Time / Date: 7/11/2024 13:59:58
JSP ID: 2746
Scope of Work: ZVV first exposure of 480V booster bend power supply disconnect that was put u dear LOTO previously. for installing new 4 inch AC conduits for new BBPS.
Work Order: 390770
Building: 6 ALS
Person in Charge: Christopher Nelson
Lead / Supervisor: Combs, Everett
Logged Email: cnelson@lbl.gov
Division: ALS
QEW Level: QEW 2
Modes of Work: Mode 1 - LOTO & Zero Voltage Verification
Second Person Requirement: Standby Person
Second Person Identified: Robert Ralph
List Other Participants:
Affected Persons Notified: Yes
Switching: No Switching Required
Panel / Equipment ID: 303A2A1A
System Information Review: Single Line Drawing, 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.

Briefing with the RI place personal LOTO locks on group LOTO boxes in place. Fill out the JSP select PPE for ZVV place danger barricade and signage for unauthorized persons to be kept out of the arc flash boundary. Complete and verify the ZVV and do the work.

Control of Work Area

Minimum Approach Boundary: 65”
Barricade Tape / Attendant: Danger - Red

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: 9.39 cal^cm2 at 18” cal/cm2
Arc Flash Boundary: 65”
Working Distance: 18 inches
Arc Flash PPE Level: 4
Incident Energy Reduction Measures: 0

Capacitor Hazards

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

Emergency Response Plan

Nearest Landline Location: In the booster pit where we are by br2 gate
Emergency Number to Call: 911
Sufficient cell phone signal? Yes
Clear exit path? Yes
AED Location: In lobby of b 15 is closest
Fire Extinguisher Location: Right next to the panel to be ZVV
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: Time pressure (in a hurry), High workload (memory requirements)
Work Environment: Distractions/interruptions
Individual Capabilities:
Human Nature: Stress (limits attention), Mind-set
Error Precursor Mitigations:

Keep a good mindset don’t get complacent

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 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