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S&W READY MIX CONCRETE COMPANY Appendix A CORPORATE SAFETY PROGRAM LOCKOUT / RAGOUT INSPECTION FORM LOT Revised 6/11/2009 Lockout/Ragout Periodic Inspection Form PLANT: Date Of Inspection: Name of

How to fill out lockouttagout periodic inspection form

How to fill out a lockout/tagout periodic inspection form:

1. Start by carefully reviewing the lockout/tagout periodic inspection form and familiarize yourself with the sections and requirements.
2. Begin by entering the necessary information such as the date, equipment or machine identification number, and the name of the person responsible.
3. Check the equipment or machine thoroughly to ensure that all energy sources have been correctly isolated and locked out.
4. Inspect the lockout devices and tagout labels to verify that they are in good condition and properly attached.
5. Evaluate the effectiveness of the lockout/tagout procedures by inspecting the isolation points and energy controls.
6. Document any findings, observations, or abnormalities on the form, making sure to be specific and clear.
7. Complete all required sections of the form, including any additional comments or recommendations.
8. Sign and date the form, indicating that the inspection has been completed, and any necessary actions have been taken.
9. Submit the completed lockout/tagout periodic inspection form to the appropriate person or department for review and follow-up actions.

Who needs a lockout/tagout periodic inspection form:

1. Employers who have workers engaged in activities involving lockout/tagout procedures need to implement a lockout/tagout periodic inspection form. This is to ensure that proper lockout/tagout protocols are being followed, and equipment or machinery is being maintained in a safe state.
2. Employees who perform lockout/tagout procedures should also be aware of the lockout/tagout periodic inspection form as it helps them assess the effectiveness of their procedures and identify any potential safety risks.
3. Safety inspectors and auditors may require the lockout/tagout periodic inspection form as part of their examination to ensure compliance with safety regulations and standards.

For pdfFiller’s FAQs

What is lockouttagout periodic inspection form?

Lockout/tagout periodic inspection form is a document used to verify that lockout/tagout procedures are being followed correctly and that equipment is being maintained properly to prevent unexpected energization or release of hazardous energy.

Who is required to file lockouttagout periodic inspection form?

Employers or authorized employees who are responsible for implementing and maintaining lockout/tagout procedures are required to file the periodic inspection form.

How to fill out lockouttagout periodic inspection form?

To fill out the lockout/tagout periodic inspection form, one must document the date of inspection, equipment or machines inspected, findings, corrective actions taken, and the signature of the inspector.

What is the purpose of lockouttagout periodic inspection form?

The purpose of lockout/tagout periodic inspection form is to ensure that lockout/tagout procedures are properly implemented and equipment is maintained to prevent accidents or injuries caused by hazardous energy sources.

What information must be reported on lockouttagout periodic inspection form?

Information such as date of inspection, equipment inspected, findings, corrective actions taken, and signature of the inspector must be reported on the lockout/tagout periodic inspection form.

When is the deadline to file lockouttagout periodic inspection form in 2024?

The deadline to file lockout/tagout periodic inspection form in 2024 is typically within 30 days of the inspection, but specific deadlines may vary depending on regulations or company policies.

What is the penalty for the late filing of lockouttagout periodic inspection form?

The penalty for late filing of lockout/tagout periodic inspection form may vary depending on regulations or company policies, but it could result in fines, citations, or other consequences related to non-compliance.

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