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QEW 1 / 2 / 3 Job Safety Plan

Electrical Safety
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Time / Date: 8/2/2023 8:03:57
JSP ID: 1340
Scope of Work: MCC 38A6A, GP27 (ARU7) PMTs Switching & LOTO Support to replace bearings

General Information

Work Order
W0332368
Building
50B
Person in Charge
Joseph Pica
Lead / Supervisor
Cameron, Benjamin
Logged Email
josephpica@lbl.gov
Division
Facilities

Work Planning

Modes of Work
☑ Mode 1 - LOTO & Zero Voltage Verification
QEW Level
QEW 2
Second Person Requirement
Not Required
Second Person Identified
N/A
Other Participants
PMT, HVAC, Riggers
Affected Persons Notified
Yes

System / Equipment

Switching
Non-Hazardous Switching
Panel / Equipment ID
MCC 38A6A Bkr Tower Pump#1, GP27
System Information Review
☑ Arc Flash Labels
☑ Equipment Labels
Control of Hazardous Energy
Simple LOTO
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
Inform Affected Users Switch, ZVV & LOTO GP27 PMTs to replace Bearings Release & Restore

Control of Work Area

Minimum Approach Boundary
42”
Barricade Tape / Attendant
Attendant

Shock Risk Assessment

System Voltage
120/208 V ac
Limited Approach Boundary
42 inches
Restricted Approach Boundary
Avoid Contact
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
.78cal cal/cm2
Arc Flash Boundary
14”
Working Distance
18 inches
Arc Flash PPE Level
2
Incident Energy Reduction Measures
0

Capacitor Hazards

Capacitor Bus Voltage
No Cap
Capacitor Total Stored Energy (Joules)
No Cap
Discharge Wait Time (Minutes)
No Cap

Emergency Response Plan

Nearest Landline Location
Local Wall Mount 486-6232
Emergency Number to Call
7911
Sufficient Cell Phone Signal
Yes
Clear Exit Path
Yes
AED Location
Truck
Fire Extinguisher Location
Wall Mount at Entry
Contact Release Method Available and Tested
Upstream breaker or switch

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
PreJob Planning

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

Notes / Other

OUTDATED ARC FLASH LABEL 2018

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:
  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 2026.03.17.1
Form Content and Feedback Contact: Michael Rose -- mvr@lbl.gov