Time / Date: 3/21/2024 8:55:25
JSP ID: 2349
Scope of Work: Loto and zvv at disconnect for annex crane over storage ring to attain manufacturer and info off VFD driving crane motor nameplate
Work Order: 313674
Building: 6
Person in Charge: Chris Ryken
Lead / Supervisor: Combs, Everett
Logged Email: ccryken@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: E Combs
List Other Participants: EM group rep applying lock and possibly mech tech group with access
Affected Persons Notified: Yes
Switching: Hazardous Switching
Panel / Equipment ID: Bldg 6 Annex Crane Disconnect
System Information Review: 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.

Zvv at disconnect and proceed to vfd upon crane cat walk

Control of Work Area

Minimum Approach Boundary: 48 inches
Barricade Tape / Attendant: Attendant

Shock Risk Assessment

System Voltage: 120/240 V ac
Limited Approach Boundary: 42 inches
Restricted Approach Boundary: Avoid contact
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: 8.76 cal/cm2
Arc Flash Boundary: 48 inches
Working Distance: 18 inches
Arc Flash PPE Level: 4
Incident Energy Reduction Measures: 0

Capacitor Hazards

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

Emergency Response Plan

Nearest Landline Location: Bldg 15 copy room
Emergency Number to Call: 911
Sufficient cell phone signal? Yes
Clear exit path? Yes
AED Location: Bldg 15 first floor lobby
Fire Extinguisher Location: Bldg 15 multiple
Contact release method available and tested: Voltage gloves

Environmental Conditions

Does the environment present additional hazards that should be addressed?

Noisy environment

Error Precursors

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

Star method to clearly assess all potential issues and potential issues. Group discussions

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

Using a routine work order to attain vfd info only

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