LOCKOUT/TAGOUT LOCK REMOVAL FORM - Ruan
LOCKOUT/TAGOUT LOCK REMOVAL FORMWhen an authorized employee who applied a lock or tag device is not available to remove the lock or tag, then this lock removal procedure shall be used. The supervisor, acting supervisor/leadman, maintenance manager or safety manager will apply the following procedure: Verify that the authorized employee who applied the device is not at the facility; Make all reasonable efforts to contact the authorized employee to inform he/she that his/her lockout or tag out device has been removed; Call home, cell phone, leave message.Ensure that the authorized employee has this knowledge before he/she resumes work. This can be accomplished by meeting with the employee prior to that employee beginning work activities upon their earliest return to work. A note attached to their time card is also warranted as an additional safety precaution; telephone or personal plete a lock removal form and submit to the safety manager upon completion of this form.Owner of Lock :___________________________________________________________(print)Person attempting to contact Owner of Lock/Tag___________________________(Print/Sign)Equipment Locked Out:__________________________ Dept:_________________________ Date of Removal: ________________________________ Time: _________________________Steps taken to contact Owner of Lock/Tag: __________________________________________________________________________________________________________________________________________________________________________Reason for removing Lock or tag:__________________________________________________________________________________ ................
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