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QEW 1 / 2 / 3 Job Safety Plan

Electrical Safety
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Time / Date: 7/8/2024 12:23:18
JSP ID: 2737
Scope of Work: LOTO/ZVV of Cavity #1 & 2 SCR water heater controller and water system pumps #1-3

General Information

Work Order
378442
Building
B6
Person in Charge
Greg Neidiger
Lead / Supervisor
Combs, Everett
Logged Email
gcn@lbl.gov
Division
ALS

Work Planning

Modes of Work
☑ Mode 1 - LOTO & Zero Voltage Verification
QEW Level
QEW 2
Second Person Requirement
Not Required
Second Person Identified
Dave Davis
Other Participants
Affected Persons Notified

System / Equipment

Switching
Non-Hazardous Switching
Panel / Equipment ID
301A2A3A-9,10,15,16,21
System Information Review
☑ Panel Schedules
☑ Arc Flash Labels
Control of Hazardous Energy
Complex LOTO w/ RI
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

Sequence of Job Steps

List basic sequence of steps from start to finish
1) Switch circuits 2) apply locks 3) verify absence of voltage on line side of disconnects

Control of Work Area

Minimum Approach Boundary
42in
Barricade Tape / Attendant
Attendant

Shock Risk Assessment

System Voltage
277/480 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
0.6 cal/cm2
Arc Flash Boundary
11inches
Working Distance
No Arc Flash Hazard Present
Arc Flash PPE Level
Minimum PPE for Electrical Work
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
Adjacent to equipment
Emergency Number to Call
911
Sufficient Cell Phone Signal
Yes
Clear Exit Path
Yes
AED Location
In pit near work area
Fire Extinguisher Location
In pit near work area
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
We reviewed error precursors for this task and determined no additional mitigations be

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
☑ Multimeter and other electrical test instruments

Notes / Other

Discussed exit routes and location of AED, phone, and fire extinguisher

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