Checklist for Compliance of Positive Isolation Implementation at Site

Site Audit on Positive Isolation on Date:

ITEM Yes No

S No SYSTEM AUDIT- Check List

1 Positive Isolation Display/ Posters
Availability of Locks & P.I tools :-
a)Personal Locks (TISCO Employee & Contractors)
b) Equipment Locks
c) Group Locks
d) Scissor Locks
e) Group Isolation Box
f) Lock/Key storage Box
g) Equipment & Group Identification tags
h) Wire Loops
i) Valve Locking device
2
3Record of locks for TISCO Employees & Contractors
4Documents for Energy Source Identification
5Documents for Isolation Procedure/Method
6Display of Life saving Rules at Site
7P.I inclusion in Job Safety Plan / SWP for shut down activities
8 Records available with List of employees trained & authorized for Level 1, Level 1A &
9 Level
Record2 of Control stop points & Procedure for each
10 Awareness of P.I. system for Employees & Contractor

JOB SITE AUDIT-Check List

11 Whether all Enegy source covered for Isolation
12 Whether Energy source has been positively Isolated in Safe Mode with Locking Device
Whether Concept of Equipment Lock, Group Isolation has been addressed where desired
13
Whether Individulas(Tata Steel Employee) and Supervisor( Contracor Employees) have put their
14 Lock
15 Whether Tags have been put Properly marked
16 Whether SWP/OCP for Isolation Procedure placed in /Gr Isolation/Isolation Box
17 Whether Concept over Use of Positive Isolation Procedure is clear amongst employees

Total Yes=
Total No=
% Compliance= (Yesx100)/Total(17)