Time / Date: 10/31/2022 9:05:30
JSP ID: 165
Scope of Work: Apply LOTO and make Final Power Amplifier electrically safe, so we can do a inspection to look for any possible issues.
Work Order:
Building:
Person in Charge: Taimoor
Lead / Supervisor: Other
Logged Email: hassan@lbl.gov
Division: Facilities
QEW Level: QEW 2
Modes of Work: Mode 1 - LOTO & Zero Voltage Verification
Second Person Requirement: Standby Person
Second Person Identified: Kenneth Lambert
List Other Participants:
Affected Persons Notified: Yes
Switching: Hazardous Switching
Panel / Equipment ID: A3120-CB3
System Information Review: Single Line Drawing, Arc Flash Labels
Control of Hazardous Energy: Complex LOTO (requires LP, CLP, FLP)
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.

Apply 12 kV DC LOTO and then trip all the circuit breakers as per LOTO procedure R5G-1. Open FPA and do a ZVV after ZVV visual inspection for any signs of electrical arcing.

Control of Work Area

Minimum Approach Boundary: 65
Barricade Tape / Attendant: Notice - Blue

Shock Risk Assessment

System Voltage: 120/208 V ac
Limited Approach Boundary: 60 inches
Restricted Approach Boundary: 12 inches
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: 9.25 cal/cm2
Arc Flash Boundary: 65
Working Distance: 18 inches
Arc Flash PPE Level: 2
Incident Energy Reduction Measures: 0

Capacitor Hazards

Capacitor Bus Voltage: 15.6
Capacitor total stored energy (joules): 409
Discharge wait time (minutes): 7

Emergency Response Plan

Nearest Landline Location: high bay area
Emergency Number to Call: 5104866999
Sufficient cell phone signal? Yes
Clear exit path? Yes
AED Location: high bay entrance
Fire Extinguisher Location: high bay
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:

LOTO procedure and second person to verify all the steps to make FPA electrically safe

PPE Inspections

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