Template

Exclusive Control Checklist

10+

This exclusive control checklist helps teams create safe work areas and manage isolation during high risk tasks. Use it to establish an exclusive control zone, choose suitable barricading devices, identify designated entry points, and set up a drop zone when required. Capture details on isolation points that are energized or de energized, apply personal locks and tags, manage lockboxes, and complete exclusive control tags bags and sheets. Support safe operations and compliance on site.

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Confirm accountability and compliance with a digital log

With SafetyCulture you can

Digitize any process, procedure or policy

Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

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Community

This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions .

Template

Hazardous Energy Isolation Checklist

Use this hazardous energy isolation checklist to plan and verify lockout, tagout, and isolation steps before maintenance or repair. Capture site, auditor, and location details; verify risk assessments; complete LOTO sheets; confirm trade and personal locks; place tags and signage; establish exclusion zones; and verify systems are de-energized at the power source. Record live work controls, stop-work actions, and final sign-offs to keep teams compliant and safe.

by Jared Swenson, from the Community

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Template

Electrical Pre-Task Plan Checklist

This electrical pre-task plan checklist helps crews prepare for live or de-energized electrical work. Verify required PPE, assess whether equipment can be de-energized, and follow the steps to establish an electrically safe work condition including lockout tagout and discharge of stored energy. Identify when an energized work permit is required for testing, troubleshooting, or voltage measuring. Use it to reduce risk, follow NFPA 70E practices, and work safely on sites and HVAC equipment.

by Rj Kiesel-Kauhane, from the Community

20+

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Energized Electrical Work Permit - Local

Energized work procedures

by Enrique Alegria, from the Community

80+

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Template

High Risk Audit - Isolation Test Checklist

Use this high risk isolation audit to assess compliance with isolation and lockout procedures on construction and electrical works. Check that workers are identified on danger or out of service tags, understand the procedure, and can identify hazardous energy sources. Verify methods to isolate, test effectiveness, and manage multiple isolation points. Confirm TRA and permit requirements, assignment of an isolation coordinator, and adherence to site procedures. Ensure communication with nearby workers, completion checks before re-energizing, and documentation of observations and corrective actions.

by JUSTINE YOUL, from the Community

10+

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Template

Electrical Isolation Procedure and Test Sheet

This isolation procedure and test sheet guides safe electrical work by documenting power isolation before and after tasks. Record job details and workers, identify the area of the installation, isolate at the main switch or final subcircuits, apply lockout kits and danger tags, and capture photos of the isolation and re-energization. Document required testing to verify circuits are de-energized and reinstated correctly. Designed to support compliance with Western Australia regulations 1991.

by Gerrit Ballast, from the Community

10+

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Template

Permit to Work including Electrical Isolation

Use this Permit to Work including Electrical Isolation checklist to support safe isolation and control of work on site. The template guides permit authorities and isolating authorities through verifying competency, cross-referencing Work Control Certificates and Isolation Confirmation Certificates, identifying and labeling isolation points, and ensuring up-to-date drawings are available. It also prompts toolbox talks, hazard identification, and confirmation that prerequisite controls and supporting certificates are in place. Use it to monitor boundaries of the task, manage changes in scope, and document compliance with the site's safe system of work.

by Lisa Johnston, from the Community

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