Time / Date: 4/21/2025 9:44:24
JSP ID: 3650
Scope of Work: LOTO and electrical troubleshooting of the 1430 compressor PLC module.
Work Order:
Building: 88
Person in Charge: Brendan Ford
Lead / Supervisor: Other
Logged Email: bpford@lbl.gov
Division: Other
QEW Level: QEW 2
Modes of Work: Mode 0 - Electrically Safe Work Condition, Mode 1 - LOTO & Zero Voltage Verification
Second Person Requirement: Standby Person
Second Person Identified: Brendan Ford
List Other Participants: Patrick Coleman, Collin Anderson, Michel Kireeff Covo
Affected Persons Notified: Yes
Switching: Hazardous Switching
Panel / Equipment ID: 80A3A5A9A CB 5 and 1430 Disconnect.
System Information Review: Panel Schedules, Arc Flash Labels
Control of Hazardous Energy: Simple LOTO
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 Safely shut down the 1430 compressor. 2 Have QEW 2 that's qualified to switch and ZVV 480 VAC with an arc flash hazard of 23.4 cal/cm2. Switch off 80A3A5A9A CB 5. 3 Open the 1430 Disconnect and apply LOTO lock. 4 Open the 1430 electrical cover and ZVV on the 480 Vac terminal feeding the equipment. 5 Perform the needed troubleshooting under electrically safe conditions (no power present). 6 Clean area of tools and replace electrical cover. 7 Remove the 1430 LOTO and return to service.

Control of Work Area

Minimum Approach Boundary: 116"
Barricade Tape / Attendant: Attendant

Shock Risk Assessment

System Voltage: 277/480 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: 23.4 cal/cm2 cal/cm2
Arc Flash Boundary: 116"
Working Distance: 18 inches
Arc Flash PPE Level: 4
Incident Energy Reduction Measures: 0

Capacitor Hazards

Capacitor Bus Voltage: None
Capacitor total stored energy (joules): None
Discharge wait time (minutes): N/A

Emergency Response Plan

Nearest Landline Location: Around the corner to the SouthWest about 25 feet away.
Emergency Number to Call: 911
Sufficient cell phone signal? Yes
Clear exit path? Yes
AED Location: Will bring to location.
Fire Extinguisher Location: 15 feet directly to the South.
Contact release method available and tested: Rescue hook, Voltage gloves

Environmental Conditions

Does the environment present additional hazards that should be addressed?

Noisy environment

Error Precursors

Task Demands: Critical steps or irreversible acts
Work Environment:
Individual Capabilities: Unfamiliar with, or first time performing task
Human Nature:
Error Precursor Mitigations:

Go through steps before starting LOTO.

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,
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