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Template

Lock Out Tag Out Evaluation Form

by David Rumsey, from the Community

Downloads: 20+
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Use this Lock Out Tag Out LOTO Evaluation Form to assess the competency of authorized employees performing energy isolation. The checklist covers notification of affected employees, procedure review, required supplies, step by step lockout, dissipation of residual energy, verification attempts, and safe restoration. Capture names of the employee and evaluator, date, site, and comments to support compliance and continuous improvement.

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Digitize any process, procedure or policy
Eliminate mistakes made by paper-based processes
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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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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.