Lockout/tagout (Control Of Hazardous Energy) - Sample Lockout Procedures Page 5
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10Sample Lockout Procedure
Use with Lockout/Tagout (Control of Hazardous Energy), Chapter 296-803 WAC
MEETING THE REQUIREMENTS OF THIS PROGRAM:
•
All employees need to follow the restrictions and limitations that result from this
procedure.
•
Authorized employees will perform lockout as described in this procedure.
•
No employee will attempt to start, energize or use any machine or equipment
that is locked out.
•
Failure to follow this procedure will result in the following action:
_____________________________________________________________
_____________________________________________________________
______________________________________________________________
List above the actions that will be taken if employees violate the procedure.
INTENDED USE:
•
This procedure will be used for the following service or maintenance actions:
_____________________________________________________________
_____________________________________________________________
_____________________________________________________________
List above the service and maintenance activities that require use of the procedure.
h t t p : / / w w w . l n i . w a . g o v /
R-5
11/04
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