Time / Date: 10/4/2023 7:31:26
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JSP ID: 1642
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Scope of Work: Live diagnostic testing at elev control
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Work Order: 15816713
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Building: 66
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Person in Charge: Cliff Woo
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Lead / Supervisor: Other
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Logged Email: konecliff@gmail.com
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Division: Facilities
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QEW Level: QEW 2
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Modes of Work: Mode 2 - Energized Diagnostics, Testing and Troubleshooting, Visual Inspection
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Second Person Requirement: Safety Watch
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Second Person Identified: Derek Mccabe
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List Other Participants: Na
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Affected Persons Notified: Yes
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Switching: Hazardous Switching
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Panel / Equipment ID: 66-EL001-DISC. B66 elev control disc.
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System Information Review: Arc Flash Labels
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Control of Hazardous Energy: LOTO Not Required (Mode 2 or 3 only)
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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
List basic sequence of steps from start to finish.
Donn ArcFlash ppe. Open control door. Check LCD faults. Troubleshoot as needed for norm operation. Close control door. 480vac switching may be needed to reset system apply mode 2 ,1.3b steps |
Control of Work Area
Minimum Approach Boundary: Warning Danger sign Live 480 testing
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Barricade Tape / Attendant: Danger - Red
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Shock Risk Assessment
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: 00
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Will any other part of the body enter the RAB: No
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Arc Flash Risk Assessment
Incident Energy: 13.1 at DISC. .18 at elev control panel cal/cm2
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Arc Flash Boundary: 59”
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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: 00
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Capacitor Hazards
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
Nearest Landline Location: Mroom on north wall
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Emergency Number to Call: 7911
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Sufficient cell phone signal? Yes
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Clear exit path? Yes
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AED Location: None
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Fire Extinguisher Location: Machine room
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Contact release method available and tested: Voltage gloves
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Environmental Conditions
Does the environment present additional hazards that should be addressed?
None |
Error Precursors
Task Demands: Time pressure (in a hurry)
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Work Environment: Distractions/interruptions, Personality conflicts
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Individual Capabilities: Unfamiliar with, or first time performing task
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Human Nature: Stress (limits attention)
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Error Precursor Mitigations:
See above |
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
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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:
Rev 2023.08.22.1 Form Content and Feedback Contact: Michael Rose -- mvr@lbl.gov |