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QEW 1 / 2 / 3 Job Safety Plan

Electrical Safety
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Time / Date: 1/9/2024 9:24:43
JSP ID: 2055
Scope of Work: Shutdown PDU 33 replace breakers and disconnect feeders.

General Information

Work Order
355172
Building
59
Person in Charge
Anthony Pilz
Lead / Supervisor
Secheck, Stephen
Logged Email
apilz@lbl.gov
Division
Facilities

Work Planning

Modes of Work
☑ Mode 1 - LOTO & Zero Voltage Verification
QEW Level
QEW 2
Second Person Requirement
Safety Watch
Second Person Identified
Shane Miller
Other Participants
Ernie Jew
Affected Persons Notified
Yes

System / Equipment

Switching
Non-Hazardous Switching
Panel / Equipment ID
UE599A3A
System Information Review
☑ Single Line Drawing
☑ 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
Don PPE LOTO PDU 33 ZVV ALL PANELS ASSOCIATED PDU 33 A,B,C, and D along with the main panel for E,F,G and H Replace breakers in those panels Install shunt trip wiring Get inspected Reenergize PDU 33

Control of Work Area

Minimum Approach Boundary
42
Barricade Tape / Attendant
Warning - Orange

Shock Risk Assessment

System Voltage
277/480 V ac
Limited Approach Boundary
42 inches
Restricted Approach Boundary
12 inches
Will the hands enter the RAB
Yes
Voltage Glove Class
00
Will any other part of the body enter the RAB
No

Arc Flash Risk Assessment

Incident Energy
3 cal/cm2
Arc Flash Boundary
36 inches
Working Distance
18 inches
Arc Flash PPE Level
2
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
Control room
Emergency Number to Call
6999
Sufficient Cell Phone Signal
Yes
Clear Exit Path
Yes
AED Location
In control room
Fire Extinguisher Location
In server room
Contact Release Method Available and Tested
Upstream breaker or switch

Environmental Conditions

Does the environment present additional hazards that should be addressed?
Insufficient lighting, Insufficient/cramped/awkward space, Heavy traffic, Lookalike equipment, Noisy environment

Error Precursors

Task Demands
Work Environment
Distractions/interruptions
Individual Capabilities
Human Nature
Stress (limits attention)
Error Precursor Mitigations
Relax and focus

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
☑ Insulated tools
☑ 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:
  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 2026.03.17.1
Form Content and Feedback Contact: Michael Rose -- mvr@lbl.gov