QEW 1 / 2 / 3 Job Safety Plan

General Information

Work Order

386820

Building

77

Person in Charge

Benjamin Cameron

Lead / Supervisor

Hendrick, Jeffery

Logged Email

AJTurner2@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

Safety Watch

Second Person Identified

Avery turner

Other Participants

Locater

Affected Persons Notified

Yes

System / Equipment

Switching

No Switching Required

Panel / Equipment ID

72A9A

System Information Review

☑ Panel Schedules
☑ Arc Flash Labels

Control of Hazardous Energy

LOTO Not Required (Mode 2 or 3 only)

Equipment Condition

☑ Properly installed

Sequence of Job Steps

List basic sequence of steps from start to finish

Open panels and locate circuit s

Control of Work Area

Minimum Approach Boundary

18

Barricade Tape / Attendant

Attendant

Shock Risk Assessment

System Voltage

277/480 V ac

Limited Approach Boundary

14 inches

Restricted Approach Boundary

12 inches

Will the hands enter the RAB

Yes

Voltage Glove Class

00

Will any other part of the body enter the RAB

No

Arc Flash Risk Assessment

Incident Energy

0.73 cal/cm2

Arc Flash Boundary

14

Working Distance

24 inches

Arc Flash PPE Level

2

Incident Energy Reduction Measures

00

Capacitor Hazards

Capacitor Bus Voltage

None

Capacitor Total Stored Energy (Joules)

None

Discharge Wait Time (Minutes)

None

Emergency Response Plan

Nearest Landline Location

Cell phone

Emergency Number to Call

911

Sufficient Cell Phone Signal

Yes

Clear Exit Path

Yes

AED Location

On-site

Fire Extinguisher Location

Near by

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

Error Precursor Mitigations

Nonone

PPE Inspections

☑ Safety glasses (ANSI Z87)
☑ Hearing protection
☑ Rubber insulating gloves and leather protectors
☑ Non-melting footwear that fully covers the feet
☑ Removal of conductive articles
☑ Multimeter and other electrical test instruments

Notes / Other

None

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)
Emergency Response Plan