Free template
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.
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
Walk the machine
With maintenance and the operators, find every energy source: electrical, pneumatic, hydraulic, mechanical, gravity, thermal, chemical and stored energy.
- 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
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
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
Train and list the authorized employees
Only trained, authorized people lock out the machine. List them with the training date.
- 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 benchmarkAn example: the energy table for a hydraulic press brake (illustrative).
- 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.
In the lean glossary
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FAQ
Lockout/tagout (LOTO) procedure template: common questions
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A shift handover sheet, a red tag log, a changeover checklist for one machine: if your team uses it on the floor, ask.