lockout tagout by 6Vt6e4J6

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									                                   V i r g i n i a Ar m y N a t i o n a l G u a r d
                            State Safety and Occupational Health Office
                                      Sandston, VA 23150-5050


STANDING OPERATING                                                                             22 January 2008
PROCEDURES


    LOCKOUT/TAGOUT CONTROL OF HAZARDOUS ENERGY
                     SOURCES

SUBJECT                                                                                          P AR AG R AP H

Purpose ………………………………………………………………………………                                                                     1
Scope …………………………………………………………………………………                                                                      2
Policy …………………………………………………………………………………                                                                     3
Responsibilities ……………………………………………………………………                                                                4
Lockout/Tagout ….………. ………………………………………………………                                                                5
F u l l E m p l o ye e P r o t e c t i o n … … … … … … … … … … … … … … … … … … . . … … …                   6
Posting and Documentation ………. …………………………………………                                                            7
Protective Hardware and Materials…………………………………………                                                          8
Annual Evaluation………. ………………………………………………………                                                                9
Energy Isolation .………………………………………………………..………                                                               10
N o t i f i c a t i o n o f E m p l o ye e s … … … … … … … … … … … … … … … … … … … …                       11
Application of Control ………………………………………………..………                                                             12
Additional Requirements ………………………………………………………                                                              13
E m p l o ye e T r a i n i n g … … … … … … … … … … … … … … … … … … … … … . . … …                           14
Training Intervals ………………………………………………………………                                                                15
Training Procedure ……………………………………………………………..                                                               16
B a s i c P r o c e d u r e s f o r L o c k o u t T a g o u t S ys t e m P r o c e d u r e s … … . … … …   17
Reference …………………………………………………………………………..                                                                   18

AP P E N D I X

Appendix A – Glossary

Appendix B – List of All Lockout/Tagout Procedures

Appendix C – Specific Tagout Procedures

Appendix D – Specific Lockout Procedures

Appendix E – Annual Evaluation Report

Appendix F – General Procedures For Shutdown Lockout/Tagout Verification and
Removal

Appendix G – Training Record/Certification for Lockout/Tagout

Appendix H – List of Authorized Energy Control Designees




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FIGURES

Figure 1 - Example of Lockout/Tagout Tag

1. PURPOSE. This SOP establishes the VAARNG Lockout/Tagout Program. It
c o n s i s t s o f e n e r g y c o n t r o l p r o c e d u r e s a n d e m p l o ye e t r a i n i n g t o e n s u r e t h a t
m achines and equipm ent are isolated from all potentially hazardous energy so urces
prior to any servicing or maintenance operations.

2. SCOPE. This SOP applies to all VAARNG personnel while working in
m aintenance facilities. It also applies to all contractors working on VAARNG
premises.

            a. This regulation covers the servici ng and maintenance of machines and
equipm ent in which the unexpected energization or start -up of the m achine or
equipment, or release of stored energy could cause injury to personnel. It does not
apply to wheeled or tracked vehicles. This SOP establishes the m inim um
p e r f o r m a n c e r e q u i r e m e n t s f o r t h e c o n t r o l p e r f o r m a n c e o f s u c h h a z a r d o u s e n e r g y.
Servicing and m aintenance which takes place during norm al operation is also
covered by this SOP if:

             ( 1 ) A n i n d i v i d u a l i s r e q u i r e d t o r e m o v e o r b yp a s s a g u a r d o r o t h e r
safety device.

             (2) An individual is required to place any part of their body into an
area or piece of equipm ent where an associated danger zone exists.

              b. This SOP does not apply to servicing and maintenance on cord and plug
connected electr ical equipm ent for which exposure to the hazards of unexpected
energization or start -up is controlled by unplugging of the equipm ent from the
energy source. The plug must at all times remain under the exclusive control of the
i n d i v i d u a l p e r f o r m i n g t h e s e r v i c e o r m a i n t e n a n c e . A d d i t i o n a l l y, t h i s S O P d o e s n o t
apply to minor tool changes and adjustments, and other minor servicing activities,
which take place during norm al operations, if they are routine, repetitive and
integral to the use of the equipm ent for production, provided that the work is
perform ed using alternative m easures which provide effective protection.

3. POLICY.

          a. It is the policy of the VAARNG to provide a safe and healthy workplace for
a l l e m p l o ye e s . T h i s S O P w i l l b e u s e d t o e n s u r e c o m p l i a n c e w i t h O S H A E l e c t r i c a l
Standards and Lock out/T agout Standards when the unexpected energization, start -
u p o r r e l e a s e o f s t o r e d e n e r g y c o u l d c a u s e i n j u r y. A d d i t i o n a l l y, i t e n s u r e s
m achines and equipm ent are isolated from all potential hazardous ene rgy sources
before individuals perform any service or maintenance activities.

          b. Lockout will be the preferred m ethod of isolating m achines and equipm ent
f r o m e n e r g y s o u r c e s . I f t h e m a c h i n e o r e q u i p m e n t w i l l a c c e p t l o c k s , t h e s ys t e m w i l l
be locked.

         c. Tagout procedures m ay only be used when the m achine or equipm ent
d o e s n o t h a v e l o c k i n g c a p a b i l i t y.




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           d. W hen tags are used.

                      (1) A specific written procedure m ust be developed.

                   ( 2 ) I n a d d i t i o n t o i n f o r m i n g a f f e c t e d e m p l o ye e s o f t h e t a g o u t , a l l o t h e r
e m p l o ye e s w h o h a v e a c c e s s t o t h e w o r k a r e a w i l l b e b r i e f e d o n t h e a r e a , m a c h i n e
a n d t yp e o f h a z a r d t a g g e d o u t .

4. RESPONSIBILITIES.

           a. Supervisors will:

             (1) Ensure all requirem ents of this program are im plem ented within
their workplace.

            (2) Certify that individual training has been accomplished in
accordance with this SOP and is being kept up to date. The Certification will
contain each trained individual’s name and the date of training (Appendix G)

            (3) Appoint, in writing, an indi vidual authorized to act as the Energy
Control Designee for each specific procedure (Appendix C and/or D).

             (4) Ensure civilian contractors working onsite are inform ed of this
regulation and the methods for compliance implemented. Coordination must be
m aintained between the contractor and the supervisor(s) during lockout/tagout
procedures.

            (5) Annually evaluate the effectiveness of the program utilizing
Appendix E. This report will be kept on file as part of the program until the next
annual evaluation replaces it.

             (6) Fully investigate all lockout/tagout accidents and report the cause
to the State Safety Office.

           b. Energy Control Designee will:

             (1) Make a survey of the workplace to identify all isolating devices.
Ascertain which switch( s), valve(s) or other energy isolation devices apply to each
piece of equipment to be locked out. Record this information in Appendix C or D.
W hen written procedures are required.

             (2) List the affected individuals for each machine and/or piece of
equipm ent requiring written procedures in Appendix C or D.

                      (3) Act as the only authorized individual to im plem ent, m aintain,
t r a n s f e r a n d r e m o v e l o c k o u t / t a g o u t s ys t e m s w i t h i n t h e f a c i l i t y p r i o r t o a n y s e r v i c e
or m aintenance on m achines or equipm ent. Proc edures outlined in this SOP will be
followed. A quick reference for the general procedures for shutdown,
lockout/tagout, verification and removal is found at Appendix F.

               ( 4 ) P r i o r t o l o c k o u t / t a g o u t , b r i e f a f f e c t e d e m p l o ye e s t h a t t h e s ys t e m
is being utilized and the reason for it.

       c . E m p l o ye e s w i l l c o m p l y w i t h t h i s S O P a n d p a r t i c i p a t e i n a l l r e q u i r e d
training program s. T hey will report any hazardous conditions or non -com pliance of
the program to their first level supervisor



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5 . L O C K O U T / T AG O U T .

               a. If an energy isolating device is capable of being locked out, the Energy
C o n t r o l D e s i g n e e w i l l u t i l i z e a l o c k o u t s ys t e m u n l e s s t h e y c a n d e m o n s t r a t e t h a t
u t i l i z a t i o n o f a t a g o u t s ys t e m w i l l p r o v i d e f u l l i n d i v i d u a l p r o t e c t i o n a s d e f i n e d i n
Paragraph 6.

           b. If an energy isolation device is not capable of being locked out, the
E n e r g y C o n t r o l D e s i g n e e w i l l u t i l i z e a t a g o u t s ys t e m .

      c. W henever major repairs, replacement, renovation or modification of
machines or equipment is performed, or new ones installe d, energy isolating
devices for such m achines and equipm ent will be designed to accept a lockout
device if they are hard wired (conduit).

6 . F U L L I N D I V I D U AL P R O T E C T I O N . W h e n a t a g o u t s ys t e m i s u t i l i z e d o n a n
energy isolating device which is not capable of being locked out, the following
criteria must be met:

      a. The tagout device must be attached at the same location that the lockout
device would have been attached.

            b. The tagout device must provide a level of safety equivalent to that
o b t a i n e d b y u s i n g a l o c k o u t d e v i c e . T h i s w i l l b e d e m o n s t r a t e d b y:

                      (1) Full com pliance with all tagout -related provisions of this SOP.

              (2) Implementation of additional safety measures, if possible, such as
the rem oval of an isolating circuit elem ent, blocking of a controlling switch, rem oval
of a valve handle and other measures to reduce the likelihood of inadvertent
energization.

7 . P O S T I N G AN D D O C U M E N T AT I O N .

             a. W ritten procedures will be posted for individual m achines and equipm ent
lockout/tagout procedures (Example formats are in Appendices C and D). A
procedure sum m ary reference sheet will be placed on top of all procedures for a
quick reference (Appendix B), which will be followed by (Appendix F) which
i n d i c a t e s s h u t d o w n , v e r i f i c a t i o n a n d r e m o v a l s t e p s . I n s u m m a r y, w h a t n e e d s t o b e
posted, in this order, is: Appendices B, F, D and C. This posting is for the benefit
o f a l l e m p l o ye e s , E n e r g y C o n t r o l D e s i g n e e s a n d c o n t r a c t o r s .

      b. The above written procedures are not required for a particular m achine if
ALL of the following exist:

             (1) The machine or equipment has no potential for stored energy or
the accum ulation of stored energy after shut down which could endanger personnel.

             (2) The m achine or equipm ent has a single energy source which can
be readily identified and isolated.

            (3) The isolation and locking out of that energy source will com pletely
deenergize and deactivate the m achine or equipm ent.




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             (4) The machine or equipment is isolated from that energy source and
locked out during servicing or maintenance.

                      (5) A single lockout device will achieve a lock -out condition.

            (6) The lockout device is under the exclusive control of the Energy
Control Designee.

                      (7) T he servicing and m aintenance does not create hazards to other
e m p l o ye e s .

             (8) The facility has no accidents involving the unexpected activation
or reenergization of the m achine or equipm ent during servicing and m aintenance.

8 . P R O T E C T I V E H AR D W AR E AN D M AT E R I AL S . L o c k o u t a n d t a g o u t d e v i c e s w i l l
be standardized and will m eet the following criteria:

       a. Locks will be num bered sequentially at the facility and issued only to the
Energy Control Designees. The lock num ber will be recorded on Appendix H to
identify the individual assigned to the lock.

      b. T agout devic es will warn against the hazardous condition(s). T he tagout
device used is shown in Figure 1. The Energy Control Designee will write his nam e
on the tag and attach the tag at the same location that the lockout device would
have been attached if it would accept a lock.
NOTE: Tags m ust also be used with locks to identify who initiated the lockout.

9 . AN N U AL E V AL U AT I O N .

           a. Supervisors will conduct an annual evaluation of the Facility Energy
C o n t r o l P r o g r a m i n J a n u a r y o f e a c h ye a r . A p p e n d i x E w i l l b e u s e d t o c o n d u c t a n d
record the evaluation.

           b. W here lockout is used for energy control, the evaluation will include a
r e v i e w o f e a c h e m p l o ye e ’ s r e s p o n s i b i l i t i e s f o r t h e m a c h i n e o r e q u i p m e n t b e i n g
reviewed.

           c. W here tagout is used for energy control, the evaluation will include a
r e v i e w o f e a c h e m p l o ye e ’ s r e s p o n s i b i l i t i e s f o r t h e m a c h i n e o r e q u i p m e n t b e i n g
reviewed and elem ents set forth in the tagout training section, paragraph 3 -4, this
regulation.

1 0 . E N E R G Y I S O L AT I O N . I m p l e m e n t a t i o n o f a l o c k o u t a n d / o r a t a g o u t s ys t e m w i l l
be performed only by Facility Energy Control Designees.

1 1 . N O T I F I C AT I O N O F E M P L O Y E E S . A f f e c t e d e m p l o ye e s w i l l b e n o t i f i e d b y
Energy Control Officer of the application and removal of lockout and/or tagout
s ys t e m . N o t i f i c a t i o n w i l l b e g i v e n b e f o r e c o n t r o l s a r e a p p l i e d a n d a f t e r t h e y a r e
removed from the machine or equipment.

1 2 . AP P L I C AT I O N O F C O N T R O L . T h e e s t a b l i s h e d p r o c e d u r e s f o r t h e
i m p l e m e n t a t i o n o f l o c k o u t / t a g o u t s ys t e m s w i l l c o v e r t h e f o l l o w i n g e l e m e n t s a n d
actions and will be done in the following sequence:




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           a. Preparation for shutdown. Before the Energy Control Designee turns off
a m a c h i n e o r p i e c e o f e q u i p m e n t , h e / s h e w i l l h a v e k n o w l e d g e o f t h e t yp e a n d
m a g n i t u d e o f t h e e n e r g y, t h e h a z a r d s o f t h e e n e r g y t o b e c o n t r o l l e d a n d t h e m e t h o d
a n d m e a n s t o c o n t r o l t h e e n e r g y.

      b. Machine or equipment shutdown . The m achine or equipm ent will be
turned off or shut down utilizing the procedure required by this regulation. See
Appendix F.

          c. Machine or equipment isolat ion. All energy isolating devices that are
n e e d e d t o c o n t r o l t h e e n e r g y t o t h e m a c h i n e o r e q u i p m e n t w i l l b e p h ys i c a l l y l o c a t e d
and operated to ensure isolation from the energy source lockout or tagout device
was applied.

            (1) Lockout or tagout devices will be attached to each isolating device
by the Energy Control Designee.

             (2) Lockout devices, when used, will be affixed in a m anner that will
hold the energy isolating devices in a “safe” or “off” position.

                     (3) Tagout devices, when used with ener gy isolating devices capable
of being locked, will be attached at the sam e point at which the lock is attached.
W here the tag cannot be attached directly to the isolating device, it will be located
as close as safely possible to the device and in a positi on that will be immediately
o b v i o u s t o a n yo n e a t t e m p t i n g t o o p e r a t e t h e d e v i c e .

      d. Stored energy relieved. Following the application of lockout and/or
tagout devices to energy isolating devices, all potential hazardous stored or
residual energy will be safely relieved, disconnected, restrained or otherwise
rendered safe.

       e. Verification of isolation . Prior to starting work on a m achine or piece of
equipm ent that has been locked out or tagged out, the Energy Control Designee will
verify that isolatio n and deenergization has been accom plished.

       f. Release from lockout or tagout. Before lockout or tagout devices are
rem oved and energy is restored to the m achine or equipm ent, procedures will be
followed and actions taken by the Energy Control Designee to ensure the following:

            (1) The work area will be inspected to ensure all tools and m aterials
have been removed and the machine or equipment is operationally intact.

                     ( 2 ) A f f e c t e d e m p l o ye e s w i l l b e n o t i f i e d a n d t h e l o c k o u t o r t a g o u t
d e v i c e s a r e b e i n g r e m o v e d a n d t h e w o r k a r e a i n s p e c t e d t o e n s u r e a l l e m p l o ye e s
are safely positioned or removed.

                     (3) Each lockout or tagout device will be rem oved only by the Energy
Control Designee who applied it. If the Energy Control Designee who applied the
d e v i c e i s n o t p r e s e n t a t t h e f a c i l i t y, t h e d e v i c e m a y o n l y b e r e m o v e d b y t h e
supervisor and must meet all the criteria above.




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1 3 . AD D I T I O N AL R E Q U I R E M E N T S .

       a. Outside personnel (contractors). W henever civilian contractors are
working on VAARNG prem ises, the facility supervisor and the contractor will inform
each other of the their respective lockout/tagout procedures. Contractors will
com ply with all aspects of this regulation.

       b. Group lockout or tagout. W hen servicing and or maintenance is
perf orm ed by a crew, or other group, they will utilize special procedures.

            (1) Primary responsibility is vested in ONE facility Energy Control
Designee, identified in writing, for the specific group.

             (2) Each Energy Control Designee will affix a person al lockout/tagout
device to the group lockout device when the work begins and will rem ove those
devices when work stops on the m achine or equipm ent being serviced or
maintained. W hen this procedure is used, the Energy Control Designee should
contact SSO for a device used to group all the locks.

       c. Shift or personnel changes. Special procedures will be outlined to ensure
the continuity of lockout or tagout protection. This will include provisions for the
orderly transfer of lockout or tagout devices du ring shift and or personnel changes
in the work area.

1 4 . E M P L O Y E E T R AI N I N G . E d u c a t i o n a n d t r a i n i n g m u s t b e p r o v i d e d f o r
e m p l o ye e s t o i n c l u d e t h e p u r p o s e a n d r e q u i r e m e n t s o f t h e L o c k o u t / T a g o u t
Program . The next three paragraphs describe the criteria by which personnel are
inform ed about electrical and other hazards and trained to protect them selves. All
training will be docum ented by use of Appendix G. Initial training docum entation
will be perm anently m aintained with the SOP. Annual refresher traini ng can be
conducted by using the First Level Supervisor Lockout/Tagout Training Guide.
R e f r e s h e r t r a i n i n g a n d t e s t w i l l b e m a i n t a i n e d b y t h e s u p e r v i s o r f o r f i v e ( 5 ) ye a r s .

1 5 . T R AI N I N G I N T E R V AL S .

          a . A f f e c t e d e m p l o ye e s w i l l :

             (1) Receive initial instruction in the purpose and use of the energy
control procedure and annual refresher training thereafter.

                      (2) Be briefed on the safety significance of the specific lockout/tagout
p r o c e d u r e a t e a c h s ys t e m i m p l e m e n t a t i o n .

       b. New, reassigned and othe r personnel whose work operations are or m ay
be in the area will be initially instructed in the purpose and use of the lockout or
tagout procedure with annual refresher training thereafter.

          c. Re-training will be conducted when:

                     (1) A change of job occurs.

            (2) A change in machines, equipment or processes that present new
hazards occurs.

                     (3) New or revised energy control procedures are introduced.




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            ( 4 ) R e - e s t a b l i s h m e n t o f e m p l o ye e p r o f i c i e n c y i s n e c e s s a r y o r
whenever the supervisor has reas on to believe that there are deviations from the
inadequacies in the individual’s knowledge or use of the energy control procedures.

1 6 . T R AI N I N G P R O C E D U R E . T h e f o l l o w i n g p o i n t s w i l l b e c o v e r e d i n t h e t r a i n i n g
sessions:

           a. T he Facility procedure devel oped, docum ented and utilized for the control
o f p o t e n t i a l l y h a z a r d o u s e n e r g y.

          b. Review basic rules of the Lockout/Tagout Program.

       c . R e v i e w o f t h e l o c k o u t d e v i c e s a n d t a g s p r o v i d e d b y t h e e m p l o ye r f o r
isolating, securing or blocking machines or equ ipment.

       d. Lockout/Tagout devices are used only for controlling energy and for no
other purpose.

       e. Lock out/T agout devices will be standardized throughout the facility in at
least color, shape or size.

       f. T agout devices will be standardized in pri nt and f orm at; they will be
legible and understandable.

             g. Lockout/Tagout devices will indicate the identity of the Energy Control
O f f i c e r a p p l yi n g t h e d e v i c e .

      h . W h e n m a j o r m o d i f i c a t i o n s a r e m a d e t o m a c h i n e r y, e l e c t r i c a l s ys t e m s o r
when m achinery is installed, the energy source will be designated to accept a
lockout device.

       i. Facility Energy Control Program evaluations will be conducted annually by
Facility Supervisor.

            (1) Evaluations are designed to correct any deviations or
inadequacies observed.

               (2) The evaluation will include a review of each individual’s
responsibilities under Lockout/Tagout Program. If tagout is used, a review of the
lim itations of tags will be discussed.

1 7 . B AS I C R U L E S F O R L O C K O U T O R T AG O U T S Y S T E M P R O C E D U R E S .

       a. All m achinery and equipm ent will be locked out or tagged out to protect
against accidental or inadvertent operation when such operation could cause injury
to personnel.

      b. Do not attem pt to operate any switch, valve or other energy isolating
device where it is locked or tagged out.

      c. Only the Energy Control Designee who applied the lockout and/or tagout
device may remove such device.

      d. In cases where the Energy Control Designee is not available to remove
devices, they will only be rem oved by t he supervisor who will inform the Energy
Control Designee im m ediately upon their return to the worksite.



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           e. W hen a tag is attached to an energy isolating means, it is not to be
rem oved without authorization of the Energy Control Designee responsible for it. It
i s n e v e r t o b e b yp a s s e d , i g n o r e d o r o t h e r w i s e d e f e a t e d .

       f. Tags alone may evoke a false sense of security and their meaning needs
to be understood as part of the overall Energy Control Program:

            ( 1 ) T a g s a r e a w a r n i n g d e v i c e , n o t a p h ys i c a l r e s t r a i n t a g a i n s t
hazardous conditions if m achine or equipm ent is energized.

                     (2) T ags m ust never be rem oved without authorization; never
b yp a s s e d , i g n o r e d o r o t h e r w i s e d e f e a t t h e t a g .

             (3) Tags must be securely attached or as close as possible to the
energy isolating device and in an obvious position.

              (4) Tags must be legible, understandable and clearly indicate that the
operation or movement of energy isolating devices from “safe” or “off” or “neutral”
position is prohibited.

18. Reference. 29 CFR 1910.147 T he control of hazardous energy



                                                              FIGURE 1

T h e s e T a g s w i l l a l w a ys b e s e c u r e d b y a s e l f - l o c k i n g t i e , w h i c h w i l l r e q u i r e c u t t i n g
to remove the tie




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10
                                                            AP P E N D I X A


                                                          GLOSSARY
1 . Af f e c t e d E m p l o y e e . A n e m p l o ye e w h o s e j o b r e q u i r e s t h e m t o o p e r a t e o r u s e a
m achine or equipm ent on which servicing or m aintenance is being perform ed under
lockout or tag-out or whose job requires them to work in an area in which such
servicing or maintenance is being performed

2. Capable of being locked out . An energy isolating device will be considered to
be capable of being locked out either if it is designed with a hasp or other
attachm ent or integral part to which, or through which, a lock can be affixed, or if it
has a locking m echanism built into it. Other energy isolating devices will also be
considered to be capable of being locked out of lockout can be achieved without
the need to dismantle, rebuild or replace the energy isolating device or permanently
a l t e r i t s e n e r g y c o n t r o l c a p a b i l i t y.

3. Energized. Connected to an energy source or containing residual or stored
e n e r g y.

4. Energy Control Designee . An individual who is authorized, on orders, to
i m p l e m e n t l o c k o u t a n d / o r t a g - o u t s ys t e m p r o c e d u r e s o n m a c h i n e s o r e q u i p m e n t
where personnel will be perform ing servicing or m aintenance on that m achine or
equipment.

5 . E n e r g y I s o l a t i n g D e v i c e . A m e c h a n i c a l d e v i c e t h a t p h ys i c a l l y p r e v e n t s t h e
transm ission or release of energy including but not lim ited to the following: A
,m anually operated electrical circuit breaker; a disconnect switch; a m anually
operated switch by which the conductors of a circuit can be disconnected from all
ungrounded supply conductors and in addition, no pole can be operated
i n d e p e n d e n t l y; a s l i d e g a t e ; a s l i p b l i n d ; a l i n e v a l v e ; a b l o c k ; a n y s i m i l a r d e v i c e
u s e d t o b l o c k o r i s o l a t e e n e r g y. T h e t e r m d o e s n o t i n c l u d e a p u s h b u t t o n , s e l e c t o r
s w i t c h a n d o t h e r c o n t r o l c i r c u i t t yp e d e v i c e s .

6 . E n e r g y S o u r c e . A n y s o u r c e o f e l e c t r i c a l , m e c h a n i c a l , h yd r a u l i c , p n e u m a t i c ,
c h e m i c a l , t h e r m a l o r o t h e r e n e r g y.

7. Lockout. The placement of a lockout device on an energy isolating device in
accordance with established procedure, ensuring that the energy isolating device
and the equipment being controlled cannot be operated until the lockout device is
removed.

8. Lockout Device. Any device that utilizes a positive m eans such as a lock ,
e i t h e r k e y o r c o m b i n a t i o n t yp e , t o h o l d a n e n e r g y i s o l a t i n g d e v i c e i n t h e s a f e
position and prevent energizing of m achine or equip m ent.

9. Servicing and/or maintenance. W orkplace activities such as construction,
i n s t a l l i n g , s e t t i n g u p , a d j u s t i n g , i n s p e c t i n g , m o d i f yi n g a n d m a i n t a i n i n g a n d / o r
servicing machines or equipment. These activities include lubrication, cleaning or
un-jamming of machines or equipment and making adjustments or tool changes,
w h e r e t h e e m p l o ye e m a y b e e x p o s e d t o u n e x p e c t e d s t a r t - u p o f t h e e q u i p m e n t o r
r e l e a s e o f h a z a r d o u s e n e r g y.




                                                                     11
10. Tag-out. The placement of a tag-out device on an energy isolating device in
accordance with established procedure, to indicate that the energy isolating device
and the equipment being controlled may not be operated until the tag-out device is
removed.

11. Tag-out Device. A prom inent warning device, such as a tag and a m eans of
attachm ent, which can be securely fastened to an energy isolating device in
accordance with an established procedure, to indicate that the energy isolating
device and the equipment being controlled may not be operated until the tag -out
device is removed.




                                        12
                                  AP P E N D I X B


        LIST OF ALL LOCKOUT/TAGOUT PROCEDURES

L/O indicates Lockout and T/O indicates Tag -out followed by a num ber that
corresponds with num bers used in Appendix C and D. L/O and T/O num bers will be
sequentially listed starting with L/O first. This Appendix m ust be posted on a
bulletin board followed by the corresponding Appendices C and D.


PROCEDURE NO.                          E Q U I P M E N T , M AC H I N E O R P R O C E S S

L/O




                                        13
                                AP P E N D I X C




                   SPECIFIC TAGOUT PROCEDURE


NOTE: Required for all equipment, machinery and/or processes that fails to
have lockout capabilities.

EQUIPMENT, MACHINERY OR PROCESS

TAGOUT PROCEDURE NUMBER: T/O                       DATE IMPLEMENTED:


THE PURPOSE OF THIS SPECIFIC PROCEDURE IS TO PROTECT THE LIFE AN D
L I M B O F T H E E M P L O Y E E S O F : ( N a m e o f F a c i l i t y)




                              ENERGY SOURCE

           T YPE                                   MAGNITUDE




T YPE OF ISOLAT ING MEANS:     SW ITCH         VALVE     OTHER:

LOCATION OF ISOLATING MEANS:



MET HOD USED T O RELEASE ST ORED ENER GY:



ADDITIONAL SAFETY MEASURES TAKEN TO ENSURE ENERGY CONTROL:



NAME OF ENERGY CONTROL DESIGNEE:


LIST OF AFFECT ED EMPLOYEES BY JOB T IT LES:

           NAME                                    JOB TITLE




                                      14
LIST OF AFFECT ED EMPLOYEES BY JOB T IT LES : (Continued)

           NAME                                        JOB TITLE




                      O T H E R AF F E C T E D E M P L O Y E E S


           NAME                                        JOB TITLE




                                         15
                                  AP P E N D I X D




                    SPECIFIC LOCKOUT PROCEDURE


NOTE: Required for all equipment, machinery and/or processes that fails to meet
the exceptions noted in 29 CFR Part 1910.147 (c) (4) (I).

EQUIPMENT, MACHINERY OR PROCESS

TAGOUT PROCEDURE NUMBER: L/O                         DATE IMPLEMENTED


THE PURPOSE OF THIS SPECIFIC PROCEDURE IS TO PROTECT THE LIFE AND
L I M B O F T H E E M P L O Y E E S O F : ( N a m e o f F a c i l i t y)




                               ENERGY SOURCE

            T YPE                                    MAGNITUDE




T YPE OF ISOLAT ING MEANS:       SW ITCH         VALVE     OTHER:

LOCATION OF ISOLATING MEANS:



MET HOD USED T O RELEASE ST ORED ENERGY:




NAME OF ENERGY CONTROL DESIGNEE:

ENERGY CONTROL DESIGNEE LOCK #:


LIST OF AFFECT ED EMPLOYEES BY JOB T IT LES:

            NAME                                     JOB TITLE




                                        16
LIST OF AFFECT ED EMPLOYEES BY JOB T IT LES : (Continued)

           NAME                                        JOB TITLE




                      O T H E R AF F E C T E D E M P L O Y E E S


           NAME                                        JOB TITLE




                                         17
                            AP P E N D I X E


                ANNUAL EVALUATION REPORT

DATE OF REPORT: JANUARY

EVALUAT ION PERFORMED BY:
                                Print name            Signature


GENERAL POLICY REVIEW ED:     YES          NO

THE FOLLOW ING SPECIFIC PROCEDURES HAVE BEEN REVIEW ED:




THE FOLLOW ING GENERAL PROCEDURES W ERE MODIFIED:




THE FOLLOW ING SPECIFIC PROCEDURES W ERE ADDED:




A REVIEW OF FACILITY OCCUPATIONAL INJURIES AND ASSOCIATED ACCIDENT

REPORTS (DA 285-AB-R) W ERE/W AS PERFORMED:     YES     NO


THE FOLLOW ING INJURIES RESULTED FROM LOCKOUT/TAGOUT PROCEDURES
W HICH RESULTED IN NEW OR MODIFIED PROCEDURES LISTED ABOVE:

    NONE OR




                                  18
                                                 AP P E N D I X F

             GENERAL PROCEDURES FOR
     SHUTDOWN, LOCKOUT/TAGOUT, VERIFICATION AND
                     REMOVAL

1.   P R E P AR E .             Before you begin, be sure you know:

                                           - A l l t yp e s o f e n e r g y i n v o l v e d .

                                           - H a z a r d s p r e s e n t e d b y e n e r g y.

                                           - H o w t o c o n t r o l e n e r g y.

2.   SHUTDOWN.                  Turn off machine or equipment.

3.   I S O L AT E .             Isolate machine or equipment from its energy source(s).
                                (For example, turn off main circuit breaker)

4.   LOCKOUT.               A p p l y yo u r l o c k . B e s u r e t h a t i t h o l d s t h e i s o l a t i n g
                      device in the “Off” or “Safe” position.

5.   R E L E AS E .             C a r e f u l l y r e l e a s e s t o r e d e n e r g y. R e l i e v e , d i s c o n n e c t ,
                                restrain, block or otherwise ensure that all energy
                                s o u r c e s – e l e c t r i c a l , m e c h a n i c a l , h yd r a u l i c , c o m p r e s s e d ,
                                etc. – are de-energized.

6.   VERIFY.                    Try the on-off switch or other controls to be sure the
                                m achine won’t start. Return the switch to the “Off”
                                position.



                      YOUR LOCKOUT IS COMPLETE.




                                                          19
                STEPS FOR REMOVAL

1.   INSPECT.   Inspect the equipment to be sure that:

                      - All tools and material removed.

                      - Machine is fully reassembled.

                      - Guards and other safety devices are installed.

2.   NOTIFY.    Be sure that:

                      - A l l e m p l o ye e s a r e s a f e l y p o s i t i o n e d .

                      - A l l a f f e c t e d e m p l o ye e s a r e n o t i f i e d o n t h e r e s t a r t .

3.   REMOVE.    Remove lockout device. Remember that only the
                individual who placed the lock or tag on the m achine or
                equipment may remove it.


LIST ANY SPECIAL PROCEDURES REQUIRED FOR YOUR
ORGANIZATION AND YOUR EQ UIPMENT




                                    20
                                   AP P E N D I X G


             TRAINING RECORD/CERTIFICATION FOR
                      LOCKOUT/TAGOUT
This is to certify that the undersigned conducted trainee in accordance with 29 CFR
Part 1910.147 (c) (7) and the provisions of this lockout/tag-out SOP. The following
individuals received training on this energy control program.


                                                         I n d i c a t e t yp e o f t r a i n i n g
                                                         I.E. initial, refresher, new
      Print Name                Signature                e m p l o ye e , e t c .




DATE OF TRAINING:



PRINT INSTRUCTORS NAME                 TITLE                       SIGNATURE




                                         21
                       AP P E N D I X H

   LIST OF AUTHORIZED ENERGY CONTROL DESIGNEES


    P R I N T N AM E    LOCK #            W O R K AR E A




NOTE: ONLY APPOINTED ENERGY CONTROL DESIGNEES ARE AUTHORIZED TO
IMPLEMENT LOCKOUT/TAGOUT PROCEDURES. THIS FORM SERVES AS THE
APPOINTMENT ORDER.




                                  22
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