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QEW 1 / 2 / 3 Job Safety Plan

Electrical Safety
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Time / Date: 7/22/2024 9:51:40
JSP ID: 2764
Scope of Work: Visual inspection of panel 95A

General Information

Work Order
386817
Building
62
Person in Charge
Greg Neidiger
Lead / Supervisor
Ramer, Robert
Logged Email
gcn@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
Armand Uribe
Other Participants
Affected Persons Notified
N/A

System / Equipment

Switching
No Switching Required
Panel / Equipment ID
95A
System Information Review
☑ Arc Flash Labels
Control of Hazardous Energy
LOTO Not Required (Mode 2 or 3 only)
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) Don PPE 2) remove screws to cover and swing door open 3) inspect panel without breaking plane 4) close panel

Control of Work Area

Minimum Approach Boundary
93in
Barricade Tape / Attendant
Attendant

Shock Risk Assessment

System Voltage
No Shock Hazard Present
Limited Approach Boundary
42 inches
Restricted Approach Boundary
12 inches
Will the hands enter the RAB
No
Voltage Glove Class
0
Will any other part of the body enter the RAB
No

Arc Flash Risk Assessment

Incident Energy
17.8 cal/cm2
Arc Flash Boundary
93in.
Working Distance
18 inches
Arc Flash PPE Level
4
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
Emergency Number to Call
911
Sufficient Cell Phone Signal
Yes
Clear Exit Path
Yes
AED Location
Work vehicle
Fire Extinguisher Location
Adjacent to work location
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 have reviewed potential error precursors and did not identify any for this task

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

Notes / Other

Looking for spare wires from a junction box in Rm 101

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