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Time / Date: 7/19/2023 8:41:12
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JSP ID: 1280
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Scope of Work: Performed scheduled maintenance
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Work Order: 325770
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Building: 62
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Person in Charge: Justin walker
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Lead / Supervisor: Delgado, Alex
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Logged Email: jwwalker@lbl.gov
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Division: Facilities
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QEW Level: QEW 2
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Modes of Work: Mode 0 - Electrically Safe Work Condition, Mode 1 - LOTO & Zero Voltage Verification
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Second Person Requirement: Standby Person
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Second Person Identified: Mike capeto
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List Other Participants:
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Affected Persons Notified: Yes
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Switching: Hazardous Switching
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Panel / Equipment ID: 66a8a-23. 62 ac 11
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System Information Review: Panel Schedules, Arc Flash Labels
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Control of Hazardous Energy: Simple LOTO
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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
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Sequence of Job Steps
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List basic sequence of steps from start to finish.
Go over job scope, gather materials, fill out and submit JSP, gather proper ppe, perform safety briefing, apply loto and verify zvv, loto condensor inlet and outlet valves. Perform maintenance , reassemble chiller, restore and check supply power. Check operatio |
Control of Work Area
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Minimum Approach Boundary: 102 inces
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Barricade Tape / Attendant: Warning - Orange
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Shock Risk Assessment
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System Voltage: 277/480 V ac
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Limited Approach Boundary: 42 inches
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Restricted Approach Boundary: 12 inches
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Will the hands enter the RAB: Yes
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Voltage Glove Class: 0
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Will any other part of the body enter the RAB: No
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Arc Flash Risk Assessment
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Incident Energy: 39.4 calcm2 cal/cm2
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Arc Flash Boundary: 102”
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Working Distance: 18 inches
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Arc Flash PPE Level: 4
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Incident Energy Reduction Measures: 0
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Capacitor Hazards
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Capacitor Bus Voltage: Na
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Capacitor total stored energy (joules): Na
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Discharge wait time (minutes): Na
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Emergency Response Plan
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Nearest Landline Location: 201 b
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Emergency Number to Call: 911
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Sufficient cell phone signal? Yes
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Clear exit path? Yes
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AED Location: 62 etrtrance in lobby
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Fire Extinguisher Location: Truck fire extinguisher at location
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Contact release method available and tested: Upstream breaker or switch, Voltage gloves
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Environmental Conditions
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Does the environment present additional hazards that should be addressed?
Heavy traffic |
Error Precursors
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Task Demands:
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Work Environment:
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Individual Capabilities:
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Human Nature:
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Error Precursor Mitigations:
No current error precursors. Technicians have performed this task numerous times and are comfortable. |
PPE Inspections
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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
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Perform Job Breifing
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PIC Conducts the Job Briefing. Cover all the contents of the Job Safety Plan.
A Job Briefing at a minimum must include:
Rev 2023.08.22.1 Form Content and Feedback Contact: Michael Rose -- mvr@lbl.gov |