Time / Date: 10/19/2023 8:33:45
JSP ID: 1718
Scope of Work: Initiate Auto Gen Start / Run
Work Order: W0346477
Building: B85 Gen and Electric Rm
Person in Charge: Joseph Colmenares
Lead / Supervisor: Cameron, Benjamin
Logged Email: josephpica@lbl.gov
Division: Facilities
QEW Level: QEW 3
Modes of Work: Mode 0 - Electrically Safe Work Condition, Mode 1 - LOTO & Zero Voltage Verification
Second Person Requirement: Safety Watch
Second Person Identified: J. Pica
List Other Participants: Fire Alarm
Affected Persons Notified: Yes
Switching: Hazardous Switching
Panel / Equipment ID: 85 Gen &ATS panel 357A1A
System Information Review: Single Line Drawing, Panel Schedules, Arc Flash Labels, Procedure
Control of Hazardous Energy: LOTO Not Required (Mode 2 or 3 only)
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.

Existing Procedure Request Permission Execute Report Return to Normal Lineup

Control of Work Area

Minimum Approach Boundary: 67”
Barricade Tape / Attendant: Attendant

Shock Risk Assessment

System Voltage: 277/480 V ac
Limited Approach Boundary: None
Restricted Approach Boundary: 12 inches
Will the hands enter the RAB: No
Voltage Glove Class: 0
Will any other part of the body enter the RAB: No

Arc Flash Risk Assessment

Incident Energy: None cal/cm2
Arc Flash Boundary: 67”
Working Distance: 18 inches
Arc Flash PPE Level: 4
Incident Energy Reduction Measures: 0

Capacitor Hazards

Capacitor Bus Voltage: No Capacitors
Capacitor total stored energy (joules): No Capacitors
Discharge wait time (minutes): No Capacitors

Emergency Response Plan

Nearest Landline Location: 85 Mechanical Room
Emergency Number to Call: 911
Sufficient cell phone signal? Yes
Clear exit path? Yes
AED Location: Crew Carry
Fire Extinguisher Location: Wall Mount at Gen
Contact release method available and tested: Upstream breaker or switch, Rescue hook, Voltage gloves

Environmental Conditions

Does the environment present additional hazards that should be addressed?

Noisy environment

Error Precursors

Task Demands: Simultaneous or multiple tasks
Work Environment:
Individual Capabilities:
Human Nature:
Error Precursor Mitigations:

Multi Craft Coordination & Brief Maintain Comm

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

Notes / Other

Monthly Gen Test

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