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Berkeley Lab

Forms

FormsShock Warning 03Electrical Injury Report Form

This information sheet and checklist is provided to assist medical personnel in determining the potential severity of an ELECTRICAL INJURY (electrical shock, arc flash or arc blast).

Electrical Injury Report Form

Red Lock Keyed Alike

LOTO Procedure Template

A LOTO procedure is a formal document detailing all the steps required to establish the lockout. It is specific both to the equipment or system and to the scope of work. A LOTO procedure is required for all complex LOTOs.

View the complete process HERE.

LOTO Procedure Templatebolt cutters

Absent Person LOTO Lock Removal Form

Pub-3000, Chapter 18, Work Process O addresses Special Condition LOTO Lock Removal.

View the complete process and requirements HERE.

Absent Person Removal of LOTO Devices Form