QEW 1 / 2 / 3 Job Safety Plan

Back to Index

Time / Date: 4/1/2025 7:13:09

JSP ID: 3562

Scope of Work: Assist contractors with troubleshooting of the outbound grizzly gate, provide Mo to work if necessary

General Information

Work Order

W0430971

Building

Grizzly Gate

Person in Charge

Colmenares

Lead / Supervisor

Cameron, Benjamin

Logged Email

jcolmenares@lbl.gov

Division

Facilities

Work Planning

Modes of Work

☑ Mode 0 - Electrically Safe Work Condition
☑ Mode 1 - LOTO & Zero Voltage Verification
☑ Mode 2 - Energized Diagnostics
☑ Testing and Troubleshooting
☑ Visual Inspection

QEW Level

QEW 2

Second Person Requirement

Standby Person

Second Person Identified

Rich

Other Participants

Contractors

Affected Persons Notified

N/A

System / Equipment

Switching

Hazardous Switching

Panel / Equipment ID

525A

System Information Review

☑ Panel Schedules
☑ Arc Flash Labels

Control of Hazardous Energy

Complex LOTO (requires LP, CLP, FLP)

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 tape off area perform Mode 2, LOTO ZVV. Replace defective sensor or circuit cardPerform test on gate.

Control of Work Area

Minimum Approach Boundary

42 inch

Barricade Tape / Attendant

Danger - Red

Shock Risk Assessment

System Voltage

120/208 V ac

Limited Approach Boundary

42 inches

Restricted Approach Boundary

3 inches

Will the hands enter the RAB

Yes

Voltage Glove Class

Will any other part of the body enter the RAB

Arc Flash Risk Assessment

Incident Energy

4.38 cal cal/cm2

Arc Flash Boundary

40 inch

Working Distance

18 inches

Arc Flash PPE Level

Incident Energy Reduction Measures

Capacitor Hazards

Capacitor Bus Voltage

Capacitor Total Stored Energy (Joules)

Discharge Wait Time (Minutes)

Emergency Response Plan

Nearest Landline Location

Bldg 69

Emergency Number to Call

7911

Sufficient Cell Phone Signal

Yes

Clear Exit Path

Yes

AED Location

Bldg 69

Fire Extinguisher Location

Bldg 69

Contact Release Method Available and Tested

Voltage gloves

Environmental Conditions

Does the environment present additional hazards that should be addressed?

Heavy traffic, Lookalike equipment, We’re protective safety vests

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

Stop work if it rains

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