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Cook Inlet Offshore
Nikiski Onshore
Anchorage
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🔒 OSHA 29 CFR 1910.147
Energy Isolation / LOTO Permit
Lockout/Tagout - Control of Hazardous Energy
⚠️
WARNING:
Equipment must NOT be operated until ALL locks and tags are removed by authorized personnel.
📝 New Permit
✅ Close Out Permit
📋
Permit Information
District / Base
*
Select District / Base...
Allegra Leigh (formerly Julius R)
Spartan 151 jack-up
Other
Date
*
Start Time
*
Expected End Time
*
Equipment/System
*
Equipment ID/Tag Number
Work Location
Work Description
*
👥
Personnel
Authorized Employee
*
Affected Employees
⚡
Energy Isolation Points
Isolation Point #1
Energy Type
*
Select...
Electrical
Mechanical
Hydraulic
Pneumatic
Chemical
Thermal
Gravity/Potential
Stored/Residual
Multiple Sources
Isolation Point Location
*
Isolation Method
*
Select...
Circuit Breaker
Disconnect Switch
Valve (Ball/Gate/Butterfly)
Blind/Blank Flange
Double Block & Bleed
Line Break
Removal of Fuses
Physical Blocking
Other
Lock Number
*
Isolation Point #2 (if applicable)
Energy Type
Select...
Electrical
Mechanical
Hydraulic
Pneumatic
Chemical
Thermal
Gravity/Potential
Stored/Residual
Multiple Sources
Isolation Point Location
Isolation Method
Select...
Circuit Breaker
Disconnect Switch
Valve (Ball/Gate/Butterfly)
Blind/Blank Flange
Double Block & Bleed
Line Break
Removal of Fuses
Physical Blocking
Other
Lock Number
Isolation Point #3 (if applicable)
Energy Type
Select...
Electrical
Mechanical
Hydraulic
Pneumatic
Chemical
Thermal
Gravity/Potential
Stored/Residual
Multiple Sources
Isolation Point Location
Isolation Method
Select...
Circuit Breaker
Disconnect Switch
Valve (Ball/Gate/Butterfly)
Blind/Blank Flange
Double Block & Bleed
Line Break
Removal of Fuses
Physical Blocking
Other
Lock Number
Additional Energy Sources / Notes
✅
Zero Energy Verification
Zero Energy State Verified?
*
Select...
Yes
No
Verification Method
*
Select...
Try Start
Voltage Test
Pressure Gauge Check
Visual Inspection
Bleeding/Venting
Multiple Methods
Verified By
*
Verification Time
*
Try Start Performed?
--
Yes
No
N/A
All Locks Applied?
--
Yes
No
Tags Applied?
--
Yes
No
Affected Personnel Notified?
--
Yes
No
N/A
✍️
Authorization Signatures
Authorized Employee Signature
*
Supervisor Signature
*
🔒 Issue LOTO Permit
AnthroSafe™ Field Driven Safety
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