LOCKOUT / TAGOUT PROCEDURES

DEPT:
ASSET NO.

EQUIPMENT IDENTIFICATION
ASSET NAME:
RELATED EQUIPMENT:

DPT050
PPP021

ENERGY SOURCES AND MAGNITUDE

TYPE

NO.
SOURCES

ELECTRICAL
PNEUMATIC
HYDRAULIC
CHEMICAL
WATER
STORED ENERGY
NATURAL GAS

1
1

ELECTRICAL

480VAC
100PSI

TURN OFF POWER AND

LOCK AND TAG OUT
WITH LOCK.
LOCATED ON SIDE
OF MACHINE

PNEUMATIC

TYPE

AMOUNT

TURN OFF MAIN

PADLOCK AND TAG

LG. PLUG LOCKOUT
AIR COUPLING LOCKOUT
SM. BALL VALVE LOCK
LG. BALL VALVE LOCK
BREAKER LOCK
BLOCKING DEVICE

AIR SUPPLY DUMP VALVE,

LOCK AND TAGOUT
WITH LOCK.
LOCATED ON BACK
OF MACHINE

APPROVED BY:

John Doe

PUNCH PRESS 55 TON

LOCATIONS AND LOTO DEVICE TYPE NEEDED

LARGEST
MAGNITUDE

EQUIPMENT NEEDED TO LOCKOUT OR CONTROL

IDENTIFIED ENERGY SOURCE

REVISION:
(date)

REVIEWED 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

LOCKOUT/TAGOUT WORK INSTRUCTIONS

1

NOTIFY OPERATOR, SUPERVISOR AND ANY AFFECTED PERSONNEL OF IMPENDING WORK TO BE PERFORMED.

CLEAR MACHINE OF ALL MATERIALS/PRODUCT AND TURN MACHINE OFF BY DEPRESSING THE "OFF" OR "E-STOP" BUTTON/S

TURN OFF MAIN ELECTRICAL DISCONNECT AND LOCKOUT.

TURN OFF MAIN AIR DUMP VALVE AND LOCK OUT. WAIT TILL AIR BLEEDS FROM SYSTEM.

WHEN THE ABOVE STEPS ARE COMPLETED TRY TO START THE MACHINE USING THE START OR ON BUTTONS TO VERIFY THAT
THE MACHINE IS CORRECTLY LOCKED OUT. AFTER VERIFICATION DEPRESS THE STOP BUTTONS AGAIN.

MAKE ABSOLUTELY SURE ALL PERSONNEL AND TOOLS ARE REMOVED FROM THE EQUIPMENT.

CONFIRM ALL GUARDS AND COVERS ARE ON AND ALL ELECTRICAL ENCLOSURES ARE CLOSED.

WHEN ALL THE ABOVE STEPS ARE COMPLETE THE AUTHORIZED EMPLOYEE WHO PLACED THE LOCKOUT DEVICE/S ON THE
MACHINE MAY NOW REMOVE THEM AND PROCEDE WITH START-UP AND/OR TEST.

AFTER SUCCESSFUL TEST THE AUTHORIZED EMPLOYEE NOTIFIES THE OPERATOR AND/OR AFFECTED PERSONNEL THAT THE
MACHINE IS READY FOR USE.

REMOVING THE LOCKOUT/TAGOUT DEVICE

AUTHORIZED PERSONNEL

AFFECTED PERSONNEL
MACHINE OPERATORS

SETUP AND LEADHANDS

MAINTENANCE OR MANAGEMENT PERSONNEL

ALL PERSONNEL

LOCKOUT / TAGOUT PROCEDURES

DEPT:
ASSET NO.

EQUIPMENT IDENTIFICATION
ASSET NAME:
RELATED EQUIPMENT:

DPT051
ASE014

ENERGY SOURCES AND MAGNITUDE

TYPE

NO.
SOURCES

ELECTRICAL
PNEUMATIC
HYDRAULIC
CHEMICAL
WATER
STORED ENERGY
NATURAL GAS

1
1

ELECTRICAL

480VAC
100PSI

BACK OR SIDE ON
CORD DROP
LARGE PLUG LOCKOUT
LOCK AND TAG

TYPE

AMOUNT

BACK OF WELDER

PADLOCK AND TAG

LG. PLUG LOCKOUT
AIR COUPLING LOCKOUT
SM. BALL VALVE LOCK
LG. BALL VALVE LOCK
BREAKER LOCK
BLOCKING DEVICE

LARGE PLUG LOCKOUT

LOCK AND TAG

John Doe

INLINE TIG WELDER

PNEUMATIC

APPROVED BY:

2/6/2007

LOCATIONS AND LOTO DEVICE TYPE NEEDED

LARGEST
MAGNITUDE

EQUIPMENT NEEDED TO LOCKOUT OR CONTROL

IDENTIFIED ENERGY SOURCE

REVISION:
(date)

REVIEWED 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015

LOCKOUT/TAGOUT WORK INSTRUCTIONS

1

NOTIFY OPERATOR, SUPERVISOR AND ANY AFFECTED PERSONNEL OF IMPENDING WORK TO BE PERFORMED.

CLEAR MACHINE OF ALL MATERIALS/PRODUCT AND TURN MACHINE OFF BY DEPRESSING THE "OFF" OR "E-STOP" BUTTON/S

UNPLUG 480 VOLT TWIST-LOCK. PLACE LARGE PLUG LOCKOUT DEVICE OVER MALE PLUG AND LOCK OUT.

UNHOOK 1/2" QUICK COUPLER. PLACE LARGE PLUG LOCKOUT OVER COUPLER AND LOCK OUT. CAN ALSO USE COUPLING LOCK.

WHEN THE ABOVE STEPS ARE COMPLETED TRY TO START THE MACHINE USING THE START OR ON BUTTONS TO VERIFY THAT
THE MACHINE IS CORRECTLY LOCKED OUT. AFTER VERIFICATION DEPRESS THE STOP BUTTONS AGAIN.

MAKE ABSOLUTELY SURE ALL PERSONNEL AND TOOLS ARE REMOVED FROM THE EQUIPMENT.

CONFIRM ALL GUARDS AND COVERS ARE ON AND ALL ELECTRICAL ENCLOSURES ARE CLOSED.

WHEN ALL THE ABOVE STEPS ARE COMPLETE THE AUTHORIZED EMPLOYEE WHO PLACED THE LOCKOUT DEVICE/S ON THE
MACHINE MAY NOW REMOVE THEM AND PROCEDE WITH START-UP AND/OR TEST.

AFTER SUCCESSFUL TEST THE AUTHORIZED EMPLOYEE NOTIFIES THE OPERATOR AND/OR AFFECTED PERSONNEL THAT THE
MACHINE IS READY FOR USE.

REMOVING THE LOCKOUT/TAGOUT DEVICE

AUTHORIZED PERSONNEL

AFFECTED PERSONNEL
MACHINE OPERATORS

SETUP AND LEADHANDS

MAINTENANCE OR MANAGEMENT PERSONNEL

ALL PERSONNEL

LOCKOUT/TAGOUT DOCUMENT REVISION TRACKING

DATE/REV.
REASON FOR REVISION
3/20/2006 INITIAL LOCKOUT / TAG OUT INSTRUCTIONS

INITIALS
MSK