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Time / Date: 8/12/2024 7:58:56
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JSP ID: 2827
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Scope of Work: Perform scheduled maintenance
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Work Order: 388060
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Building: 50B
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Person in Charge: Justin walker
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Lead / Supervisor: Delgado, Alex
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Logged Email: johwalker@yahoo.com
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Division: Facilities
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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: Justin solis
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List Other Participants:
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Affected Persons Notified: Yes
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Switching: Hazardous Switching
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Panel / Equipment ID: E38A9A-4/ 50B ac 29
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System Information Review: 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.
Go over job scope. Gather information and perform shock hazard and arc flash hazard assessment. And establish correct ppe. Contact user. Conduct a safety briefing. Perform switching. Apply loto and verify zvv. Perform maintenance tasks. Remove loto and restore power. Check operations and return equipment back to service. |
Control of Work Area
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Minimum Approach Boundary: 46 inches
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Barricade Tape / Attendant: Attendant
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Shock Risk Assessment
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System Voltage: 120/208 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: 6.58 cal/cm2 cal/cm2
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Arc Flash Boundary: 46 inches
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Working Distance: 18 inches
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Arc Flash PPE Level: 2
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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: 50b room 1232
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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: 1 st floor across from elevator
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Fire Extinguisher Location: 1st floor by elevator
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Contact release method available and tested: Upstream breaker or switch, Voltage gloves
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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:
No current error precursors. All technicians comfortable with job scope |
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 |