Time / Date: 2/20/2024 7:28:00
JSP ID: 2243
Scope of Work: Remove low volt cables from ladder tray in sector 11
Work Order: 366540
Building: 6
Person in Charge: E combs
Lead / Supervisor: Combs, Everett
Logged Email: ccryken@lbl.gov
Division: ALS
QEW Level: QEW 1
Modes of Work: Mode 0 - Electrically Safe Work Condition
Second Person Requirement: Not Required
Second Person Identified: C. Nelson
List Other Participants: N/A
Affected Persons Notified: N/A
Switching: No Switching Required
Panel / Equipment ID: N/A
System Information Review: N/A
Control of Hazardous Energy: Exclusive Control of Plug
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.

Investigate both ends of cable for correct locations

Control of Work Area

Minimum Approach Boundary: N/A
Barricade Tape / Attendant: Attendant

Shock Risk Assessment

System Voltage: No Shock Hazard Present
Limited Approach Boundary: None
Restricted Approach Boundary: None
Will the hands enter the RAB: No
Voltage Glove Class: Not Required
Will any other part of the body enter the RAB: No

Arc Flash Risk Assessment

Incident Energy: N/A cal/cm2
Arc Flash Boundary: N/A
Working Distance: No Arc Flash Hazard Present
Arc Flash PPE Level: Minimum PPE for Electrical Work
Incident Energy Reduction Measures: Not Required

Capacitor Hazards

Capacitor Bus Voltage:
Capacitor total stored energy (joules):
Discharge wait time (minutes):

Emergency Response Plan

Nearest Landline Location: Storage ring pit various locations
Emergency Number to Call: 911
Sufficient cell phone signal? Yes
Clear exit path? Yes
AED Location: Control room bldg 6
Fire Extinguisher Location: Storage ring pit various locations
Contact release method available and tested: N/A

Environmental Conditions

Does the environment present additional hazards that should be addressed?

Insufficient/cramped/awkward space, Lookalike equipment, Noisy environment

Error Precursors

Task Demands: Critical steps or irreversible acts, Interpretation requirements, Unclear goals, roles, or responsibilities
Work Environment: Distractions/interruptions, Changes/departures from routine
Individual Capabilities: Imprecise communication habits
Human Nature:
Error Precursor Mitigations:

N/A

PPE Inspections

Safety glasses (ANSI Z87),
Arc-rated clothing (flash suit,
daily wear) including face shield,
balaclava,
hood.,
Non-melting footwear that fully covers the feet,
Removal of conductive articles

Notes / Other

Perform Job Breifing

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 2023.08.22.1
Form Content and Feedback Contact: Michael Rose -- mvr@lbl.gov