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QEW 1 / 2 / 3 Job Safety Plan

Electrical Safety
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Time / Date: 3/14/2024 10:57:15
JSP ID: 2312
Scope of Work: Absent personal LOTO lock removal for electrical panel E22A circuits 57 & 69 and verify circuits are in safe working order to energize.

General Information

Work Order
372022
Building
071
Person in Charge
Alejandro Lopez
Lead / Supervisor
Secheck, Stephen
Logged Email
Alopez2@lbl.gov
Division
Facilities

Work Planning

Modes of Work
☑ Mode 2 - Energized Diagnostics
☑ Testing and Troubleshooting
☑ Visual Inspection
QEW Level
QEW 2
Second Person Requirement
Standby Person
Second Person Identified
Beau Erwin
Other Participants
none
Affected Persons Notified
Yes

System / Equipment

Switching
Non-Hazardous Switching
Panel / Equipment ID
E22A
System Information Review
☑ Single Line Drawing
☑ Panel Schedules
☑ Arc Flash Labels
Control of Hazardous Energy
Simple LOTO
Equipment Condition
☑ Properly installed
☑ 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
Trace circuits and verify if it is safe to energize.

Control of Work Area

Minimum Approach Boundary
18 inches
Barricade Tape / Attendant
Attendant

Shock Risk Assessment

System Voltage
120/208 V ac
Limited Approach Boundary
42 inches
Restricted Approach Boundary
3 inches
Will the hands enter the RAB
No
Voltage Glove Class
00
Will any other part of the body enter the RAB
No

Arc Flash Risk Assessment

Incident Energy
8.6 cal/cm2 cal/cm2
Arc Flash Boundary
54 inches
Working Distance
18 inches
Arc Flash PPE Level
2
Incident Energy Reduction Measures
00

Capacitor Hazards

Capacitor Bus Voltage
n/a
Capacitor Total Stored Energy (Joules)
n/a
Discharge Wait Time (Minutes)
n/a

Emergency Response Plan

Nearest Landline Location
cell phone
Emergency Number to Call
911
Sufficient Cell Phone Signal
Yes
Clear Exit Path
Yes
AED Location
in main lobby
Fire Extinguisher Location
in main lobby
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
Mind-set
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
☑ Insulated tools
☑ Multimeter and other electrical test instruments

Notes / Other

none at this time

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