stopping procedure
- Operate each isolation device to isolate the energy
- Apply each authorized employee's lock and tag
- Release or restrain stored energy (pressure, springs, capacitors, raised parts)
- Verify isolation: try the start controls, test for zero energy
- Return controls to off
Restart
- Tools and materials removed; guards back on
- Employees clear of the machine
- Locks and tags removed by the employees who applied them
- Affected employees told the machine is restarting
Fill it in the right way
- Walk the machine and list every energy source: electrical, hydraulic, pneumatic, mechanical, thermal, chemical, gravity.
- For each source, write its isolation device and where it is.
- Write the shutdown, isolation and lock placement steps in order.
- Write how stored energy is released or blocked.
- Write how to verify zero energy before work starts.
- Write the restart steps, then have the authorized employees review and sign it.
Tips
- Post the procedure at the machine and keep a copy with its records.
- Photos of each isolation point make the procedure easier to follow.
- Each person working on the machine puts on their own lock.
- Review the procedure whenever the machine is changed or a new energy source is added.
Do it in FleetZap
- Attach the LOTO steps to the machine's work order procedure, with required steps that block closing until they're done.
- Checklists can include pass/fail, reading, photo and signature steps, with required steps that block closing.
- Machine documents and procedures stay on the machine's record.
- FleetZap records checks and repairs; it doesn't certify compliance.
Sources
FleetZap Maintenance
Work orders, PM, parts, compliance, assets and KPIs. Explore FleetZap Maintenance.
Frequently asked questions
What is a lockout tagout procedure?
A written, step-by-step energy control procedure for one machine: how to shut it down, isolate and lock out every energy source, release stored energy, verify it's dead, and restart it safely. OSHA 29 CFR 1910.147 requires one for machines where unexpected start-up could injure workers.
What must a lockout/tagout procedure include?
Under OSHA 1910.147(c)(4)(ii): a statement of its intended use, steps to shut down, isolate, block and secure the machine, steps to place, remove and transfer locks or tags and who is responsible, and how to verify the energy controls work.
Does every machine need its own LOTO procedure?
Generally yes, because energy sources and isolation points differ. OSHA allows exceptions in narrow cases set out in 1910.147(c)(4)(i).
What is stored energy?
Energy left in a machine after it's switched off: pressure in hydraulic or air lines, springs, capacitors, flywheels and raised parts that could fall.
Who removes a lock?
The employee who applied it, except under the specific removal procedure OSHA sets out for when that person isn't available.