Annual inspection of energy control procedures checklist

Energy control procedures aim to protect employees from unexpected release of stored energy from the machines/equipment during servicing or maintenance. Failing to follow the procedures can lead to fatal injuries. There is a written procedure for energy control for every machine and a few sets of employees are assigned this job. This is an audit of those few employees.

General
Machine
Machine ID
Machine type
Out of service since when
Carried out remedial action
Picture of service engineer's report
Parts that were repaired
Parts that were replaced
When was repair done
Picture of Test run report done after repair
Sign off
Is the item fit for use?
Is further inspection needed?
Comments
Supervisor name
Signature
Date

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