Time / Date: 3/11/2024 8:42:30
JSP ID: 2292
Scope of Work: Replace thermostat for modulator AC.
Work Order: n/a
Building: B88
Person in Charge: Ken Lambert
Lead / Supervisor: Other
Logged Email: klambert@lbl.gov
Division: Other
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: Rick Bloemhard
List Other Participants:
Affected Persons Notified: Yes
Switching: Hazardous Switching
Panel / Equipment ID: FE0, FE1, F1, F2
System Information Review: Single Line Drawing, Arc Flash Labels
Control of Hazardous Energy: Complex LOTO w/ RI
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 the modulator. Remove old thermostat. Install new thermostat. Remove LOTO. Test new thermostat

Control of Work Area

Minimum Approach Boundary: 60
Barricade Tape / Attendant:

Shock Risk Assessment

System Voltage: 120 Vac
Limited Approach Boundary: 60 inches
Restricted Approach Boundary: 2 feet, 2 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: 2.18, 3.37 cal/cm2
Arc Flash Boundary: 32 inches
Working Distance: 24 inches
Arc Flash PPE Level: 1
Incident Energy Reduction Measures: 0

Capacitor Hazards

Capacitor Bus Voltage: 25kV
Capacitor total stored energy (joules): 3.125 kJ
Discharge wait time (minutes): >26

Emergency Response Plan

Nearest Landline Location: On transformer pad, switchgear room, modulator room, control room
Emergency Number to Call: 911
Sufficient cell phone signal? Yes
Clear exit path? Yes
AED Location: B88 lobby
Fire Extinguisher Location: transformer pad, switchgear room (door), modulator room (door), outside control 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:

none

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,
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