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<CompanyName>

Energy Control Program & Procedures

(Lockout/Tagout)

Version <Version>

Updated: <Date>

Contents

1.	Program Purpose	4

2.	Definitions	4

3.	Responsibilities	5

4.	Equipment	6

5.	Exceptions to Lockout/Tagout	6

6.	Preparation for Lockout or Tagout	7

7.	Energy Sources	8

8.	Multi-Person Lockout	10

9.	Removal of an Authorized Employee’s Lockout/Tagout by the Company	10

10.	Shift or Personnel Changes	11

11.	Procedures for Outside Personnel/Contractors	11

12.	Training & Communication	11

13.	Periodic Inspection & Audits	11

Appendix I – List of Authorized Personnel	13

Appendix II – Machine-Specific Energy Control Procedures	14

Certificate of Training – Authorized Personnel	16

Certificate of Training – Affected Personnel	17

Lockout/Tagout Inspection Certification	18

Employee Acknowledgement	19

Program Purpose

The purpose of this program is to establish a means of control to safeguard employees from the unexpected energization or startup of machinery and equipment, or the release of hazardous energy during service or maintenance activities.

This program serves to:

Establish a safe and positive means of shutting down machinery, equipment and systems.

Prohibit unauthorized personnel or remote control systems from starting machinery or equipment while it is being serviced.

Provide a secondary control system (Tagout) when it is impossible to positively lockout the machinery or equipment.

Establish responsibility for implementing and controlling lockout/tagout procedures.

Ensure that only approved locks, standardized tags and fastening devices provided by the company will be utilized in the lockout/tagout procedures.

Ensure both compliance with the OSHA Control of Hazardous Energy Standard and the safety of our employees.

The program shall be utilized for all servicing and/or maintenance activities that require employees to work in hazardous areas.

The program is not required for normal production operations so long as employees are not exposed to unsafe conditions.

Definitions

Authorized employee – an employee who locks or tags machines or equipment in order to perform servicing or maintenance.

Affected employee – an employee who is required to use machines or equipment on which servicing is performed under the lockout/tagout standard or who performs other job responsibilities in an area where such servicing is performed.

Other employees – all employees who are or may be in an area where energy control procedures may be utilized.

Capable of being locked out - an energy-isolating device is considered capable of being locked out if it:

Is designed with a hasp or other means of attachment to which a lock can be affixed.

Has a locking mechanism built into it.

Can be locked without dismantling, rebuilding, or replacing the energy-isolating device or permanently altering its energy control capability.

Energized – machines and equipment are energized when they are connected to an energy source or they contain residual or stored energy.

Energy-isolating device – a mechanical device that physically prevents the transmission or release of energy, including but not limited to the following:

A manually operated electrical circuit breaker

A disconnect switch

A manually operated switch by which the conductors of a circuit can be disconnected from all ungrounded supply conductors and, in addition, no pole can be operated independently

A line valve

A block and any similar device used to block or isolate energy

Push buttons, selector switches and other control circuit type devices are not energy isolating devices

Energy source – any source of electrical, mechanical, hydraulic, pneumatic, chemical, thermal, or other energy.

Lockout – the placement of a lockout device on an energy-isolating device, in accordance with an established procedure, ensuring that the energy-isolating device and the equipment being controlled cannot be operated until the lockout device is removed.

Lockout device – any device that uses positive means, such as a lock, blank flanges and bolted slip blinds, to hold an energy-isolating device in a safe position, thereby preventing the energizing of machinery or equipment.

Normal production operations – utilization of a machine or equipment to perform its intended production function.

Servicing and/or maintenance – workplace activities such as constructing, installing, setting up, adjusting, inspecting, modifying, maintaining and/or servicing machines or equipment, including lubrication, cleaning or unjamming of machines or equipment, and making adjustments or tool changes, where employees could be exposed to the unexpected energization or startup of the equipment or release of hazardous energy.

Tagout – the placement of a tagout device on an energy-isolating device, in accordance with an established procedure, to indicate that the energy-isolating device and the equipment being controlled may not be operated until the tagout device is removed.

Tagout device – any prominent warning device, such as a tag and a means of attachment, which can be securely fastened to an energy-isolating device to indicate that the machine or equipment to which it is attached may not be operated until the tagout device is removed.

Responsibilities

<ImplementationOwner> will be responsible for implementing the Lockout/Tagout program.

<EnforcementOwners> are responsible for enforcing the program and ensuring compliance with the procedures in their departments.

<ComplianceOwner> is responsible for monitoring the compliance of this procedure and will conduct the annual inspection and certification of the authorized employees.

Authorized employees (those listed in Appendix I) are responsible for following established lockout/tagout procedures.

Affected employees (all other employees in the facility) are responsible for ensuring they do not attempt to restart or re-energize machines or equipment which are locked out or tagged out.

Equipment

All locks will be durable, standardized, keyed individually, labeled to identify who the lock is assigned to, and purchased by <CompanyName>.

All tags will be durable, standardized, and have legibly written on it a warning such as Do Not Use, Do Not Close, or Do Not Open.

<LockListOwner> will maintain a list of lock assignments, recoding the name, position, and lock identification.

Any additional equipment (lock boxes, hasps, valve covers, etc.) used to perform lockout/tagout will be purchased by <CompanyName> from a reputable safety supplier.

Employees may not share their locks with other employees or bring in outside equipment for lockout/tagout.

Exceptions to Lockout/Tagout

Exceptions to lockout/tagout may occur when:

Exposure to hazardous energy is controlled completely by unplugging the equipment from an electric outlet when electricity is the only source of energy, and where the employee doing the service or maintenance has exclusive control of the plug.

The employee is performing minor tool changes or other minor servicing activities that are routine, repetitive, and integral to production, and that occur during normal production operations. In these cases, employees must have effective, alternative protection.

Related exceptions are outlined in the below table:

Activity	Alternative Protection
<Activity1>	<Alternative1>
<Activity2>	<Alternative2>
<Activity3>	<Alternative3>
<Activity4>	<Alternative4>
<Activity5>	<Alternative5>
<Activity6>	<Alternative6>
<Activity7>	<Alternative7>
<Activity8>	<Alternative8>
<Activity9>	<Alternative9>
<Activity10>	<Alternative10>

Tagout Only Operations

If lockout is not possible, it will be indicated in the machine-specific procedure.

In these cases, tags must be securely fastened as close as safely possible to the energy-isolating device in a position where it will be immediately obvious to anyone attempting to operate the device.

Tagout must provide the same level of protection as lockout.

Safety measures to take during tagout operations may include:

Using at least one added safety measure that prevents unexpected energization

Removing an isolating circuit element

Blocking a controlling switch

Opening an extra disconnecting device

Removing a valve handle

Preparation for Lockout or Tagout

Employees who are required to utilize the lockout/tagout procedure (see Appendix I) must be knowledgeable of the different energy sources and the proper sequence of shutting off or disconnecting energy means. The four types of energy sources are:

Electrical (most common form)

Hydraulic or pneumatic

Fluids and gases

Mechanical (including gravity)

More than one energy source may be utilized on some equipment, and the machine-specific procedure must be followed in order to identify energy sources and lockout/tagout accordingly.

Before any lockout or tagout operation begins, the lead employees must notify affected employees, which includes the supervisor.

Energy Sources

Electrical Lockout/Tagout

Shut down the machine through normal shutdown procedures

Isolate or disconnect the energy source

Possible disconnection means include the power cord, power panels (look for primary and secondary voltage), breakers, the operator's station, motor circuit, relays, limit switches, and electrical interlocks.

Only qualified electrical workers may perform lockout inside a breaker panel where live electrical wiring may exist.

Apply locks and tags to energy isolation device

The plug end of the cord must be locked out or tagged out if authorized employees cannot keep complete direct control over the cord for the duration of the work.

Release stored energy – if a machine or piece of equipment contains capacitors, they must be drained of stored energy

Shut off, lockout, or tagout other energy sources

Check for zero energy state

Return all controls to their safest position

Hydraulic/Pneumatic Lockout Tagout

Shut down the machine through normal shut down procedures

Shut off all energy sources (pumps and compressors), if the pumps and compressors supply energy to more than one piece of equipment

Lockout and tagout the valve supplying energy to the piece of equipment being serviced

Release stored energy

Shut off, lockout, or tagout other energy sources

Check for zero energy state

Return all controls to their safest position

Fluids and Gases Lockout/Tagout

Shut down the machine through normal shut down procedures

Identify the type of fluid or gas and the necessary personal protective equipment

Close valves to prevent flow

Determine the proper isolating device, apply device, and lockout/tagout

Drain and bleed lines to zero energy state

Some systems may have electrically controlled valves. If so, they must be shut off and locked/tagged out

Shut off, lockout or tagout other energy sources

Check for zero energy state

Return all controls to their safest position

Mechanical Energy

Shut down the machine through normal shut down procedures

Apply safety device such as block, die ram, safety chain

Lockout or tagout safety device

Shut off, lockout, or tagout other energy sources

Check for zero energy state

Return controls to safest position

Release from Lockout/Tagout

Inspection and clean up – make certain the work is completed and inventory the tools and equipment that were used. Remove all towels, rags, tools, equipment, work-aids, etc.

Replace guards – replace all guards removed during maintenance activity. Occasionally, a particular guard may have to be left off until the start sequence is over due to possible adjustments. However, all other guards should be put back into place.

Check controls – all controls should be in their safest position.

Check the work area to ensure that all employees have been safely positioned.

Notify affected employees of start-up.

Remove locks/tags.

No employee shall remove anyone else’s lock or tag

Employee must remove his or her own lock and tag

Release the machine for start-up to the affected employees or supervisor.

Machine-Specific Lockout/Tagout procedures

Each machine will have a specific procedure defining energy sources, lockout points, and procedures for shut down and start up. including isolation, blocking, verification of zero energy state, and securement of machines.

This procedure will be located next to each machine.

The procedure is to be followed at all times. If a change is needed, management must be notified before lockout/tagout operations may take place.

The machine-specific lockout/tagout program will follow the template in Appendix II.

Multi-Person Lockout

When servicing and/or maintenance is performed by more than one person, each authorized employee shall place his own lock or tag on the energy isolating source.

This shall be done by utilizing a multiple lock hasp clamp if the equipment is capable of being locked out.

If the equipment lockout points cannot be locked, then each authorized employee must place his tag on the equipment.

If needed, a multi-person lock box can be used when it is not feasible for each individual person to attach locks to energy isolating device. In this case, each person will apply their personal locks to the outside of a lockout box that contains the key(s) to the lock(s) applied to the actual isolation devices for each energy source.

Removal of an Authorized Employee’s Lockout/Tagout by the Company

Under specific and certain circumstances, a lock may be removed by a supervisor if the employee is not available to remove his or her own lock.

Possible situations where this would be acceptable include:

Employee is physically unable to remove lock due to illness or injury

Employee is no longer employed by the company

Employee is on an extended time away from work and not able to return

If a supervisor removes a lock, the following must be done prior to removal:

Verification by employer that the authorized employee who applied the device is not in the facility.

Make reasonable efforts to advise the employee that his/her device has been removed. (This can be done when he/she returns to the facility.)

Ensure that the authorized employee has this knowledge before he/she resumes work at the facility.

Shift or Personnel Changes

Continuity of lockout or tagout protection must be maintained at all times.

Employee coming onto shift must apply locks/tags before the employee leaving shift may remove locks/tags.

If continuity cannot be kept, the machine must go through full shutdown procedures by the incoming employee.

Procedures for Outside Personnel/Contractors

Outside personnel/contractors shall be advised that the company enforces the use of lockout/tagout procedures.

They will be informed of the lockout/tagout situations just as internal affected employees are notified.

They will be notified about the prohibition of attempts to restart or re-energize machines or equipment that are locked out or tagged out.

The company will obtain information from the outside personnel/contractor about their lockout/tagout procedures and advise affected employees of this information.

The outside personnel/contractor are required to sign a certification form agreeing to follow all safety procedures including lockout/tagout while working at the facility.

Training & Communication

Each authorized employee who will be utilizing the lockout/tagout procedure will be trained in the recognition of applicable hazardous energy sources, type and magnitude of energy available in the work place, and the methods and means necessary for energy isolation and control.

Each affected employee (all employees other than authorized employees utilizing the lockout/tagout procedure) shall be instructed in the purpose and use of the lockout/tagout procedure, and the prohibition of attempts to restart or re-energize machines or equipment that are locked out or tagged out.

Training will be certified using the Authorized Personnel and Affected Personnel forms provided at the end of this document. The certifications will be retained and stored in the <RecordsLocation>.

Retraining will take place with change in job assignment, change in machinery or equipment, change in energy control procedures, or after the occurrence of a lockout/tagout procedure violation.

Periodic Inspection & Audits

A periodic inspection, at least annually, will be conducted for each authorized employee under the lockout/tagout procedure. This inspection shall be performed by the <Inspector>. If the <Inspector> is also using the energy control procedure being inspected, then the inspection shall be performed by another party.

The inspection will include a review between the inspector and each authorized employee of that employee's responsibilities under the energy control procedure. The inspection will also consist of a physical inspection of the authorized employee while performing work under the procedures.

The <Inspector> shall certify in writing that the inspection has been performed. The written certification (attached at the end of this document) shall be retained in the <RecordsLocation>.

Machine-specific energy control procedures will be audited by <Auditor> and updated after any changes to the machinery and buildings power systems including any and all energy sources.

Appendix I – List of Authorized Personnel

Employee Name	Position
<EmployeeName1>	<Position1>
<EmployeeName2>	<Position2>
<EmployeeName3>	<Position3>
<EmployeeName4>	<Position4>
<EmployeeName5>	<Position5>
<EmployeeName6>	<Position6>
<EmployeeName7>	<Position7>
<EmployeeName8>	<Position8>
<EmployeeName9>	<Position9>
<EmployeeName10>	<Position10>

Appendix II – Machine-Specific Energy Control Procedures

Equipment Name:
Location in Facility:
Supervisor of Affected Employees:

Energy	Disconnect Location Description	Photo of Disconnect Location
Electrical:
Air:
Steam:
Hydraulic:
Gravity:
Other:

Identify lockout/tagout devices to be used:

Shut Down

Description of the shutdown procedures:

Isolation

Procedures for isolation of equipment from all power sources:

Lockout/Tagout Device Application

Procedure for locking out or tagging out equipment:

Release of Stored Energy

Procedures for the release of stored energy (where applicable):

Verification of Isolation

Procedures to ensure that equipment is isolated from all power sources:

Start-Up

Description of the start-up procedures:

Certificate of Training – Authorized Personnel

I certify that I received training as an Authorized Employee under <CompanyName>’s Energy Control Lockout/Tagout program. I further certify that I understand the procedures and will abide by those procedures.

Authorized Employee Name:
Employee Signature:
Date:

Certificate of Training – Affected Personnel

I certify that I received training as an Affected Employee under <CompanyName>’s Energy Control Lockout/Tagout program. I further certify and understand that I am prohibited from attempting to restart or re-energize machines or equipment that are locked out or tagged out.

Affected Employee Name:
Employee Signature:
Date:

Lockout/Tagout Inspection Certification

I certify that Enter Equipment Name was inspected on this date utilizing lockout/tagout procedures.

The inspection was performed while working on Enter Equipment Name.

Authorized Employee Name:
Employee Signature:
Inspector Name:
Inspector Signature:
Date:

Employee Acknowledgement

I have received information on <CompanyName>’s Energy Control Lockout/Tagout Program. By signing below, I agree to abide by the procedures in this document and bring to the attention of my supervisor any questions or concerns had.

Employee Name:
Employee Signature:
Date:

icwgroup.com ICW Group is the marketing name for ICW Group Holdings, Inc. For a list of all ICW Group Holdings, Inc. subsidiaries, please visit our website www.icwgroup.com.
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