CSEA Energy Control (Lockout/Tagout) Program Evaluation Form

Transcription

1 CSEA Energy Control (Lockout/Tagout) Program Evaluation Form Employer Name: Work Location: _ Evaluation Date: Energy Control Program Evaluation Questions YES NO N/A 1. Do members perform servicing or maintenance on equipment that could unexpectedly start and cause injury (note: this does not apply to cord and plug equipment)? (if yes, list the equipment, if no got to 2) a. 2. Do contractors perform servicing or maintenance on equipment that could start unexpectedly and cause injury (note: this does not apply to cord and plug equipment)? (if yes, list the equipment and answer question 30, if not mark it N/A) a. 3. Has the employer developed and implemented a written Energy control program that consists of: a. energy control procedures? worker training? periodic inspections? 4. Does the program state that it applies to all energy sources including: electrical, mechanical (spring), hydraulic, pneumatic, chemical, thermal, radiation, gravitational, et 5. Does the program require the use of lockout procedures where equipment is designed to accept a lock? 1

2 6. Does the program require the installation of new equipment to be designed to accept lockout devices? 7. Does the program allow for the use of tagout procedures only if: a. equipment is present that cannot be locked? the employer has demonstrated that a tagout system provides full worker protection? (if yes answer questions 8, 11e, 11h, 13d, 17 and 24c, if not mark this question and those N/A) 8. When using tagout, does the program require: a. tags be placed at the same location that locks would be if used? that additional safety measures are used like the removal of cut off switch fuses or valve handles? 9. Does the program require lockout/tagout (LO/TO) devices: a. be provided by the employer? only allowed to be used for energy control procedures? able to survive the environments where they are used? be standardized by color, shape or size? e. have an standard warning statement, for tags? f. identify the authorized employee that applied them? g. be only to forcibly removed by the use of a tool? h. held with a 50 pound nylon cable tie or equivalent, for tags? 10. If the program has a procedure for the emergency removal of a lockout/tagout device, does the procedure require: a. verification the worker who applied the device is not present? attempts to contact the worker to tell them the device has been removed? a means to notify the worker that their device has been removed before they return to the work place? all authorized employees are trained on the procedure. 11. If the program has group energy control procedures, does it: a. provide the same level of protection as the personal lockout/ tagout procedures? follows the same steps as the standard energy control procedures with the group steps added? give responsibility to a lead authorized employee to complete the energy control procedure and coordinate the involved work group(s) to assure the continuity of protection? have each authorized employee apply their lock to the group lockout device when they start work, and immediately remove it when they stop working on the equipment. e. have specific steps for shift changes to assure the continuity of protection and orderly transfer of lockout/tagout devices? e. f. g. h. e. 2

3 12. For contractors that perform servicing work requiring energy control does the program require: a. the contractor and employer exchange their written Energy Control Programs and procedures? workers be informed of the contractors program requirements? 13. Has the employer made written, equipment specific, energy control procedures (ESECPs) for all equipment, except those with: a. no potential to store or re-accumulate energy? a single energy source that can be easily identified and controlled? a single energy source that completely deenergizes it? their energy source controlled when they are serviced? e. their energy controlled by the application of one lockout device? f. the lockout device under the direct control of the person performing the work? g. servicing or maintenance that does not create a hazard for any other workers? h. not had any incidents in the use of this exception? 14. Do the ESECPs have: a. a statement of their intended use? procedures for shutting down and isolating the equipment to control all energy sources? procedures for the placement, transfer and removal of lockout/ tagout devices and the responsibility for them? requirements to test the equipment using the operating controls to verify the equipment s energy is controlled? 15. Do the ESECPs require: a. the authorized workers doing the work each apply their own lockout/tagout device to each energy control device? all affected employees are notified before the energy control devices are applied and when they are removed? 16. Do the ESECPs have detailed steps for application of the energy control devices, in this order: a. Authorized workers know the location, type, magnitude and location of each energy source? The equipment is shut down using the standard operating procedures established by the manufacturer? Energy isolating devices that hold the device in the off or disconnected position are applied to every energy source to isolate them from the equipment? e. f. g. h. 3

4 17. Do the ESECPs have steps for energy control application, in this order: a. Energy control devices are placed on every energy isolation device? Lockout devices are placed to prevent movement from the off position? Tagout devices are placed to indicate movement from the on to the off position, are placed where locks would be, or as close to the energy isolating device as possible? 18. Do the ESECPs have these steps for releasing or controlling stored energy, where applicable? a. After the application of the LO/TO devices there are steps for release or control of any stored energy sources like, electrical, gravitational, mechanical (spring), etc? Where stored energy could re-accumulate to a hazardous level, procedures are given for the monitoring and continued safe release of that energy? 19. Do the ESECPs verify isolation by trying to start it using the operational controls after the energy isolation is complete? 20. Do the ESECPs have steps for the repositioning or testing equipment, in this order: a. The equipment is inspected to assure all foreign items have been removed and it is ready to operate? The work area is checked to assure all authorized and affected workers are safely positioned? Removal of the LO/TO and energy control devices by the workers that placed them using steps the steps in item 21? Operate the equipment to allow the testing or repositioning? e. Repeat steps in questions to reapply energy control? e. 21. Do the ESECPs contain the following steps for release of the equipment from lockout/tagout, in this order: a. The equipment is inspected to assure all items have been removed and it is ready to operate? The work area is checked to assure all authorized and affected workers are safely positioned? After the lockout/tagout, and energy control devices are removed, by the workers that placed them, and before the equipment is energized, the affected workers are notified the equipment is being released from energy control? The control of the equipment is released to the affected workers? 4

5 22. Where contractors perform energy control procedures, does the Energy Control Program require: a. the contractor and employer to exchange written Energy Control Programs and procedures? workers be informed of the contractors program requirements? 23. Are periodic inspections required annually by the Energy Control Program? 24. Do the periodic inspections include: a. inspection performed by an authorized employee other than those performing the energy control procedure? correction of any deficiencies observed? review of each workers responsibilities for lockout? review of the limited protections provided by tagout described in question 28, if used? e. documentation in writing including the machine being serviced, the date of the inspection, the workers performing the procedure and the worker performing the inspection? 25. Is initial training provided so each authorized employee understands the: a. purpose of the Energy Control Plan? function of the Energy Control Plan? 26. Is the training designed to assure each authorized employee can demonstrate the: a. knowledge to perform the ESECPs? skills needed to properly perform the ESECPs? 27. Does the training include a review of the: a. employer s written Energy Control Plan? types and magnitudes of the energy sources in the work place? methods and means used to control the energy sources? the purpose and use of the written energy control procedures? 28. Where tags are used does the training include a review that: a. tags are warning devices and do not provide the physical protection of a lock? tags may only be removed by the worker that applied them? tags must be legible and understandable? tags and their attaching means must be able to withstand the environment? e. tags may give a false sense of security and be understood as part of the overall program? f. tags must be securely fastened to the energy isolating device so they cannot be inadvertently remove e. e. f. 5

6 29. Is retraining provided when: a. there is a new energy type introduced to the work place? there is a change to the energy control procedures? a periodic inspection shows the procedures are not being performed properly? the employer has reason to believe workers have not retained the knowledge and skills from previous training? 19. Does the retraining have a method included for authorized employees to show their proficiency in performing the energy control procedures? 20. Is training provided for all affected workers that explain the energy control procedures and prohibiting tampering with equipment that has been locked or tagged out? 21. Is all training documented to show, the date of the training and the names of the participants? 6