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A lockout tagout procedure template for one machine.

A procedure says exactly how to lock out one machine, step by step, so nobody works from memory. Fill out one sheet per machine. Print the sheet or save it as a PDF. Use it alongside the manufacturer's operator manual and your site's procedures.

Also calledLOTO procedure template, Machine-specific lockout procedure, Energy control procedure, Lockout procedure form

How to use it

Three habits that make it worth filling out.

  1. Step 1

    Write it for one machine

    A general policy isn't a procedure. Walk the machine, find every energy source and write the steps in the order they're done.

  2. Step 2

    Test it with someone

    Have an authorized person follow it as written. Change anything that was unclear or out of order.

  3. Step 3

    Review it

    Review it on the schedule your program sets, and whenever the machine, the energy sources or the work changes.

Do this on a phone instead of paper.

Keep the procedure on a phone beside the machine, and log each lockout with the lock number and a photo of the isolation point. It works with no signal.

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Common questions

What goes in a lockout tagout procedure?
OSHA 1910.147 lists what a written procedure has to cover, including the steps to shut down, isolate, block and secure the machine, how locks and tags go on and come off, and how to test that it's isolated. Check the current text of the standard and your own program.
Do I need a written procedure for every machine?
Usually, because each machine has its own energy sources and steps. The note to 1910.147(c)(4)(i) says a procedure need not be documented for a machine only if all eight conditions it lists are true, such as a single readily identified energy source and no stored energy. Check the standard and your program. The standard also calls for a periodic inspection of each procedure at least once a year.
Who can apply a lock?
Authorized, trained people, per your program. Each one uses their own lock and key. Nobody removes another person's lock outside the process your procedure sets out.