Time / Date: 2/24/2024 7:19:52
JSP ID: 2258
Scope of Work: LOTO and ZVV emergency panel ZVV ATS for removal of old 277V lighting in als storage ring
Work Order: 3666605
Building: ALS
Person in Charge: Ben Cameron
Lead / Supervisor: Combs, Everett
Logged Email: cnelson@lbl.gov
Division: Facilities
QEW Level: QEW 2
Modes of Work: Mode 1 - LOTO & Zero Voltage Verification
Second Person Requirement: Standby Person
Second Person Identified: Christopher Nelson
List Other Participants: Rob Ralph fatse2
Affected Persons Notified: Yes
Switching: Hazardous Switching
Panel / Equipment ID: EM304A3A1A
System Information Review: Panel Schedules, Arc Flash Labels
Control of Hazardous Energy: Complex LOTO (requires LP, CLP, FLP)
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.

LOTO ZVV ATS Then open e panel and ZVV panel when 0 voltage is established perfor the work.

Control of Work Area

Minimum Approach Boundary: 42”
Barricade Tape / Attendant: Attendant

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: 0
Will any other part of the body enter the RAB: No

Arc Flash Risk Assessment

Incident Energy: .43 cal/cm2 cal/cm2
Arc Flash Boundary: 10”
Working Distance: 18 inches
Arc Flash PPE Level: 1
Incident Energy Reduction Measures: 0

Capacitor Hazards

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

Emergency Response Plan

Nearest Landline Location: Next to fire alarm panel
Emergency Number to Call: 911
Sufficient cell phone signal? Yes
Clear exit path? Yes
AED Location: Building 15 lobby
Fire Extinguisher Location: Closest entrance to our location in bld6
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: Time pressure (in a hurry), High workload (memory requirements), Simultaneous or multiple tasks, Repetitive actions or monotony, Interpretation requirements
Work Environment: Distractions/interruptions, Changes/departures from routine
Individual Capabilities: Unfamiliar with, or first time performing task, Lack of knowledge (faulty mental model)
Human Nature: Stress (limits attention), Habit patterns, Assumptions, Complacency/overconfidence
Error Precursor Mitigations:

E alert and confident

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 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