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Time / Date: 9/15/2023 12:29:03
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JSP ID: 1554
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Scope of Work: Perform PM on UPS 2
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Work Order: NA
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Building: B59
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Person in Charge: Ernest Jew
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Lead / Supervisor: Grounds, Jeff
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Logged Email: ejew@lbl.gov
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Division: Other
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QEW Level: QEW 2
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Modes of Work: Mode 1 - LOTO & Zero Voltage Verification
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Second Person Requirement: Standby Person
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Second Person Identified: Jeff Grounds
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List Other Participants: Eaton Technician
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Affected Persons Notified: Yes
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Switching: Hazardous Switching
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Panel / Equipment ID: UPS 2
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System Information Review: Single Line Drawing, Panel Schedules, Arc Flash Labels
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Control of Hazardous Energy: Complex LOTO w/ RI
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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.
Set up orange warning tape and signage Notify the Control Room Take UPS out of ESS mode Put UPS into Bypass from UPS display Follow steps on red sign on UPS switchboard to Bypass UPS system and open circuit breakers Power off UPS 1&2 at UPS display Apply LOTO locks at UPS switchboard and battery cabinet circuit breakers Open UPS input cabinet and perform ZVV at UPS 1&2 Sign LOTO permit Perform LOTO briefing and have subcontractor sign LOTO permit Perform PM Notify Control Room that UPS will be coming back on line Release LOTO Follow steps on red sign on UPS to take UPS out of bypass at UPS switchboard Power on UPS 1&2 Take UPS 1&2 out of bypass at display Put UPS 1&2 in ESS mode Notify Control Room that work on UPS is complete Remove warning tape and signage |
Control of Work Area
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Minimum Approach Boundary: 100"
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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: 20 cal/cm2
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Arc Flash Boundary: 100"
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Working Distance: 18 inches
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Arc Flash PPE Level: 3
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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: Container office
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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: Portable unit in UPS room
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Fire Extinguisher Location: UPS room
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Contact release method available and tested: Rescue hook
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Environmental Conditions
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Does the environment present additional hazards that should be addressed?
None |
Error Precursors
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Task Demands:
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Work Environment: Distractions/interruptions
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Individual Capabilities:
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Human Nature:
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Error Precursor Mitigations:
May get phone call because of On Call duties. Stay on task and return call later |
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 |