Time / Date: 10/21/2022 9:53:23
JSP ID: 127
Scope of Work: Create slack in CT wiring in panels 693A1A and 693A3A to make terminations at Trendpoint cabinets
Work Order: NA
Building:
Person in Charge: Ernie Jew
Lead / Supervisor: Other
Logged Email: ejew@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: Jeff Grounds
List Other Participants: Eric Lucas as attendant so nobody crosses LOTO work zone
Affected Persons Notified: Yes
Switching: Hazardous Switching
Panel / Equipment ID: Sub 693A, 693A1A, 693A3A
System Information Review: Single Line Drawing, Panel Schedules, Arc Flash Labels
Control of Hazardous Energy: Simple LOTO
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.

Set up orange Warning tape and signage Perform job briefing Notify Operations of power shut down Open disconnects at Perlmutter computer cabinets and CDU Open breakers at Substation 693A for panels 693A1A and 693A3A Wear proper PPE and open panel covers at 693A1A and 693A3A Perform ZVV at panels 693A1A and 693A3A Create slack in CT wiring to reach terminations in Trendpoint cabinets Close up panel covers at 693A1A and 693A3A Notify Operations that power will be restored Close breakers at Substation 693A Close disconnects at Perlmutter computer cabinets and CDU Remove orange Warning tape and signage Review job performance with Group

Control of Work Area

Minimum Approach Boundary: 42"
Barricade Tape / Attendant: Warning

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: 0
Will any other part of the body enter the RAB: No

Arc Flash Risk Assessment

Incident Energy: 2.7 cal/cm2
Arc Flash Boundary: 40"
Working Distance: 24 inches
Arc Flash PPE Level: 2
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: Control Room
Emergency Number to Call: 911
Sufficient cell phone signal? Yes
Clear exit path? Yes
AED Location: 3rd floor near Men's restroom
Fire Extinguisher Location: Next to panel 693A3A
Contact release method available and tested: Rescue hook

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:

NA

PPE Inspections

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