SUGGESTED ELEMENTS OF A LOCK OUT PROCEDURE

It is the policy of ______________ to maintain and enforce a written Lock
Out Procedure.  This procedure is to be applied at any time when
unexpected motion or electrical or other energy release may cause injury.

PURPOSE 
The purpose of this procedure is to protect all employees from unintended release of energy or unintended machine motion which could result in injury when they set up, adjust, repair, service, install, or perform maintenance work on equipment, machinery or processes. This procedure and its’ enforcement are mandated by Federal and State law.
EMPLOYEE AND MANAGEMENT RESPONSIBILITY
1) Each supervisor is to train new employees and periodically update current employees as to the requirements of this procedure is to document said training. 
2) Each employee will be provided with an individually keyed lock  which will be their responsible to maintain. 
3) Managers, Foremen and Maintenance Department Supervisor are responsible for the enforcement of this policy including the use of appropriate disciplinary action.

4) The                                  is to be notified of any failure to comply with any safety rule. 

5) It is the responsibility of all plant employees to consult with their supervisor or the___________________ when ever they have questions regarding their protection or this policy . 
UTILIZATION PROCEDURE
1) The power source of any equipment or machine shall be locked out before it is adjusted, setup, repaired, serviced, installed, etc. if unintended motion or release of energy could cause personal injury.  Other sources of energy such as hydraulic, air pressure, etc. should be evaluated for the potential of personal injury the person doing the repair, etc. as above.  Such energy sources shall then be relieved.

2) Each person who is making the repairs, etc shall apply personal safety locks.

3) The employee shall retain one key for every lock, the other key will be retained by the __________________. 

4) Power is to be turned off at the main control only after the control at the point of operation is turned off. 
5) If a machine connected by plug to a 110 Volt power supply a “Do Not Start” tag shall be afixed either at the 110 Volt plug or conspicuously near the start switch.

6)  A machine connected to a power source greater than 110 Volts shall have the plug locked in an isolating device and a “DoNot Start” tag shall be applied.

7) Repair to a press or mold in a press shall not begin until the press motors (hydraulic pumps) are turned off and the press is locked out.

8) Before a granulator is cleaned the power shall be disconnected from the power source and an isolating device installed and physically locked.