Time / Date: 5/23/2023 7:15:16
JSP ID: 1076
Scope of Work: Reconfigure panel 585A6A
Work Order: 318232
Building:
Person in Charge: E Combs/ J Keusch
Lead / Supervisor: Keusch, Justen
Logged Email: ccryken@lbl.gov
Division: Facilities
QEW Level: QEW 2
Modes of Work: Mode 0 - Electrically Safe Work Condition, Mode 1 - LOTO & Zero Voltage Verification
Second Person Requirement: Standby Person
Second Person Identified: David davis
List Other Participants:
Affected Persons Notified: Yes
Switching: Non-Hazardous Switching
Panel / Equipment ID: 585A Bld 15 first floor
System Information Review: Panel Schedules
Control of Hazardous Energy: Simple LOTO
Equipment Condition: Properly installed

Sequence of Job Steps

List basic sequence of steps from start to finish.

LOTO, ZVV at panel 585A6A, remove unneeded breakers and conductors, pull in new conductors, install new breakers, make up panel, megger conductors with inspector, torque modified hardware in panel, receive approval from AHJ, close panel, bel check work area for missed items, inquire about readiness of re energization, re energize, check voltage, provide feedback

Control of Work Area

Minimum Approach Boundary: 120 inches
Barricade Tape / Attendant: Danger - Red, Attendant

Shock Risk Assessment

System Voltage: 120/208 V ac
Limited Approach Boundary: 100 inches
Restricted Approach Boundary: 3 feet, 6 inches
Will the hands enter the RAB: Yes
Voltage Glove Class: 0
Will any other part of the body enter the RAB: No

Arc Flash Risk Assessment

Incident Energy: 26.2 cal/cm2
Arc Flash Boundary: 99 inches
Working Distance: 18 inches
Arc Flash PPE Level: 4
Incident Energy Reduction Measures: 0

Capacitor Hazards

Capacitor Bus Voltage:
Capacitor total stored energy (joules):
Discharge wait time (minutes):

Emergency Response Plan

Nearest Landline Location: Outside main E room 1st floor bld 15
Emergency Number to Call: 911
Sufficient cell phone signal? Yes
Clear exit path? Yes
AED Location: Bld15 lobby
Fire Extinguisher Location: Bld 15 lobby
Contact release method available and tested: Voltage gloves

Environmental Conditions

Does the environment present additional hazards that should be addressed?

None

Error Precursors

Task Demands:
Work Environment:
Individual Capabilities:
Human Nature:
Error Precursor Mitigations:

Work interruptions due to heavy traffic typically in area work is to be done

PPE Inspections

Safety glasses (ANSI Z87),
Arc-rated clothing (flash suit,
daily wear) including face shield,
balaclava,
hood.,
Hearing protection,
Rubber insulating gloves and leather protectors,
Non-melting footwear that fully covers the feet,
Removal of conductive articles,
Insulated tools,
Multimeter and other electrical test instruments

Notes / Other

Perform Job Breifing

PIC Conducts the Job Briefing. Cover all the contents of the Job Safety Plan.

A Job Briefing at a minimum must include:
  1. Detailed Scope of Work
  2. Shock and arc flash hazards for each task
  3. Controls to mitigate the hazards (procedures, precautions, energy source controls, PPE requirements)
  4. Work area controls (barricades, signs, attendants)
  5. Emergency Response Plan

Rev 2023.08.22.1
Form Content and Feedback Contact: Michael Rose -- mvr@lbl.gov