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Lockout/ragout inspection form
Note to employers: Use this form to document an inspection of a written lockout or ragout procedure.
Department:Equipment type and serial number:Inspection conducted
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How to fill out lockouttagout inspection form

How to fill out lockouttagout inspection form
01
To fill out the lockouttagout inspection form, follow these steps:
02
Start by entering the date of the inspection at the top of the form.
03
Identify the equipment or machinery that is being inspected and enter its name or identification number.
04
Determine the specific lockouttagout procedures that need to be inspected and record them on the form.
05
Assess whether each procedure is compliant with the established lockouttagout standards and regulations.
06
Check the condition of the lockout devices, such as locks, tags, and blocking materials, ensuring they are in proper working order.
07
Document any deficiencies or non-compliance issues found during the inspection.
08
Provide recommendations for corrective actions if required.
09
Sign and date the form to certify the completion of the lockouttagout inspection.
10
Keep a copy of the completed form for record-keeping purposes.
Who needs lockouttagout inspection form?
01
Those who work in industries where hazardous energy sources are present, such as manufacturing, construction, or maintenance, often need to fill out a lockouttagout inspection form. This form is necessary for ensuring the safety of workers who perform maintenance, repairs, or servicing activities on equipment or machinery. It helps to verify that proper lockouttagout procedures are being followed and that all necessary precautions are taken to prevent accidental release of hazardous energy.
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What is lockouttagout inspection form?
The lockouttagout inspection form is a document used to ensure that proper procedures are followed when servicing or maintaining equipment to prevent accidental energy release.
Who is required to file lockouttagout inspection form?
Employees who are responsible for performing servicing or maintenance activities on equipment that requires lockout/tagout procedures.
How to fill out lockouttagout inspection form?
Fill out the form by documenting the equipment being serviced, the specific procedures followed, the employees involved, and any issues or concerns identified during the inspection.
What is the purpose of lockouttagout inspection form?
The purpose of the lockouttagout inspection form is to ensure that proper procedures are followed to protect employees from hazardous energy sources during equipment maintenance or servicing.
What information must be reported on lockouttagout inspection form?
The form should include details such as the equipment being serviced, the procedures followed, the employees involved, and any issues or concerns identified.
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