Maintenance Shutdown Planning Checklist
Complete this checklist to ensure all critical steps are planned and ready for your upcoming maintenance shutdown.
Site/Facility Name
*
Shutdown Start Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
Shutdown End Date and Time
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Hour Minutes
AM
PM
AM/PM Option
List of Equipment/Systems to be Shut Down
*
Shutdown Coordinator (Full Name)
*
First Name
Last Name
Pre-Shutdown Safety Checks Completed?
*
Lockout/Tagout procedures verified
Permits obtained (hot work, confined space, etc.)
Hazardous materials secured
Emergency equipment available
Are all required spare parts and materials available?
*
Yes
No
Partially
Assigned Personnel and Roles
*
Has the shutdown been communicated to all affected departments?
*
Yes
No
Risk Assessment and Contingency Plans in Place?
*
Yes, all risks assessed and plans ready
Some risks assessed
No risk assessment done
Additional Notes or Special Instructions
Shutdown Plan Approval Signature
*
Submit Checklist
Submit Checklist
Should be Empty: