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Time / Date: 7/3/2024 10:00:57
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JSP ID: 2727
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Scope of Work: Remove circuits from furniture on second floor cubicals.
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Work Order: 367360
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Building: ALS 6
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Person in Charge: Christopher Nelson
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Lead / Supervisor: Combs, Everett
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Logged Email: cnelson@lbl.gov
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Division: ALS
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QEW Level: QEW 2
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Modes of Work: Mode 1 - LOTO & Zero Voltage Verification
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Second Person Requirement: Standby Person
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Second Person Identified: Robert Ralph
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List Other Participants:
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Affected Persons Notified: Yes
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Switching: Non-Hazardous Switching
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Panel / Equipment ID: 347A28A
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System Information Review: Panel Schedules, Arc Flash Labels
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Control of Hazardous Energy: Complex LOTO (requires LP, CLP, FLP)
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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
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Sequence of Job Steps
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List basic sequence of steps from start to finish.
Briefing with lead fill out JSP use PPE and LOTO fill out als complex LOTO procedure form. Briefing with all parties before switching and LOTO. Switch the circuits on the LOTO procedure. Lock out tag out and then ZVV if there are unknown circuits still on during ZVV stop work and contact the lead. If all circuits are off proceed with disconnecting circuits from the cubical. When it is in electrically safe condition remove LOTO and re energize or leave off and replace LOTO locks with admin locks. |
Control of Work Area
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Minimum Approach Boundary: 42”
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Barricade Tape / Attendant: Warning - Orange
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Shock Risk Assessment
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System Voltage: 120 Vac
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Limited Approach Boundary: 42 inches
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Restricted Approach Boundary: 12 inches
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Will the hands enter the RAB: No
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Voltage Glove Class: 0
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Will any other part of the body enter the RAB: No
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Arc Flash Risk Assessment
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Incident Energy: .13 cal/cm^2 cal/cm2
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Arc Flash Boundary: 5 inches
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Working Distance: 18 inches
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Arc Flash PPE Level: 2
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Incident Energy Reduction Measures: 0
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Capacitor Hazards
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Capacitor Bus Voltage: Na
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Capacitor total stored energy (joules): Na
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Discharge wait time (minutes): Na
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Emergency Response Plan
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Nearest Landline Location: Room 2101 copy room next to the work
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Emergency Number to Call: 911
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Sufficient cell phone signal? Yes
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Clear exit path? Yes
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AED Location: Just downstairs in lobby
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Fire Extinguisher Location: In room of the ZVV work
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Contact release method available and tested: Upstream breaker or switch, Voltage gloves
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Environmental Conditions
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Does the environment present additional hazards that should be addressed?
None |
Error Precursors
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Task Demands: Time pressure (in a hurry)
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Work Environment: Distractions/interruptions
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Individual Capabilities: Imprecise communication habits
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Human Nature: Habit patterns
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Error Precursor Mitigations:
Be aware and in communication with the second person at all times keep a level head and keep on the task don’t think about the early release and holiday |
PPE Inspections
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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, Heavy duty leather cloves |
Notes / Other
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Be safe
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Perform Job Breifing
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PIC Conducts the Job Briefing. Cover all the contents of the Job Safety Plan.
A Job Briefing at a minimum must include:
Rev 2023.08.22.1 Form Content and Feedback Contact: Michael Rose -- mvr@lbl.gov |