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Electrical Isolation Record (Five Safety Rules)

For work on de-energised electrical installations: the five safety rules signed in order, the permission to start work, restoration and closeout. Written for German and Swiss rules.

Page 1 · Record, parts A to E
Page 2 · Five safety rules, permission to start, restoration and closeout
Page 3 · Isolation points, earths and covers, persons
Page 4 · Guidance

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What's in the template

Three working pages to keep at the work location and one guidance sheet.

  • A Record details and validity
  • B Installation, circuit and work
  • C Working method: de-energised, with a box that notes any separate live-work procedure
  • D Supplies and hazards, including back-feed and stored energy
  • E Persons and roles: person in control of the installation, person in charge of the work
  • F The five safety rules, each signed with initials and time
  • G Permission to start work
  • H Interruptions and changes
  • I End of work and restoration, in order
  • J Closeout

Page 3 lists the isolation points with their locks, the earthing devices and covers, and everyone working under the isolation with a personal padlock. The guidance sheet explains the steps, why work under voltage is the exception, the two roles and, for each requirement, the German and the Swiss rule side by side; where a country has no rule of its own, the sheet says so.

When do you need it?

Work on electrical installations is done de-energised: disconnect completely, secure against reconnection, verify absence of voltage, earth and short-circuit, protect against adjacent live parts. The record shows what was isolated, in which order and by whom, and who gave the permission to start. Work under voltage is not covered: it needs its own written, justified procedure.

Rules it follows

Germany

  • DGUV Vorschrift 3, Elektrische Anlagen und Betriebsmittel, §3 and §5 to §8
  • DIN VDE 0105-100, operation of electrical installations (the five safety rules and the two roles)
  • DGUV Regel 103-011, work under voltage (the separate procedure)
  • DGUV Information 209-015, maintenance of machines and installations (a personal padlock per person)
  • Occupational Safety and Health Act (ArbSchG), §5 and §8
  • BetrSichV §10 and §12 and TRBS 1112 for maintenance work

Switzerland

  • Low-Voltage Installation Ordinance (NIV), Art. 22
  • Ordinance on Heavy-Current Installations (Starkstromverordnung), Art. 11, 12 and 67 to 79
  • ESTI directive 407 (version 0526)
  • Ordinance on the Prevention of Accidents and Occupational Diseases (VUV), Art. 3, 6 and 9
  • SN EN 50110-1, operation of electrical installations (interruptions of the work)
  • Suva 84042, 84040 and 88813 (vital rules for electricity and for maintenance)

DGUV Vorschrift 3, the NIV, the Starkstromverordnung and ESTI directive 407 checked against the current editions on 15 October 2026.

Before you use it

This template is a guide only. Please adapt it to your site's internal rules and check that it is up to date with the regulations that apply to you. The Lock Box accepts no liability for its use.

Free download

Electrical Isolation Record (Five Safety Rules)

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