Time / Date: 7/28/2024 10:06:00
JSP ID: 2781
Scope of Work: Repair UPS 2 UPM
Work Order: NA
Building: B59
Person in Charge: Ernie Jew
Lead / Supervisor: Grounds, Jeff
Logged Email: ejew@lbl.gov
Division: Comp Sci
QEW Level: QEW 2
Modes of Work: Mode 0 - Electrically Safe Work Condition, Mode 1 - LOTO & Zero Voltage Verification
Second Person Requirement: Standby Person
Second Person Identified: Eugene Acasio
List Other Participants: Eric Lucas
Affected Persons Notified: Yes
Switching: Hazardous Switching
Panel / Equipment ID: UPS 1 & 2
System Information Review: Single Line Drawing
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.

Notify Control room, Put UPS in bypass, Power down UPS, LOTO isolations, Perform ZVV, Perform work, Release LOTO, Power up UPS, Take UPS out of Bypass, Notify Control Room.

Control of Work Area

Minimum Approach Boundary: 42"
Barricade Tape / Attendant: Warning - Orange

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: 5.4 Cal/Cm2 cal/cm2
Arc Flash Boundary: 38"
Working Distance: 18 inches
Arc Flash PPE Level: 2
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: Container office
Emergency Number to Call: 911
Sufficient cell phone signal? Yes
Clear exit path? Yes
AED Location: In Container Office
Fire Extinguisher Location: In UPS room
Contact release method available and tested: Rescue hook

Environmental Conditions

Does the environment present additional hazards that should be addressed?

None

Error Precursors

Task Demands: Critical steps or irreversible acts
Work Environment:
Individual Capabilities:
Human Nature:
Error Precursor Mitigations:

Follow CLP 383 LOTO procedures

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,
Longer multimeter leads

Notes / Other

NA

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