QEW 1 / 2 / 3 Job Safety Plan

General Information

Work Order

402417

Building

70 A

Person in Charge

A Turner

Lead / Supervisor

Cameron, Benjamin

Logged Email

avery.turner08@gmail.com

Division

Facilities

Work Planning

Modes of Work

☑ Mode 0 - Electrically Safe Work Condition

QEW Level

QEW 2

Second Person Requirement

Safety Watch

Second Person Identified

A Turner

Other Participants

None

Affected Persons Notified

Yes

System / Equipment

Switching

Hazardous Switching

Panel / Equipment ID

MCC 001 70

System Information Review

☑ Single Line Drawing
☑ Arc Flash Labels

Control of Hazardous Energy

LOTO Not Required (Mode 2 or 3 only)

Equipment Condition

☑ Properly installed
☑ No signs of impending failure

Sequence of Job Steps

List basic sequence of steps from start to finish

De energize circuits as per the one crew request

Control of Work Area

Minimum Approach Boundary

103 inches

Barricade Tape / Attendant

Shock Risk Assessment

System Voltage

120/208 V ac

Limited Approach Boundary

42 inches

Restricted Approach Boundary

103 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

28.3 cal/cm2

Arc Flash Boundary

103 inches

Working Distance

18 inches

Arc Flash PPE Level

2+

Incident Energy Reduction Measures

0

Capacitor Hazards

Capacitor Bus Voltage

None

Capacitor Total Stored Energy (Joules)

None

Discharge Wait Time (Minutes)

None

Emergency Response Plan

Nearest Landline Location

Cell ohone

Emergency Number to Call

911

Sufficient Cell Phone Signal

Yes

Clear Exit Path

Yes

AED Location

Onsite

Fire Extinguisher Location

On site

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

None

PPE Inspections

☑ Safety glasses (ANSI Z87)
☑ Arc-rated clothing (flash suit
☑ daily wear) including face shield
☑ balaclava
☑ hood.
☑ Hearing protection
☑ Non-melting footwear that fully covers the feet

Notes / Other

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