Logo

QEW 1 / 2 / 3 Job Safety Plan

Electrical Safety
Back to Index
Time / Date: 5/25/2023 8:54:53
JSP ID: 1095
Scope of Work: Switch for Panel 753A17A

General Information

Work Order
W0296212
Building
B077
Person in Charge
Pica
Lead / Supervisor
Cameron, Benjamin
Logged Email
josephpica@lbl.gov
Division
Facilities

Work Planning

Modes of Work
☑ Mode 2 - Energized Diagnostics
☑ Testing and Troubleshooting
☑ Visual Inspection
QEW Level
QEW 2
Second Person Requirement
Standby Person
Second Person Identified
Ben Cameron
Other Participants
Taft
Affected Persons Notified
Yes

System / Equipment

Switching
Non-Hazardous Switching
Panel / Equipment ID
77-PNL-090 / Panel 753A
System Information Review
☑ Panel Schedules
☑ Arc Flash Labels
☑ Mike Benz MOP Brief
Control of Hazardous Energy
Complex LOTO (requires LP, CLP, FLP)
Equipment Condition
☑ Properly installed
☑ Properly maintained
☑ All doors and covers closed and fully latched
☑ No signs of impending failure

Sequence of Job Steps

List basic sequence of steps from start to finish
Brief LOTO Release and MOP Verify 120/208v reBrief as necessary

Control of Work Area

Minimum Approach Boundary
22”
Barricade Tape / Attendant
Attendant

Shock Risk Assessment

System Voltage
120/208 V ac
Limited Approach Boundary
42 inches
Restricted Approach Boundary
3 inches
Will the hands enter the RAB
No
Voltage Glove Class
0
Will any other part of the body enter the RAB
No

Arc Flash Risk Assessment

Incident Energy
1.7cal cal/cm2
Arc Flash Boundary
22”
Working Distance
18 inches
Arc Flash PPE Level
2
Incident Energy Reduction Measures
0

Capacitor Hazards

Capacitor Bus Voltage
No Cap
Capacitor Total Stored Energy (Joules)
No Cap
Discharge Wait Time (Minutes)
No Cap

Emergency Response Plan

Nearest Landline Location
Adj Office
Emergency Number to Call
911
Sufficient Cell Phone Signal
Yes
Clear Exit Path
Yes
AED Location
Hallway
Fire Extinguisher Location
On Site Mount
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
Brief

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
☑ Multimeter and other electrical test instruments

Notes / Other

Hazardous Energy Control needs NONE Option for Mode 2 work

Perform Job Briefing

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 2026.03.17.1
Form Content and Feedback Contact: Michael Rose -- mvr@lbl.gov