QEW 1 / 2 / 3 Job Safety Plan

General Information

Work Order

W0386805

Building

70A

Person in Charge

Pica

Lead / Supervisor

Cameron, Benjamin

Logged Email

josephpica@lbl.gov

Division

Facilities

Work Planning

Modes of Work

☑ Mode 0 - Electrically Safe Work Condition
☑ Mode 1 - LOTO & Zero Voltage Verification

QEW Level

QEW 2

Second Person Requirement

Safety Watch

Second Person Identified

Colmenares

Other Participants

Luis Matt

Affected Persons Notified

N/A

System / Equipment

Switching

Hazardous Switching

Panel / Equipment ID

M70A4A8A

System Information Review

☑ Panel Schedules
☑ Arc Flash Labels

Control of Hazardous Energy

Simple LOTO

Equipment Condition

☑ Properly installed
☑ All doors and covers closed and fully latched
☑ No signs of impending failure

Sequence of Job Steps

List basic sequence of steps from start to finish

Brief switch

Control of Work Area

Minimum Approach Boundary

60 inch

Barricade Tape / Attendant

Attendant

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

No

Voltage Glove Class

0

Will any other part of the body enter the RAB

No

Arc Flash Risk Assessment

Incident Energy

10.7 cal cal/cm2

Arc Flash Boundary

60 inch

Working Distance

No Arc Flash Hazard Present

Arc Flash PPE Level

2+

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

Hallway by elevator

Emergency Number to Call

7911

Sufficient Cell Phone Signal

Yes

Clear Exit Path

Yes

AED Location

Main floor

Fire Extinguisher Location

In hallway by elevator

Contact Release Method Available and Tested

Rescue hook

Environmental Conditions

Does the environment present additional hazards that should be addressed?

Lookalike equipment

Error Precursors

Task Demands

Work Environment

Individual Capabilities

Human Nature

Error Precursor Mitigations

None

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

Jone

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:

Detailed Scope of Work
Shock and arc flash hazards for each task
Controls to mitigate the hazards (procedures, precautions, energy source controls, PPE requirements)
Work area controls (barricades, signs, attendants)
Emergency Response Plan