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Lockout tagout procedure template

Lockout tagout procedure template

Standardize your lockout tagout procedures with this comprehensive template. It provides clear guidelines for isolating energy sources and securing equipment. Use this template to enhance safety protocols and prevent unauthorized access during maintenance.

Use this template
or download pdf
Lockout tagout procedure template

Standardize your lockout tagout procedures with this comprehensive template. It provides clear guidelines for isolating energy sources and securing equipment. Use this template to enhance safety protocols and prevent unauthorized access during maintenance.

Use this template
or download pdf

About the Lockout tagout procedure template

A lockout tagout procedure template helps to systematically guide you through the essential steps of safely isolating hazardous energy sources. It begins with equipment identification, ensuring you correctly identify the machinery involved. Next, it details the specific steps for isolating energy sources, covering electrical, hydraulic, and other types of energy. 

The template includes instructions for applying lockout and tagout devices, ensuring only authorized personnel can control the equipment. A verification section confirms that all energy sources are effectively isolated before any maintenance begins. By using this template, you ensure consistent adherence to safety protocols, minimizing the risk of accidental activation and injuries. 

This structured approach not only enhances workplace safety but also ensures compliance with safety regulations, fostering a culture of safety and accountability. Implementing this template helps you protect your team and maintain operational efficiency.

Key elements of a lockout tagout procedure template

A lockout tagout procedure template is crucial for maintaining safety during equipment maintenance. Here are the essential components that make this template effective:

  • Equipment identification: This section ensures you accurately identify the machinery involved. Proper identification is vital to ensure that the correct devices are locked out, preventing accidental activation and enhancing safety.
  • Energy source isolation: Detail the specific steps required to isolate energy sources, such as electrical, hydraulic, and pneumatic. Provide clear instructions in this section to ensure you comprehensively address all potential hazards, reducing the risk of accidents.
  • Lockout/tagout device application: Outline the procedure for applying lockout and tagout devices. This ensures that only authorized personnel can control the equipment, maintaining safety throughout the maintenance process.
  • Verification and testing: Include a section to verify that you effectively isolate all energy sources and ensure the equipment is safe to work on. This verification confirms you execute the lockout tagout process correctly.

Best practices for using a lockout tagout procedure template

To make the most of a lockout tagout procedure template, start by customizing it to your specific equipment and processes. Ensure all machinery is accurately identified, and the steps for isolating energy sources are clearly defined. This helps prevent oversights and ensures safety.

Encourage regular training sessions for your team to familiarize them with the template and procedures. Training ensures that everyone understands their roles and responsibilities, reducing the risk of human error. Always verify each step of the lockout tagout process. Verification is crucial for confirming that all energy sources are effectively isolated before maintenance begins.

Regularly review and update the template to reflect any changes in equipment or processes. Keeping the template current ensures its continued effectiveness. Avoid common pitfalls like skipping steps or inadequate documentation. By following these best practices, you can enhance safety protocols and maintain a secure working environment.

Related categories

  • Health and safety management templates
  • Manufacturing templates
  • Workplace safety templates
Preview of the template
Lockout Tagout Procedure
Identify all energy sources
Shut down equipment and machinery
Isolate all energy sources
Apply lockout devices
Verify zero energy state
Perform maintenance or service
Remove lockout devices
Restore energy and restart equipment

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Related resources

Access a complete set of resources aimed at maximizing safety, quality, and operational excellence, including detailed guides, related templates, and real-world use cases.

Topic guides

Read in-depth guides covering key topics related to this article.

Lockout tagout: A comprehensive guideWarehouse safety guide: The best practices and principlesToolbox talks: A safety leader's guideEquipment maintenance: A detailed guide to longevity and optimal performanceEnergy performance certificate (EPC): A comprehensive guide
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Template collections

See comprehensive collections of best practice templates related to this topic.

6 free lockout tagout templates for maintenance6 free heavy equipment inspection checklists in Lumiform14 free work instruction templates for every industry9 free equipment inspection checklists for efficient maintenance17 free electrical inspection checklist templates
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Use cases

Check out how the Lumiform software can be utilized for related use cases.

Apply Lumiform's workflow automation platform to all use casesEquipment maintenance software Electrician AppFree Daily Forklift Inspection AppSafety Incident Reporting Software
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Other resources

Explore all the additional resources we offer to assist you in mastering this topic.

6 main types of maintenance4 types of predictive maintenance for your businessHow to perform safety inspectionsThe importance of personal protective equipment (PPE) in workplace safety

Frequently asked questions

What is the purpose of a lockout tagout procedure template?

A lockout tagout procedure template is designed to ensure the safe isolation of hazardous energy sources during maintenance activities. It provides a structured approach to prevent accidental machine activation, protecting workers from potential injuries and ensuring compliance with safety regulations.

How can a lockout tagout procedure improve workplace safety?

Using a lockout tagout procedure improves workplace safety by standardizing procedures for isolating energy sources. It ensures that all steps are followed consistently, reducing the risk of human error and accidents, and fostering a culture of safety and accountability.

Who should implement a lockout tagout procedure template?

Maintenance personnel, safety officers, and facility managers should implement this procedure template. It helps them ensure that all safety protocols are followed during equipment servicing, protecting workers and maintaining compliance with safety standards.

When is the best time to review a lockout tagout procedure?

The best time to review a lockout tagout procedure is during routine safety audits or after any changes in equipment or processes. Regular reviews ensure that procedures remain effective and up-to-date, providing maximum protection for workers and maintaining operational efficiency.


This template, developed by Lumiform employees, serves as a starting point for businesses using the Lumiform platform and is intended as a hypothetical example only. It does not replace professional advice. Companies should consult qualified professionals to assess the suitability and legality of using this template in their specific workplace or jurisdiction. Lumiform is not liable for any errors or omissions in this template or for any actions taken based on its content.
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