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QEW 1 / 2 / 3 Job Safety Plan

Electrical Safety
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Time / Date: 3/15/2024 9:53:58
JSP ID: 2318
Scope of Work: LOTO and ZVV for CHA evaporator equipment for repair/maintenance work of vacuum unit.

General Information

Work Order
n/a
Building
Bldg. 2
Person in Charge
Felipe Sanchez
Lead / Supervisor
Other
Logged Email
fbsanchez@lbl.gov
Division
Other

Work Planning

Modes of Work
☑ Mode 1 - LOTO & Zero Voltage Verification
QEW Level
QEW 1
Second Person Requirement
Not Required
Second Person Identified
n/a
Other Participants
n/a
Affected Persons Notified
Yes

System / Equipment

Switching
No Switching Required
Panel / Equipment ID
n/a
System Information Review
☑
Control of Hazardous Energy
Cord & Plug LOTO
Equipment Condition
☑ Properly installed
☑ Properly maintained
☑ All doors and covers closed and fully latched

Sequence of Job Steps

List basic sequence of steps from start to finish
Turn off power switches for main power and equipment located behind the main equipment. Applied LOTO locks on the unit. Performed zero voltage verification procedure at the back of equipment (proving unit = 244.2Vac, outlet receptacle = 0 values). Customer was advised about the test values.

Control of Work Area

Minimum Approach Boundary
n/a
Barricade Tape / Attendant
Attendant

Shock Risk Assessment

System Voltage
120/240 V ac
Limited Approach Boundary
42 inches
Restricted Approach Boundary
12 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
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
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
inside the room
Emergency Number to Call
(510) 486-6999
Sufficient Cell Phone Signal
Yes
Clear Exit Path
Yes
AED Location
next room
Fire Extinguisher Location
inside room
Contact Release Method Available and Tested
Upstream breaker or switch

Environmental Conditions

Does the environment present additional hazards that should be addressed?
Insufficient lighting, Confined space, Insufficient/cramped/awkward space, Noisy environment

Error Precursors

Task Demands
Work Environment
Individual Capabilities
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.
☑ 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 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