Time / Date: 12/3/2024 8:17:28
JSP ID: 3160
Scope of Work: Disconnect perm power and put temp power on all 4 FA panels off same breaker panel
Work Order: 406704
Building: B50B
Person in Charge: Ben Agas and Ed Bekheet
Lead / Supervisor: Baird, Shawn
Logged Email: edbekheet@lbl.gov
Division: Facilities
QEW Level: QEW 1
Modes of Work: Mode 0 - Electrically Safe Work Condition
Second Person Requirement: Safety Watch
Second Person Identified: Ben Agas
List Other Participants:
Affected Persons Notified: Yes
Switching: No Switching Required
Panel / Equipment ID: E38A9A1A. 21,22,24 and 2
System Information Review: Single Line Drawing, Panel Schedules, Arc Flash Labels
Control of Hazardous Energy: Exclusive Control of Plug
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.

1. Put LOTO on building LOTO 2. Perform ZVV on all 4 FA panels 3. Hook up temp power cord to all 4 panels while unplugged and while having control over temp power 4. Run temp power cord and plug into power for all 4 panels 5. Verify units are on

Control of Work Area

Minimum Approach Boundary:
Barricade Tape / Attendant: Attendant

Shock Risk Assessment

System Voltage: 120/208 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: 7.98 cal/cm2
Arc Flash Boundary: 59
Working Distance: No Arc Flash Hazard Present
Arc Flash PPE Level: Minimum PPE for Electrical Work
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: By FACP in Rm 243
Emergency Number to Call: 911
Sufficient cell phone signal? Yes
Clear exit path? Yes
AED Location: B50B by 1st floor elevator
Fire Extinguisher Location: Near FACP
Contact release method available and tested: Voltage gloves

Environmental Conditions

Does the environment present additional hazards that should be addressed?

Insufficient lighting, None

Error Precursors

Task Demands: Time pressure (in a hurry), High workload (memory requirements), Simultaneous or multiple tasks
Work Environment: Obscure electrical supplies or configurations
Individual Capabilities:
Human Nature: Stress (limits attention)
Error Precursor Mitigations:

Reviewed error precursors

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

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