Time / Date: 3/8/2024 7:45:36
JSP ID: 2286
Scope of Work: LOTO panel 650A/2. ZVV inside panel 650A2A. install new breaker and terminate new conductors.
Work Order: 334438
Building: 30
Person in Charge: steve sechak
Lead / Supervisor: Secheck, Stephen
Logged Email: ngripe@lbl.gov
Division: Facilities
QEW Level: QEW 2
Modes of Work: Mode 0 - Electrically Safe Work Condition, Mode 1 - LOTO & Zero Voltage Verification
Second Person Requirement: Standby Person
Second Person Identified: jared tissot
List Other Participants: beau erwin, steve sechak
Affected Persons Notified: Yes
Switching: Hazardous Switching
Panel / Equipment ID: 650A and 650A2A
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

Sequence of Job Steps

List basic sequence of steps from start to finish.

mount the racking device to the breaker, LOTO panel 650A/2. ZVV inside panel 650A2A. install new breaker and terminate new conductors.

Control of Work Area

Minimum Approach Boundary: 10 feet. keep away.
Barricade Tape / Attendant: Danger - Red

Shock Risk Assessment

System Voltage: 277/480 V ac
Limited Approach Boundary: 42 inches
Restricted Approach Boundary: 3 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: 650A- 17.2 cal 650A2A -3.4 cal cal/cm2
Arc Flash Boundary: 650A- 105 inches. 650A2A - 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: B30-109
Emergency Number to Call: 911
Sufficient cell phone signal? Yes
Clear exit path? Yes
AED Location: on cart
Fire Extinguisher Location: outside electrical room
Contact release method available and tested: Voltage gloves

Environmental Conditions

Does the environment present additional hazards that should be addressed?

None

Error Precursors

Task Demands:
Work Environment:
Individual Capabilities:
Human Nature:
Error Precursor Mitigations:

NA

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,
racking device to switch breaker

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