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Time / Date: 8/7/2024 7:54:24
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JSP ID: 2809
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Scope of Work: Replace power module for PDU 26 display
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Work Order: NA
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Building: 59
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Person in Charge: Ernie Jew
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Lead / Supervisor: Grounds, Jeff
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Logged Email: ejew@lbl.gov
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Division: Comp Sci
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QEW Level: QEW 2
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Modes of Work: Mode 0 - Electrically Safe Work Condition, Mode 1 - LOTO & Zero Voltage Verification
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Second Person Requirement: Standby Person
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Second Person Identified: Jeff Grounds
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List Other Participants: Eric Lucas
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Affected Persons Notified: Yes
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Switching: Hazardous Switching
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Panel / Equipment ID: 590A21A
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System Information Review: Single Line Drawing, Panel Schedules, Arc Flash Labels
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Control of Hazardous Energy: Simple LOTO
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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
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Sequence of Job Steps
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List basic sequence of steps from start to finish.
Notify OPS, Job briefing, switch and LOTO circuit, ZVV at PDU, Perform work, release LOTO, Notify OPS, Switch and test PDU 26 |
Control of Work Area
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Minimum Approach Boundary: 102"
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Barricade Tape / Attendant: Warning - Orange
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Shock Risk Assessment
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System Voltage: 277/480 V ac
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Limited Approach Boundary: 42 inches
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Restricted Approach Boundary: 12 inches
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Will the hands enter the RAB: Yes
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Voltage Glove Class: 0
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Will any other part of the body enter the RAB: No
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Arc Flash Risk Assessment
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Incident Energy: 20.7 cal/cm2
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Arc Flash Boundary: 102"
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Working Distance: 18 inches
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Arc Flash PPE Level: 4
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Incident Energy Reduction Measures: 0
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Capacitor Hazards
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Capacitor Bus Voltage: NA
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Capacitor total stored energy (joules): NA
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Discharge wait time (minutes): NA
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Emergency Response Plan
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Nearest Landline Location: Control Room
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Emergency Number to Call: 911
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Sufficient cell phone signal? Yes
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Clear exit path? Yes
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AED Location: Next to Double doors to lobby on 2nd floor
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Fire Extinguisher Location: West side of Computer floor
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Contact release method available and tested: Rescue hook
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Environmental Conditions
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Does the environment present additional hazards that should be addressed?
Lookalike equipment |
Error Precursors
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Task Demands:
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Work Environment:
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Individual Capabilities:
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Human Nature:
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Error Precursor Mitigations:
Identify the correct PDU before beginning work |
PPE Inspections
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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
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Perform Job Breifing
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PIC Conducts the Job Briefing. Cover all the contents of the Job Safety Plan.
A Job Briefing at a minimum must include:
Rev 2023.08.22.1 Form Content and Feedback Contact: Michael Rose -- mvr@lbl.gov |