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Get the free Lock Out Tag Out (LOTO) Permit Form - University of Houston

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UNIVERSITY of HOUSTON All Permits Must Be Submitted to Facilities Communications 3 Days Prior to the Lock Out/Tag Out Activity Email form tofaccomm@central.uh.eduContractor Lock Out/Tag Out Request
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How to fill out lock out tag out

01
To fill out a lock out tag out form, follow these steps:
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Gather the necessary information, such as the equipment or machinery being locked out and the reason for the lockout.
03
Identify the energy sources that need to be controlled and determine the appropriate lockout methods.
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Use a lockout tag to visually indicate that the equipment is locked out. Write down the date, time, and your name on the tag.
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Securely attach the tag to the equipment or machinery in a visible location.
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Make sure that all energy sources are properly isolated and disabled.
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Verify that the equipment is in a safe state and cannot be accidentally re-energized.
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Inform all relevant personnel about the lockout and ensure that they understand the importance of not removing the lockout tag.
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Keep a record of the lockout in a central log and update it as necessary.
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When the work is completed, remove the lockout tag and restore the equipment to its normal operating condition.
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Conduct a final check to confirm that all energy sources are restored and the equipment is functioning properly before resuming operations.

Who needs lock out tag out?

01
Lock out tag out is needed by individuals working with or around equipment or machinery that has potential energy sources.
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This includes but is not limited to:
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- Maintenance and repair workers
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- Machine operators
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- Electricians
06
- Plumbers
07
- Janitors
08
- HVAC technicians
09
- Construction workers
10
- Warehouse staff
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- Any personnel involved in servicing or maintenance tasks
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Implementing lock out tag out procedures helps ensure their safety by preventing unexpected startup or release of hazardous energy during servicing or maintenance activities.
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Lock out tag out (LOTO) is a safety procedure used to ensure that dangerous machines are properly shut off and unable to be started up again until maintenance or servicing is completed.
All employees and contractors who operate, maintain, or service machinery and equipment that have potential hazardous energy must file lock out tag out procedures.
To fill out lock out tag out, identify the energy source, notify affected employees, isolate the energy source, attach lock out devices to the energy isolating devices, and complete the lock out/tag out form with relevant details.
The purpose of lock out tag out is to protect workers from the unexpected energization, start-up, or release of stored energy from equipment during maintenance or servicing.
Reported information should include the date and time of lock out, equipment identification, the reason for the lock out, and the names of employees involved in the lock out process.
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