SYMBOL
ENERGY TYPE
X
MAGNITUDE
SYMBOL
ENERGY TYPE
X
MAGNITUDE
Chemical
Electrical
X
Electrocution
Mechanical
X
Accidental Start up
Hydraulic
X
Engulfment
Thermal
Pneumatic
RF Radiation
Gravitational
Asset Identifiers: 15783 _______________________________ Created by & Date: Rick Davis, 8-17-2021 _______________________________ Revised by & Date:
| Facility: Sunderland Pump Station | Asset Location: Bottom of Pump Station |
Asset Description:
Motor, Sewage Pump #1 | ||
SYMBOL | ENERGY TYPE | X | MAGNITUDE | SYMBOL | ENERGY TYPE | X | MAGNITUDE | |
| Chemical |
| Electrical | X | Electrocution | |||
| Mechanical | X | Accidental Start up |
| Hydraulic | X | Engulfment | |
| Thermal |
| Pneumatic | |||||
| RF Radiation |
| Gravitational | |||||
Check | Lockout Application Process | Check | Lockout Removal Process |
| Notify affected Personnel. |
| Ensure all tools and items have been removed. |
| Properly shut down unit. |
| Confirm all employees are safely located. |
| Isolate all energy sources. |
| Verify controls are in neutral. |
| Apply all lockout devices |
| Remove lockout devices and re-energize the unit. |
| Verify total de-energization of all sources. |
| Notify affected employees servicing is completed. |
# | Energy | Lockout Location | Method | Type of Device |
1 |
| Local Disconnect or MCC | Open disconnect unplug if possible and/or open breaker at MCC | Tree, tag, & lock |
2 |
| Suction Valve | Close Suction Valve | Tag, lock, tree, & cable |
3 |
| Discharge Valve |
Close discharge valve
| Tag, tree, lock, & cable |
4 |
| Seat water | Close seal water valve | Tag |
5 |
| Drain Valve | Open drain valve Bleed off system pressure | N/A |