Scribd Logo
Upload

Welcome to Scribd!

  • Appendix A. Multiple Lockout/Tagout Procedure Form: Purpose

    Uploaded by

    Anonymous ffje1rpa
    7 views1 page
    This document provides a form for documenting multiple lockout/tagout procedures. The form includes spaces to describe the job, identify all energy sources for the equipment, note the hazard magnitude and location for lockout/tagout, and obtain necessary authorizations. It is designed to protect employees performing maintenance or services by ensuring all energy sources are properly isolated before work begins.

    Original Description:

    GHHHYH

    Original Title

    Form

    Copyright

    © © All Rights Reserved

    Available Formats

    DOCX, PDF, TXT or read online from Scribd

    Did you find this document useful?

    Is this content inappropriate?

    Report this Document
    This document provides a form for documenting multiple lockout/tagout procedures. The form includes spaces to describe the job, identify all energy sources for the equipment, note the hazard magnitude and location for lockout/tagout, and obtain necessary authorizations. It is designed to protect employees performing maintenance or services by ensuring all energy sources are properly isolated before work begins.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    7 views1 page

    Appendix A. Multiple Lockout/Tagout Procedure Form: Purpose

    Uploaded by

    Anonymous ffje1rpa
    This document provides a form for documenting multiple lockout/tagout procedures. The form includes spaces to describe the job, identify all energy sources for the equipment, note the hazard magnitude and location for lockout/tagout, and obtain necessary authorizations. It is designed to protect employees performing maintenance or services by ensuring all energy sources are properly isolated before work begins.

    Copyright:

    © All Rights Reserved
    Download as DOCX, PDF, TXT or read online from Scribd
    Flag for inappropriate content
    of 1

    Appendix A.

    Multiple Lockout/Tagout Procedure Form


    Purpose: This lockout/tagout procedure for multiple energy sources is for use in protecting employees performing services and maintenance of machines and/or equipment in which the unexpected energization or start up, or release of stored energy could cause injury to employees. It is specifically designed for use with the general lockout/tagout procedure.
    (Shop/Department) (Location/Bldg/Room/Floor)

    (Procedure Number)

    (Equipment/Machine/Process)

    Procedure
    Description of Job:

    Energy Sources:E-Electrical T-Thermal P-Pneumatic C-Chemical Hazard Magnitude Location of Hazard LO/TO (i.e. V = 120, 125 135 psi) Identification (Lockout Point) Devices

    Comments:

    (Job Performed By)

    (Starting Date & Time)

    (LO/TO Procedure Authorized/Approved By)

    (Finishing Date & Time)

    You might also like