QEW 1 / 2 / 3 Job Safety Plan

General Information

Work Order

1234

Building

75A

Person in Charge

CWoo

Lead / Supervisor

Other

Logged Email

konecliff@gmail.com

Division

Facilities

Work Planning

Modes of Work

☑ Mode 1 - LOTO & Zero Voltage Verification

QEW Level

QEW 2

Second Person Requirement

Standby Person

Second Person Identified

Derek Mccabe

Other Participants

Ari Harding - LBNL EHS

Affected Persons Notified

Yes

System / Equipment

Switching

No Switching Required

Panel / Equipment ID

16A

System Information Review

☑ Arc Flash Labels
☑

Control of Hazardous Energy

Complex LOTO w/ RI

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

1. Join RI LOTO. 2. Open 16A panel=our elev control. 3. ZVV 16A Load side. 4. Do repairs. 5. Close 16A panel = our elev control. 6. Remove my lock from RI group lock.

Control of Work Area

Minimum Approach Boundary

Greater the LAB or is 42” vs arc flash 26”

Barricade Tape / Attendant

Attendant

Shock Risk Assessment

System Voltage

277/480 V ac

Limited Approach Boundary

42 inches

Restricted Approach Boundary

12 inches

Will the hands enter the RAB

Yes

Voltage Glove Class

00

Will any other part of the body enter the RAB

No

Arc Flash Risk Assessment

Incident Energy

2.37 cal/cm2

Arc Flash Boundary

26

Working Distance

18 inches

Arc Flash PPE Level

2

Incident Energy Reduction Measures

00

Capacitor Hazards

Capacitor Bus Voltage

NA

Capacitor Total Stored Energy (Joules)

NA

Discharge Wait Time (Minutes)

NA

Emergency Response Plan

Nearest Landline Location

B75 in hallway

Emergency Number to Call

7911

Sufficient Cell Phone Signal

Yes

Clear Exit Path

Yes

AED Location

On wall right hand south

Fire Extinguisher Location

Outside west door and is charged

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

Time pressure (in a hurry), High workload (memory requirements)

Work Environment

Distractions/interruptions

Individual Capabilities

Unfamiliar with, or first time performing task, New technique not used before

Human Nature

Stress (limits attention)

Error Precursor Mitigations

Step by step procedure JSP Job Safety Plan

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

Practical test for QEW 2 level

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