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QEW 1 / 2 / 3 Job Safety Plan

Electrical Safety
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Time / Date: 1/18/2024 7:29:26
JSP ID: 2096
Scope of Work: Swapping out the power supply for the System 3 Fire Alarm Panel

General Information

Work Order
Training
Building
B75A
Person in Charge
Ed Bekheet
Lead / Supervisor
Gomez, Rudy
Logged Email
edbekheet@lbl.gov
Division
Facilities

Work Planning

Modes of Work
☑ Mode 0 - Electrically Safe Work Condition
☑ Mode 1 - LOTO & Zero Voltage Verification
QEW Level
QEW 1
Second Person Requirement
Not Required
Second Person Identified
NA
Other Participants
NA
Affected Persons Notified
Yes

System / Equipment

Switching
Non-Hazardous Switching
Panel / Equipment ID
234A
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
1. Switch the breaker and perform LOTO 2. Perform ZVV and confirm zero voltage 3. Swap out power supply for a new one 4. Remove LOTO and restore power 5. Confirm battery charging and power supply is in good working condition

Control of Work Area

Minimum Approach Boundary
42
Barricade Tape / Attendant
Danger - Red

Shock Risk Assessment

System Voltage
120 Vac
Limited Approach Boundary
42 inches
Restricted Approach Boundary
3 inches
Will the hands enter the RAB
Yes
Voltage Glove Class
0
Will any other part of the body enter the RAB
No

Arc Flash Risk Assessment

Incident Energy
0 cal/cm2
Arc Flash Boundary
0
Working Distance
No Arc Flash Hazard Present
Arc Flash PPE Level
Minimum PPE for Electrical Work
Incident Energy Reduction Measures
0

Capacitor Hazards

Capacitor Bus Voltage
0
Capacitor Total Stored Energy (Joules)
0
Discharge Wait Time (Minutes)
0

Emergency Response Plan

Nearest Landline Location
B75
Emergency Number to Call
911
Sufficient Cell Phone Signal
Yes
Clear Exit Path
Yes
AED Location
South wall by FACP
Fire Extinguisher Location
Back door outside
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
Time pressure (in a hurry)
Work Environment
Individual Capabilities
Human Nature
Error Precursor Mitigations
Use STAR method

PPE Inspections

☑ Safety glasses (ANSI Z87)
☑ Arc-rated clothing (flash suit
☑ daily wear) including face shield
☑ balaclava
☑ hood.
☑ 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