Scope of Work:Reset/Switch Tripped Circuit Breaker
General Information
Work Order
331111
Building
77
Person in Charge
Chris Nelson
Lead / Supervisor
Secheck, Stephen
Logged Email
cnelson@lbl.gov
Division
Facilities
Work Planning
Modes of Work
☑ Mode 0 - Electrically Safe Work Condition
QEW Level
QEW 2
Second Person Requirement
Standby Person
Second Person Identified
Armand Uribe
Other Participants
Armand Uribe
Affected Persons Notified
Yes
System / Equipment
Switching
Non-Hazardous Switching
Panel / Equipment ID
85F
System Information Review
☑ Arc Flash Labels
Control of Hazardous Energy
Exclusive Control of Plug
Equipment Condition
☑ Properly installed ☑ Properly maintained ☑ All doors and covers closed and fully latched ☑ 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
Fill out JSP Use proper PPE Switch breaker check voltage at receptacle
Control of Work Area
Minimum Approach Boundary
42 inches
Barricade Tape / Attendant
Attendant
Shock Risk Assessment
System Voltage
No Shock Hazard Present
Limited Approach Boundary
42 inches
Restricted Approach Boundary
12 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
4.58 cal/cm2 cal/cm2
Arc Flash Boundary
42 inches
Working Distance
18 inches
Arc Flash PPE Level
1
Incident Energy Reduction Measures
0
Capacitor Hazards
Capacitor Bus Voltage
NA
Capacitor Total Stored Energy (Joules)
NA
Discharge Wait Time (Minutes)
NA
Emergency Response Plan
Nearest Landline Location
In the office on other end of the room
Emergency Number to Call
911
Sufficient Cell Phone Signal
Yes
Clear Exit Path
Yes
AED Location
Main Entrance to building
Fire Extinguisher Location
In this room
Contact Release Method Available and Tested
Voltage gloves
Environmental Conditions
Does the environment present additional hazards that should be addressed?
Be aware of surroundings lots of parts and carts in the area of panel
Error Precursors
Task Demands
Work Environment
Individual Capabilities
Human Nature
Stress (limits attention)
Error Precursor Mitigations
Be alert and aware at all times
PPE Inspections
☑ Safety glasses (ANSI Z87) ☑ Arc-rated clothing (flash suit ☑ daily wear) including face shield ☑ balaclava ☑ hood. ☑ Rubber insulating gloves and leather protectors ☑ Non-melting footwear that fully covers the feet
Notes / Other
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:
Detailed Scope of Work
Shock and arc flash hazards for each task
Controls to mitigate the hazards (procedures, precautions, energy source controls, PPE requirements)
Work area controls (barricades, signs, attendants)
