Plant Shutdown Checklist Form
Complete this Plant Shutdown Checklist Form to log and verify each step of the plant shutdown process. Ensure all required fields are filled to confirm shutdown preparation, isolation, verification, and completion.
Plant/Location Name
*
Date of Shutdown
*
-
Month
-
Day
Year
Date
Time of Shutdown
*
Hour Minutes
AM
PM
AM/PM Option
Shutdown Supervisor Name
*
First Name
Last Name
Shutdown Preparation Steps Completed
*
Equipment powered down
Warning signs posted
Area cleared of personnel
Other
Isolation Methods Applied
*
Electrical isolation
Mechanical lockout
Valve closure
Other
Isolation Verification Performed
*
Yes
No
Shutdown Completion Confirmed
*
Yes
No
Additional Comments or Observations
Shutdown Supervisor Signature
*
Submit Checklist
Submit Checklist
Should be Empty: