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Time / Date: 12/16/2022 10:44:21
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JSP ID: 360
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Scope of Work: Assessing 88 Ahu 15 not working.
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Work Order: 305633
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Building:
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Person in Charge: Juan garcia
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Lead / Supervisor: Delgado, Alex
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Logged Email: jwwalker@lbl.gov
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Division: Facilities
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QEW Level: QEW 2
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Modes of Work: Mode 1 - LOTO & Zero Voltage Verification
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Second Person Requirement: Standby Person
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Second Person Identified: Justin walker
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List Other Participants: N/A
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Affected Persons Notified: Yes
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Switching: Non-Hazardous Switching
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Panel / Equipment ID: M80A2A21A1A
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System Information Review: Panel Schedules, Arc Flash Labels
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Control of Hazardous Energy: Simple LOTO
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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
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Sequence of Job Steps
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List basic sequence of steps from start to finish.
Go over job scope, assess equipment location, analyze hazards check arc flash lanes for proper ppe. It’s a simple loto. Apply loto verify zvv secure area and perform inspection on 88 Ahu to determine issue. Repair if possible. If not report follow up if neeede |
Control of Work Area
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Minimum Approach Boundary: 42
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Barricade Tape / Attendant: Warning - Orange
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Shock Risk Assessment
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System Voltage: 277/480 V ac
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Limited Approach Boundary: 42 inches
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Restricted Approach Boundary: 12 inches
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Will the hands enter the RAB: Yes
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Voltage Glove Class: 00
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Will any other part of the body enter the RAB: No
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Arc Flash Risk Assessment
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Incident Energy: 5.04 cal/cm2 cal/cm2
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Arc Flash Boundary: 40
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Working Distance: 18 inches
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Arc Flash PPE Level: 2
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Incident Energy Reduction Measures: 00
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Capacitor Hazards
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Capacitor Bus Voltage: N/A
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Capacitor total stored energy (joules): N/A
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Discharge wait time (minutes): N/A
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Emergency Response Plan
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Nearest Landline Location: Offices 50 feet away
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Emergency Number to Call: 911
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Sufficient cell phone signal? Yes
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Clear exit path? Yes
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AED Location: 1st floor lobby
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Fire Extinguisher Location: Room 238
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Contact release method available and tested: Upstream breaker or switch
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Environmental Conditions
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Does the environment present additional hazards that should be addressed?
Confined space |
Error Precursors
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Task Demands:
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Work Environment:
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Individual Capabilities:
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Human Nature:
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Error Precursor Mitigations:
No error precursors on this job |
PPE Inspections
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Notes / Other
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Perform Job Breifing
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PIC Conducts the Job Briefing. Cover all the contents of the Job Safety Plan.
A Job Briefing at a minimum must include:
Rev 2023.08.22.1 Form Content and Feedback Contact: Michael Rose -- mvr@lbl.gov |