Scope of Work:Replace seal tight and possibly the wiring for LN tank by west side of bldg
General Information
Work Order
W0370218
Building
2
Person in Charge
Alma Armenta
Lead / Supervisor
Cameron, Benjamin
Logged Email
alarmentaduran@lbl.gov
Division
Facilities
Work Planning
Modes of Work
☑ Mode 0 - Electrically Safe Work Condition ☑ Mode 1 - LOTO & Zero Voltage Verification
QEW Level
QEW 2
Second Person Requirement
Safety Watch
Second Person Identified
Joe Colmenares
Other Participants
Affected Persons Notified
Yes
System / Equipment
Switching
Hazardous Switching
Panel / Equipment ID
239A Ct. 27
System Information Review
☑ 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 ☑ Not energizing equipment for the first time ☑ or after electrical repair
Sequence of Job Steps
List basic sequence of steps from start to finish
Verify equipment to enter, don appropriate PPE, switch, LOTO, ZVV, unbolt terminations, replace seal tight & wiring, re-bolt terminations, return to normal working operation.
Control of Work Area
Minimum Approach Boundary
46”
Barricade Tape / Attendant
Attendant
Shock Risk Assessment
System Voltage
120/208 V ac
Limited Approach Boundary
42 inches
Restricted Approach Boundary
12 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
6.65 cal/cm2
Arc Flash Boundary
46”
Working Distance
18 inches
Arc Flash PPE Level
2+
Incident Energy Reduction Measures
0
Capacitor Hazards
Capacitor Bus Voltage
None
Capacitor Total Stored Energy (Joules)
None
Discharge Wait Time (Minutes)
None
Emergency Response Plan
Nearest Landline Location
Rm 143
Emergency Number to Call
5104867911
Sufficient Cell Phone Signal
Yes
Clear Exit Path
Yes
AED Location
On hand
Fire Extinguisher Location
By side door of bldg 2
Contact Release Method Available and Tested
Voltage gloves
Environmental Conditions
Does the environment present additional hazards that should be addressed?
Lookalike equipment
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 ☑ 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:
Detailed Scope of Work
Shock and arc flash hazards for each task
Controls to mitigate the hazards (procedures, precautions, energy source controls, PPE requirements)
Work area controls (barricades, signs, attendants)
