Electrically Safe Work Condition - Verification Record

What it is

This form records, at each supply source and each point of work, the steps a crew took to establish an electrically safe work condition under NFPA 70E-2027: every possible supply source identified from current drawings, each source isolated with its load interrupted and disconnect opened, blades seen open or the breaker withdrawn, stored electrical and nonelectrical energy released, blocked or relieved, lock and tag applied under the written procedure, a rated tester proven on a known source before and after use with every required phase-to-phase and phase-to-ground combination read absent, temporary protective grounds applied where induced voltage, stored energy or contact with other energized parts is possible, and a statement by the person who established the condition. One record covers up to four sources and three points of work; equipment with more sources is split across records. The approach and arc flash boundaries for the circuit voltage are shown for information only. The record states what the crew did and observed; it does not decide that the equipment may be worked on, does not replace the employer's electrical safety program, its written lockout procedure or a qualified person's judgment, and is not a legal or regulatory determination.

Why it is performed

The steps that make equipment safe to touch are easy to describe and easy to skip under time pressure, and the one that matters most, the test for absence of voltage, can be defeated by a tester that was never proven, was not rated for the circuit, or was read on the wrong combination of conductors. A record made source by source and point by point forces each step to be stated as done, or as replaced by an allowed alternative with its basis, so a missing source, an unverified tester or a reading that showed voltage cannot disappear into a general signature. Reading the result as complete or incomplete, rather than pass or fail, keeps the record in its place: a crew treats the equipment as energized until every step the standard lists has been satisfied, and the employer's written procedure governs the work. The same record can serve as part of the yearly audit of that procedure.

When it is performed

A record is made each time a crew establishes an electrically safe work condition on equipment, with the lockout type, simple or complex, and the written plan of execution reference for a complex lockout. The test for absence of voltage is repeated under the employer's procedure where circuit conditions change or the point of work is left unattended, and the retest is recorded. Where a task on the way to the condition had to be done energized, such as operating a disconnect or testing for absence of voltage, the exception relied on, its conditions, the permit or exemption and the PPE selection method are recorded. Release from the condition is recorded when the work is complete: grounds, tools, jumpers, shorts and restraints removed, the area inspected, personnel clear, and who removed the locks and tags. The employer audits the lockout procedure at least once a year, and the record notes the last audit date and whether this record served that audit.

How it is typically performed

Job and circuit identification names the site, equipment, work, date, employer, person in charge, crew, the written lockout procedure and revision, the circuit configuration and the nominal system voltage; from the voltage the form shows the limited and restricted approach boundaries of the NFPA 70E-2027 tables and the arc flash boundary from the label or the risk assessment. Step 1 records the drawings used, the sources identified and their count. For each source, steps 2 to 6 are recorded as done, or as not applicable, not possible or none present with the basis entered, and the lock numbers and persons are listed. At each point of work the tester type is chosen: a portable contact tester; a permanently mounted absence-of-voltage tester, which counts only when it is installed as its manufacturer directs at the point of work, listed and labeled for the test, covers phase-to-phase and phase-to-ground, and is proven before and after use; or a noncontact capacitive tester, accepted only on systems over 1000 V and never on a dc two-wire circuit. The tester's identity, its rating for the circuit and its check on a known source before use are recorded, then each combination's indication, absent, present or not applicable with a basis, then the check after use, any additional method such as absence of current, an optional measured value and the retest. Temporary protective grounds are recorded as required with the basis, applied, their locations, whether they are placed to protect each worker and rated, and the set rating against the available fault current. The person who established the condition and the time are entered with the statement that the steps were performed as recorded.

What gets recorded

Job: site, equipment, work description, date, employer, person in charge, crew, written lockout procedure and revision, lockout type, written plan reference, circuit configuration, nominal system voltage and maximum phase-to-ground voltage. Boundaries, information only: lookup voltage, limited and restricted approach boundaries, typed values above the table range, arc flash boundary and its source, risk assessment reference. Sources: drawings used, sources identified and their count; per source its description, the five isolation steps with any basis, lock numbers and persons. Per point of work: location, tester type, make, model and serial, rated for the circuit, checked before, the seven combination indications, basis for not applicable, checked after, the four permanently mounted tester rows, additional method, measured value, retest. Grounds: required or not with basis, applied, locations, placed and rated, set rating, clearing time, available fault current. The person, time and statement. Energized tasks: task, exception, the seven normal-operation conditions, permit or exemption and reference, PPE selection method. Release: work complete, grounds and tools removed, area inspected, personnel clear, who removed locks and tags, time. Audit: last audit date, days since, and whether this record served it. Comments.

How results are evaluated

The record reads complete or incomplete; it is not a pass or fail and not a safety rating. Five groups must each read complete: every possible supply source recorded as identified, with the source count matching the rows filled; every source in use recorded with steps 2 to 6 done, or an allowed alternative with its basis entered; every point of work recorded with a tester rated for the circuit, checked on a known source before and after, and every required combination read absent; grounds recorded as required and applied, placed and rated, or not required with a basis; and the statement recorded by the person who established the condition. A step recorded as not done reads incomplete, and a group left blank keeps the record from reading complete without reading incomplete on its own. A present indication on any combination, required or optional, makes the point and the record incomplete, and an additional method never replaces the voltage test. A noncontact capacitive tester on a system at or below 1000 V, with the voltage blank, or on a dc two-wire circuit reads incomplete, the dc rule being an UltraDb convention stricter than the standard's text. A permanently mounted tester counts only when all four of its rows read yes. Raised as issue lines that never change the result: a complex lockout with no written plan reference, a grounding set rating below the available fault current, and a procedure audit more than 365 days before the record date. The boundaries, the measured voltage value, the retest, the energized task entries, the release and the audit link are recorded only. The condition is not established until NFPA 70E-2027 120.2 to 120.6 are satisfied; this record covers 120.6 and the employer's procedure covers the rest.