QEW 1 / 2 / 3 Job Safety Plan

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Time / Date: 6/29/2023 10:45:10

JSP ID: 1192

Scope of Work: Disconnect rental generator, Restore the house generator back to normal conditions

General Information

Work Order

w0326110

Building

84B

Person in Charge

Ben Cameron

Lead / Supervisor

Cameron, Benjamin

Logged Email

bccameron@lbl.gov

Division

Facilities

Work Planning

Modes of Work

☑ Mode 1 - LOTO & Zero Voltage Verification

QEW Level

QEW 2

Second Person Requirement

Standby Person

Second Person Identified

Avery Turner

Other Participants

Affected Persons Notified

N/A

System / Equipment

Switching

No Switching Required

Panel / Equipment ID

EG-99-84B

System Information Review

☑ Single Line Drawing
☑ Panel Schedules
☑ Arc Flash Labels

Control of Hazardous Energy

Complex LOTO w/ RI

Equipment Condition

☑ Properly installed
☑ 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

Establish LOTO, disconnect cables, Re-configure all systems

Control of Work Area

Minimum Approach Boundary

92"

Barricade Tape / Attendant

Attendant

Shock Risk Assessment

System Voltage

277/480 V ac

Limited Approach Boundary

42 inches

Restricted Approach Boundary

12 inches

Will the hands enter the RAB

Yes

Voltage Glove Class

Will any other part of the body enter the RAB

Arc Flash Risk Assessment

Incident Energy

16.3 cal cal/cm2

Arc Flash Boundary

92"

Working Distance

18 inches

Arc Flash PPE Level

Incident Energy Reduction Measures

Capacitor Hazards

Capacitor Bus Voltage

Capacitor Total Stored Energy (Joules)

Discharge Wait Time (Minutes)

Emergency Response Plan

Nearest Landline Location

Building 84

Emergency Number to Call

911

Sufficient Cell Phone Signal

Yes

Clear Exit Path

Yes

AED Location

In Truck

Fire Extinguisher Location

In the generator room

Contact Release Method Available and Tested

Upstream breaker or switch, 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
☑ Removal of conductive articles
☑ Insulated tools
☑ Multimeter and other electrical test instruments

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)
Emergency Response Plan