Time / Date: 8/14/2023 7:41:17
JSP ID: 1392
Scope of Work: Panel 318A Circuit breaker re arrangements and new conductors pulled in for a new circuit
Work Order: 335728
Building: 6
Person in Charge: Everett Combs
Lead / Supervisor: Keusch, Justen
Logged Email: ccryken@lbl.gov
Division: Facilities
QEW Level: QEW 2
Modes of Work: Mode 1 - LOTO & Zero Voltage Verification
Second Person Requirement: Safety Watch
Second Person Identified: David Davis
List Other Participants: Jared Tissot, Nick Gripe
Affected Persons Notified: Yes
Switching: Hazardous Switching
Panel / Equipment ID: 302A3A LOTO / 318A for ZVV
System Information Review: Panel Schedules
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.

Notify personnel affected of shutdown. Confirm with control room. Switch at panel 302A3A ckt 4 according to panel schedule. ZVV at panel 318A. Perform work. Finish conduit runs into panel 318A. Rearrange breaker configuration per plans. Pull in conductors to new circuit. Prepare panel for inspection by JHA.

Control of Work Area

Minimum Approach Boundary: 63” at 302A3A / 111” at 318A
Barricade Tape / Attendant: Warning - Orange

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: 9.4 at 302A3A / 23.3 at 318A cal/cm2
Arc Flash Boundary: 63” at 302A3A / 111” at 318A
Working Distance: 18 inches
Arc Flash PPE Level: 3
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: By door six entering the storage ring from the strorage pit
Emergency Number to Call: 911
Sufficient cell phone signal? Yes
Clear exit path? Yes
AED Location: Engineer’s station in storage ring pit
Fire Extinguisher Location: Door six entry to storage ring inside storage ring
Contact release method available and tested: Voltage gloves

Environmental Conditions

Does the environment present additional hazards that should be addressed?

Insufficient/cramped/awkward space, Heavy traffic, Lookalike equipment, Noisy environment

Error Precursors

Task Demands: Simultaneous or multiple tasks, Critical steps or irreversible acts
Work Environment:
Individual Capabilities:
Human Nature: Stress (limits attention), Habit patterns, Assumptions, Mind-set
Error Precursor Mitigations:

Team rolls for stated task needs a clear and concise pre task briefings

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

Operator was not able to be contacted. Project lead instructed the group to continue as planned.

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