QEW 1 / 2 / 3 Job Safety Plan

General Information

Work Order

W0428682

Building

78

Person in Charge

Colmenares

Lead / Supervisor

Cameron, Benjamin

Logged Email

jcolmenares@lbl.gov

Division

Facilities

Work Planning

Modes of Work

☑ Mode 1 - LOTO & Zero Voltage Verification

QEW Level

QEW 2

Second Person Requirement

Safety Watch

Second Person Identified

Pica

Other Participants

PMT

Affected Persons Notified

N/A

System / Equipment

Switching

Hazardous Switching

Panel / Equipment ID

PNL-003-78

System Information Review

☑ Panel Schedules
☑ Arc Flash Labels

Control of Hazardous Energy

Simple LOTO

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 adjust limit switch, and test

Control of Work Area

Minimum Approach Boundary

84 inch

Barricade Tape / Attendant

Attendant

Shock Risk Assessment

System Voltage

277/480 V ac

Limited Approach Boundary

42 inches

Restricted Approach Boundary

3 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

19.6 cal cal/cm2

Arc Flash Boundary

84 inch

Working Distance

18 inches

Arc Flash PPE Level

4

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

On site

Emergency Number to Call

7911

Sufficient Cell Phone Signal

Yes

Clear Exit Path

Yes

AED Location

Building 76

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?

Fall hazard, Noisy environment

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

None

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