Model Energy Control Inspection Form

Date First Published on SafetySmart Compliance: February 21st, 2012
Topics: Lockout Tagout | Machine Guarding |


The OSHA LOTO standard requires employers to not only establish energy control procedures—mostly involving lockout or tagout—to ensure that dangerous equipment and machinery remains shut off and doesn’t unexpectedly energize, start up or release stored energy during servicing but to review those procedures periodically. At least once a year, an “authorized employee” not involved in implementing the procedure must inspect the energy control procedure and speak with those who implement it. The inspection must cover all the bases and be properly documented. (Click here to find out how to properly conduct energy control procedures.) This form will allow you to document each inspection properly.


The Model Form can be used to document that you’ve conducted periodic inspections of energy control procedures as required by the OSHA LOTO standard.