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Attachment # 3 Lockout/Ragout Evaluation Form Facility Date Evaluator Name Title Describe the job being evaluated: Check the persons being interviewed Names of persons working on the job: Yes Did

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How to fill out Columbia University LDEO Lockout/Tagout Evaluation Form

1. Begin by obtaining the Columbia University LDEO Lockout/Tagout Evaluation Form from the appropriate departmental source.
2. Fill in the date at the top of the form to indicate when the evaluation is being conducted.
3. Provide the name of the equipment or machinery requiring lockout/tagout procedures.
4. Identify the location of the equipment and provide any relevant identification numbers.
5. List the employees involved in the lockout/tagout procedure.
6. Describe the specific energy sources associated with the equipment that need to be controlled.
7. Document the steps required to isolate the energy sources and ensure the equipment is properly locked/tagged out.
8. Indicate any special precautions or safety measures that should be followed during the lockout/tagout process.
9. Review the form with involved personnel to ensure understanding and compliance.
10. Sign and date the form to confirm it has been completed and understood by all parties.

Who needs Columbia University LDEO Lockout/Tagout Evaluation Form?

1. Employees who work with or around machinery that requires maintenance or repair.
2. Supervisors and safety personnel responsible for ensuring compliance with lockout/tagout procedures.
3. Any individuals involved in the maintenance, service, or repair of equipment that poses a risk of unintended energization or startup.

People Also Ask about

What 3 words must be on a lockout tagout?

What is Lockout/Tag out? Why the lockout/tag out is required (repair, maintenance, etc.). Time and date of application of the lock/tag. The name of the authorized person who attached the tag and lock to the system.

What does OSHA require for lockout tagout?

This section requires employers to establish a program and utilize procedures for affixing appropriate lockout devices or tagout devices to energy isolating devices, and to otherwise disable machines or equipment to prevent unexpected energization, start-up or release of stored energy in order to prevent injury to

What are the four 4 procedures for lockout tagout?

The steps below are outlined in OSHA's 1910.147 App A - Typical minimal lockout procedure. STEP 1: Notify affected employees. STEP 2: Identify procedure and hazards. STEP 3: Shut down. STEP 4: Isolate machine from energy source. STEP 5: Apply lockout tagout devices. STEP 6: Check stored energy. STEP 7: Verify isolation.

Which documents govern lockout tagout procedures?

The OSHA standard for The Control of Hazardous Energy (Lockout/Tagout) (29 CFR 1910.147) for general industry, outlines specific action and procedures for addressing and controlling hazardous energy during servicing and maintenance of machines and equipment.

What are the three main components of a lockout tagout?

OSHA requires three basic elements in a lock-out tag-out program. These are training, written procedures, and inspections. Training is required for two types of people; "authorized employees" and "affected employees." Authorized employees are people who do the maintenance or servicing work.

What is Step 3 of lockout tagout?

Lockout/Tagout Step 3: Isolation The next step of the lockout/tagout procedure is to isolate the machine or equipment from any source of energy. This may mean any number of things, such as turning off power at a breaker or shutting a valve.

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What is Columbia University LDEO Lockout/Tagout Evaluation Form?

The Columbia University LDEO Lockout/Tagout Evaluation Form is a document used to assess and record compliance with lockout/tagout procedures to ensure safety during maintenance and servicing of equipment.

Who is required to file Columbia University LDEO Lockout/Tagout Evaluation Form?

Any personnel involved in maintenance or servicing of hazardous energy sources at Columbia University LDEO are required to file the Columbia University LDEO Lockout/Tagout Evaluation Form.

How to fill out Columbia University LDEO Lockout/Tagout Evaluation Form?

To fill out the form, individuals must provide details about the equipment being locked out, the energy sources involved, the specific lockout/tagout procedures used, and the names of individuals involved in the process.

What is the purpose of Columbia University LDEO Lockout/Tagout Evaluation Form?

The purpose of the form is to enhance workplace safety by ensuring all lockout/tagout procedures are properly followed and documented to prevent accidental start-up or release of hazardous energy.

What information must be reported on Columbia University LDEO Lockout/Tagout Evaluation Form?

The form must report information such as the identification of equipment, the type of energy sources, specific lockout/tagout procedures, the names and signatures of workers involved, and any related safety observations.