Time / Date: 6/15/2023 13:39:42
JSP ID: 1159
Scope of Work: Disconnection and removal of rack P20 and panel PJ10, moving racks P21 and P22
Work Order:
Building: B88
Person in Charge: Ken Lambert
Lead / Supervisor: Other
Logged Email: klambert@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: Erik Line
List Other Participants: Mechanical tech (to be assigned at time of work), riggers (to be assigned at time of work)
Affected Persons Notified: Yes
Switching: Hazardous Switching
Panel / Equipment ID: P20, P21, P22, and PJ10
System Information Review: Single Line Drawing, Panel Schedules, Arc Flash Labels
Control of Hazardous Energy: Simple LOTO
Equipment Condition: Properly installed, No signs of impending failure, Not energizing equipment for the first time, or after electrical repair

Sequence of Job Steps

List basic sequence of steps from start to finish.

LOTO each rack and panel. Disconnect power and signal cabling from each rack and panel. Remove rack P20, move racks P21 and P22 to new locations in cave 2. Move panel PJ10 to new location in cave 3. Reconnect cabling and power to racks P21 and P22. Remove LOTO for P21, P22, and PJ10. Restore power to P21 and P22 and check operation. Leave PJ10 de-energized.

Control of Work Area

Minimum Approach Boundary: 42
Barricade Tape / Attendant: Attendant

Shock Risk Assessment

System Voltage: 120 Vac
Limited Approach Boundary: 42 inches
Restricted Approach Boundary: 12 inches
Will the hands enter the RAB: Yes
Voltage Glove Class: 00
Will any other part of the body enter the RAB: No

Arc Flash Risk Assessment

Incident Energy: 17.4 cal/cm2
Arc Flash Boundary: 79 in.
Working Distance: 18 inches
Arc Flash PPE Level: 3
Incident Energy Reduction Measures: 00

Capacitor Hazards

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

Emergency Response Plan

Nearest Landline Location: cave 2
Emergency Number to Call: 911
Sufficient cell phone signal? Yes
Clear exit path? Yes
AED Location: Front of B88
Fire Extinguisher Location: Atrium
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:

None

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,
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