Time / Date: 8/2/2023 10:38:39
JSP ID: 1344
Scope of Work: Troubleshoot phase loss for 88-v v-1
Work Order: W0337961
Building: 88
Person in Charge: Andrew Southward
Lead / Supervisor: Cameron, Benjamin
Logged Email: amsouthward@lbl.gov
Division: Facilities
QEW Level: QEW 3
Modes of Work: Mode 0 - Electrically Safe Work Condition, Mode 1 - LOTO & Zero Voltage Verification
Second Person Requirement: Safety Watch
Second Person Identified: Ben Cameron
List Other Participants:
Affected Persons Notified: Yes
Switching: Hazardous Switching
Panel / Equipment ID: ADF-2-88, VCB-88-1
System Information Review: Single Line Drawing, 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.

Perform switch tag for ADF-2-88, ZVV at designated areas, hang grounds on load side of ADF-2-88, troubleshoot phase loss, remove grounds, release LOTO, energize adf-2-88

Control of Work Area

Minimum Approach Boundary: 117
Barricade Tape / Attendant:

Shock Risk Assessment

System Voltage: 12,470 V ac
Limited Approach Boundary: 60 inches
Restricted Approach Boundary: 2 feet, 2 inches
Will the hands enter the RAB: Yes
Voltage Glove Class: 2
Will any other part of the body enter the RAB: No

Arc Flash Risk Assessment

Incident Energy: 8.53 cal/cm2
Arc Flash Boundary: 117
Working Distance: 36 inches
Arc Flash PPE Level: 4
Incident Energy Reduction Measures: 2

Capacitor Hazards

Capacitor Bus Voltage: Na
Capacitor total stored energy (joules): Na
Discharge wait time (minutes): Na

Emergency Response Plan

Nearest Landline Location: 88 office
Emergency Number to Call: 911
Sufficient cell phone signal? Yes
Clear exit path? Yes
AED Location: On hand
Fire Extinguisher Location: By bank 80
Contact release method available and tested: Rescue hook, 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 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