Lockout/Tagout Violation Report (Construction)
Reported By
Date of Violation
Time of Violation
Location/Area
Person(s) Involved
Supervisor
Description of Violation
Witnesses
Equipment Involved
Type of Lockout/Tagout Procedure Violated
Immediate Action Taken
Recommendations/Corrective Measures
Reported By (Signature)
Reviewed By (Supervisor)
Date Reviewed