Hazardous Energy & Covered Activities
Standards for identifying electrical, mechanical, hydraulic, pneumatic, chemical, thermal, gravitational, and other energy sources requiring control.

Authorized, Affected & Other Employees
Clear responsibilities for employees who apply energy controls, operate or use affected equipment, or work in areas where procedures are performed.

Equipment-Specific Energy-Control Procedures
Requirements for shutdown, isolation, lock and tag application, stored-energy control, verification, and documented steps for each covered machine or system.

Notification, Group Work & Shift Changes
Procedures for communicating shutdowns, coordinating multiple employees or contractors, transferring responsibility, and maintaining continuous protection. 

Lock and Tag Removal & Return to Service
Standards for inspection, personnel clearance, device removal, notification, reenergization, and exceptional removal by someone other than the installer.

Training, Inspections & Corrective Action
Requirements for employee instruction, retraining, periodic procedure inspections, documentation, equipment review, and response to noncompliance.

Who This Policy Is For

Designed for organizations whose employees service, maintain, inspect, clean, or repair equipment that may release hazardous energy.

A strong fit for small and mid-sized organizations, nonprofits, growing employers, organizations with machinery, powered equipment, maintenance operations, warehouses, utilities, production areas, or contractor activity, and leaders responsible for energy-control procedures, employee training, equipment safety, and regulatory compliance. 

How to Use This Template

Start with a professionally structured framework, then tailor it to your equipment, energy sources, authorized employees, shutdown procedures, and verification practices.

Customize the editable Word template with your organization’s covered equipment and activities, hazardous-energy sources, employee roles, equipment-specific shutdown steps, isolation and verification procedures, group and shift-change practices, device-removal rules, training requirements, periodic inspections, and corrective-action standards. Coordinate it with related workplace-safety, electrical-safety, equipment-maintenance, contractor-safety, incident-reporting, and disciplinary policies; train authorized and affected employees before covered work begins; and review the finalized policy as equipment, processes, facilities, or legal requirements change.