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Time / Date: 1/2/2024 8:31:43
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JSP ID: 2022
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Scope of Work: Annual preventive maintenance
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Work Order: W0344424
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Building: 70A
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Person in Charge: Walker justin
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Lead / Supervisor: Delgado, Alex
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Logged Email: juanjuarez37@lbl.gov
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Division: Facilities
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QEW Level: QEW 2
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Modes of Work: Mode 0 - Electrically Safe Work Condition, Mode 1 - LOTO & Zero Voltage Verification
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Second Person Requirement: Standby Person
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Second Person Identified: Juan juarez
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List Other Participants: Plumbers ,electricians.
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Affected Persons Notified: Yes
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Switching: Hazardous Switching
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Panel / Equipment ID: 31A/70AARU004
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System Information Review: Arc Flash Labels
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Control of Hazardous Energy: Complex LOTO (requires LP, CLP, FLP)
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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
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List basic sequence of steps from start to finish.
After the safety briefing we will established LOTO AND ZVV ,with the help of plumbers and Electricians,removed the access panel to perform visual inspection , thigh in screws and check electrical components, clean condenser coils tubes ,checked chiller components, obtain oil samples ,clean surfaces ,reconnected power supply and performed a system test. |
Control of Work Area
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Minimum Approach Boundary: 42
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Barricade Tape / Attendant: Attendant
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Shock Risk Assessment
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System Voltage: 120/208 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: 0
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Will any other part of the body enter the RAB: No
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Arc Flash Risk Assessment
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Incident Energy: Over due equipment,remote switching cal/cm2
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Arc Flash Boundary: Remote switching
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Working Distance: Over due equipment panel ,remote switching
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Arc Flash PPE Level: 2
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Incident Energy Reduction Measures: 0
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Capacitor Hazards
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Capacitor Bus Voltage:
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Capacitor total stored energy (joules):
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Discharge wait time (minutes):
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Emergency Response Plan
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Nearest Landline Location: Next to mechanical room outside corridor
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Emergency Number to Call: 6999
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Sufficient cell phone signal? Yes
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Clear exit path? Yes
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AED Location: Portable
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Fire Extinguisher Location: Door mechanical room
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Contact release method available and tested: Rescue hook, Voltage gloves
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Environmental Conditions
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Does the environment present additional hazards that should be addressed?
Noisy environment |
Error Precursors
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Task Demands:
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Work Environment: Distractions/interruptions
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Individual Capabilities:
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Human Nature:
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Error Precursor Mitigations:
Different crafts interaction , pay attention and briefing before work |
PPE Inspections
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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
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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 |