Time / Date: 12/16/2024 10:00:03
JSP ID: 3201
Scope of Work: Safe off old 10kV capacitor found on mezzanine during cleanout
Work Order:
Building: 71
Person in Charge: Ari Harding
Lead / Supervisor: Other
Logged Email: aharding@lbl.gov
Division: Other
QEW Level: QEW 1
Modes of Work: Mode 1 - LOTO & Zero Voltage Verification
Second Person Requirement: Standby Person
Second Person Identified: Rob Connelly
List Other Participants: None
Affected Persons Notified: N/A
Switching: No Switching Required
Panel / Equipment ID: N/A
System Information Review:
Control of Hazardous Energy: LOTO Not Required (Mode 2 or 3 only)
Equipment Condition: 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. ZVV capacitor with Fluke 80K adapter 2.short with wire.

Control of Work Area

Minimum Approach Boundary:
Barricade Tape / Attendant: Danger - Red

Shock Risk Assessment

System Voltage: 10kV rating on cap
Limited Approach Boundary: 60 inches
Restricted Approach Boundary: 2 feet, 2 inches
Will the hands enter the RAB: Yes
Voltage Glove Class: 1
Will any other part of the body enter the RAB: No

Arc Flash Risk Assessment

Incident Energy: No AF hazard cal/cm2
Arc Flash Boundary: N/A
Working Distance: No Arc Flash Hazard Present
Arc Flash PPE Level: Minimum PPE for Electrical Work
Incident Energy Reduction Measures: 1

Capacitor Hazards

Capacitor Bus Voltage: 10kV marked on disconnected csp
Capacitor total stored energy (joules): 50 J at rated voltage
Discharge wait time (minutes): No bleed resistor

Emergency Response Plan

Nearest Landline Location: 71 lobby
Emergency Number to Call: 911
Sufficient cell phone signal? Yes
Clear exit path? Yes
AED Location: 71 lobby
Fire Extinguisher Location: Lobby
Contact release method available and tested: DC

Environmental Conditions

Does the environment present additional hazards that should be addressed?

Egress is slightly restricted

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

Cap looks very old, likely stored for a long time.

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