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Lockout/tagout (LOTO) procedure template

A lockout/tagout (LOTO) procedure is the written, machine-specific method for isolating every energy source before servicing, so the machine cannot start or release energy while someone works on it. Page 1 of this template identifies the machine, has space for a photo with each isolation point numbered, and lists every energy source in a table: the type, the magnitude, the isolation device, where it is, how it is locked out and how isolation is verified. Page 2 sets out the steps in order (prepare, shut down, isolate, lock and tag, release stored energy, verify, restart) with space for the machine's own details under each. Page 3 lists the authorized employees, records the periodic review and tracks changes. The Excel version is an energy source list for all your machines, with the next review due a year after the last and a log of the reviews.

Free to use: print it, copy it and edit it for your team. Enter your name and work email once to download.

Page 1 of the lockout/tagout procedure templateFields for the machine, asset number, location and procedure number, a photo area to number each isolation point, a box for the hazards, a key of energy types and a table of energy sources with the magnitude, isolation device, location, lockout method and verification.
Machine detailsPhoto with isolation pointsEnergy source tableSeven steps, shutdown to restartAuthorized employeesPeriodic review recordEnergy source list in Excel

When to use it

When to use a lockout/tagout procedure

  • For every machine where servicing, cleaning, clearing jams or changeovers expose people to moving parts or hazardous energy.
  • When a machine is installed, moved or modified, or gets a new energy source.
  • When a periodic review or an incident shows the current procedure is wrong or unclear.
  • To train authorized employees on a specific machine.

How to fill it in

  1. 1

    Walk the machine

    With maintenance and the operators, find every energy source: electrical, pneumatic, hydraulic, mechanical, gravity, thermal, chemical and stored energy.

  2. 2

    Fill in the energy table

    For each source: the magnitude, the isolation device, where it is, the lock or device used and how you prove it is isolated.

  3. 3

    Photograph and number the points

    Mark each isolation point E1, E2 and so on, matching the table, and put the photo on the procedure.

  4. 4

    Write the machine's steps

    Under each of the seven steps, write the specifics: which switch, which valve, which gauge, which button to try.

  5. 5

    Train and list the authorized employees

    Only trained, authorized people lock out the machine. List them with the training date.

  6. 6

    Review it at least once a year

    Watch an authorized employee use the procedure, fix any problem found and record the review.

A filled-in example

Illustrative, not a benchmark

An example: the energy table for a hydraulic press brake (illustrative).

The example press brake's four energy sources

  1. Electrical, 480 VLock and tag the main disconnect. Verify: try the start button, test for voltage at the motor.
  2. Hydraulic, 2,500 psi accumulatorOpen the bleed valve after shutdown. Verify: the pressure gauge reads zero.
  3. Gravity, the ramLower it to the bottom of its stroke, or block it with the safety blocks.
  4. Pneumatic, 90 psiClose the lockable ball valve to the back gauge and bleed the line at the filter.
Every source gets an isolation point and a way to prove it is at zero. E4, the back gauge air, was missing from the old procedure.
  • E1 electrical: 480 V main disconnect on the wall behind the machine. Padlock and tag on the disconnect. Verified by trying the start button and testing for voltage at the motor terminals.
  • E2 hydraulic: 2,500 psi accumulator. Bleed valve opened after shutdown. Verified by the pressure gauge reading zero.
  • E3 gravity: the ram. Lowered to the bottom of its stroke, or blocked with the safety blocks if work is needed under it.
  • E4 pneumatic: 90 psi air to the back gauge. Lockable ball valve closed and the line bled at the filter.

The first annual review found that the back gauge air had been left off the old procedure; it was added as E4, and the three authorized employees were trained on the change.

Common mistakes

  • Missing stored energy

    Springs, accumulators, capacitors, raised parts and trapped air stay dangerous after the power is off. List and release them.

  • Using a control as an isolation point

    E-stops, interlocks and control buttons are not energy isolating devices. Lock the disconnect, valve or block.

  • Skipping the verify step

    Always try to start the machine and check gauges and voltage before work starts.

  • A generic procedure for every machine

    Each machine has its own sources and isolation points. Write one procedure per machine.

  • Out of date after a change

    Review the procedure whenever the machine is modified, not only once a year.

Download the template

Free to use: print it, copy it and edit it for your team. Enter your name and work email once to download.

Run this template in LeanSuite

In LeanSuite each LOTO procedure is a digital form with photo-verified isolation steps, it opens only for people with a valid Authorized Employee certification for that machine, and Document Management gives each procedure an owner and a yearly review date.

See it in a 45-minute demo

FAQ

Lockout/tagout (LOTO) procedure template: common questions

  1. A written, machine-specific set of steps for isolating every energy source and locking it off before servicing, so the machine cannot start or release energy while someone works on it.

  2. The machine it covers, every energy source with its isolation point, the steps to shut down, isolate, lock and tag, release stored energy and verify, and how to restart safely. In the US, OSHA 29 CFR 1910.147 lists what an energy control procedure must specify. Check the rules that apply where you work.

  3. In the US, OSHA 29 CFR 1910.147 requires a periodic inspection of each energy control procedure at least annually. Review it sooner when the machine is modified or a problem is found.

  4. An authorized employee locks out the machine to service it. An affected employee operates or works near the machine and must be told when it is locked out, but does not apply the locks.

  5. Generally yes, one per machine or per group of identical machines. The US standard allows a narrow exception for simple equipment that meets a list of conditions, such as a single energy source with no stored energy. Check the standard before relying on it.

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