QEW 1 / 2 / 3 Job Safety Plan

General Information

Work Order

350791

Building

84

Person in Charge

Alex Lopez

Lead / Supervisor

Secheck, Stephen

Logged Email

Alopez2@lbl.gov

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

Armand Uribe

Other Participants

None

Affected Persons Notified

Yes

System / Equipment

Switching

Hazardous Switching

Panel / Equipment ID

E465A3A3A

System Information Review

☑ Panel Schedules

Control of Hazardous Energy

Simple LOTO

Equipment Condition

☑ Properly installed
☑ Properly maintained
☑ All doors and covers closed and fully latched
☑ No signs of impending failure

Sequence of Job Steps

List basic sequence of steps from start to finish

Stablish LOTO, ZVV, make up new cord, make wire connections, test voltage and clean work area.

Control of Work Area

Minimum Approach Boundary

42

Barricade Tape / Attendant

Attendant

Shock Risk Assessment

System Voltage

120/208 V ac

Limited Approach Boundary

42 inches

Restricted Approach Boundary

3 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

12.4 Cals. cal/cm2

Arc Flash Boundary

65

Working Distance

18 inches

Arc Flash PPE Level

Minimum PPE for Electrical Work

Incident Energy Reduction Measures

0

Capacitor Hazards

Capacitor Bus Voltage

N/A

Capacitor Total Stored Energy (Joules)

N/A

Discharge Wait Time (Minutes)

N/A

Emergency Response Plan

Nearest Landline Location

Cell phone

Emergency Number to Call

911

Sufficient Cell Phone Signal

Yes

Clear Exit Path

Yes

AED Location

2nd floor main lobby

Fire Extinguisher Location

2nd floor main lobby

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

Work Environment

Individual Capabilities

Human Nature

Error Precursor Mitigations

None

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
☑ Multimeter and other electrical test instruments

Notes / Other

None

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