QEW 1 / 2 / 3 Job Safety Plan

General Information

Work Order

313735

Building

B71

Person in Charge

Shane Miller

Lead / Supervisor

Secheck, Stephen

Logged Email

spmiller@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

Nick Gripe

Other Participants

Affected Persons Notified

Yes

System / Equipment

Switching

Non-Hazardous Switching

Panel / Equipment ID

18A11A

System Information Review

☑ Panel Schedules
☑ Arc Flash Labels

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
☑ Not energizing equipment for the first time
☑ or after electrical repair

Sequence of Job Steps

List basic sequence of steps from start to finish

Dawn proper ppe, Loto,ZVV, replace breaker, inspect, release loto

Control of Work Area

Minimum Approach Boundary

67”

Barricade Tape / Attendant

Warning - Orange

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

00

Will any other part of the body enter the RAB

No

Arc Flash Risk Assessment

Incident Energy

12.8cal/cm cal/cm2

Arc Flash Boundary

67”

Working Distance

No Arc Flash Hazard Present

Arc Flash PPE Level

4

Incident Energy Reduction Measures

00

Capacitor Hazards

Capacitor Bus Voltage

Capacitor Total Stored Energy (Joules)

Discharge Wait Time (Minutes)

Emergency Response Plan

Nearest Landline Location

Room 252

Emergency Number to Call

X6999

Sufficient Cell Phone Signal

Yes

Clear Exit Path

Yes

AED Location

Corridor 20’ away

Fire Extinguisher Location

Corridor 5’ away

Contact Release Method Available and Tested

Upstream breaker or switch, 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

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
☑ Non-melting footwear that fully covers the feet
☑ Removal of conductive articles
☑ Multimeter and other electrical test instruments

Notes / Other

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