Model Lock Removal Form


Do Not Operate MachineryBENEFITS

Companies have a duty to protect workers both while using equipment and machinery for their intended purpose and when repairing and maintaining that equipment. The primary way of fulfilling that duty is through what’s called “lockout,” which is when a equipment has been turned off and rendered inoperable with the use of a lock. In general, no one should remove someone else’s lock. But there may be times when a supervisor may have to remove a worker’s lock, such as when that worker can’t be located.


Adapt this Model Lock Removal Form for your workplace. Make sure that it’s consistent with your lockout policy and the requirements in your jurisdiction’s OHS law. Require supervisors to complete this form any time they remove a worker’s lock from a piece of machinery or equipment. And ensure that supervisors are properly trained on this procedure.


AB: Guide to Part 15 of the OHS Code 2009

BC: Lockout Booklet; Lockout Safety Talk; Video: Lockout: A guide to safe work practices

MB: Guideline for Safeguarding Machinery and Equipment

NB: Lockout Hazard Alert; Lockout Handout; Lockout Safety Talk; Lockout Checklist

NS: Lock-out: A Guide to Part 6 of the Occupational Safety General Regulations