QEW 1 / 2 / 3 Job Safety Plan
Print Form
Back to Index
Time / Date:
7/23/2023 16:58:53
JSP ID:
1293
Scope of Work:
MCC 38A6A
General Information
Work Order
None
Building
50B
Person in Charge
Ben Cameron
Lead / Supervisor
Hendrick, Jeffery
Logged Email
MVR@lbl.gov
Division
Facilities
Work Planning
Modes of Work
☑ Mode 0 - Electrically Safe Work Condition
☑ Mode 1 - LOTO & Zero Voltage Verification
QEW Level
QEW 2
Second Person Requirement
Standby Person
Second Person Identified
Andrew S
Other Participants
Affected Persons Notified
Yes
System / Equipment
Switching
Hazardous Switching
Panel / Equipment ID
38A6A
System Information Review
☑ Single Line Drawing
☑ Panel Schedules
☑ Arc Flash Labels
Control of Hazardous Energy
Simple LOTO
Equipment Condition
☑
Sequence of Job Steps
List basic sequence of steps from start to finish
Loto 38A/6, open cub, investigate
Control of Work Area
Minimum Approach Boundary
Barricade Tape / Attendant
Attendant
Shock Risk Assessment
System Voltage
120/208 V ac
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
0.78 cal/cm2
Arc Flash Boundary
14 in
Working Distance
18 inches
Arc Flash PPE Level
Minimum PPE for Electrical Work
Incident Energy Reduction Measures
0
Capacitor Hazards
Capacitor Bus Voltage
Capacitor Total Stored Energy (Joules)
Discharge Wait Time (Minutes)
Emergency Response Plan
Nearest Landline Location
Near door
Emergency Number to Call
7911
Sufficient Cell Phone Signal
Yes
Clear Exit Path
Yes
AED Location
Fire Extinguisher Location
Wall
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
High workload (memory requirements)
Work Environment
Individual Capabilities
Human Nature
Error Precursor Mitigations
Smoke
PPE Inspections
☑ Safety glasses (ANSI Z87)
☑ Arc-rated clothing (flash suit
☑ daily wear) including face shield
☑ balaclava
☑ hood.
Notes / Other
MCC smoke observed, de energize and investigate, no WO at this time.
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
