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QEW 1 / 2 / 3 Job Safety Plan

Electrical Safety
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Time / Date: 4/28/2025 14:01:57
JSP ID: 3671
Scope of Work: Cable tracing in sector 7

General Information

Work Order
Wo415062
Building
ALS 6
Person in Charge
Mayumi Taylor
Lead / Supervisor
Keusch, Justen
Logged Email
mjtaylor@lbl.gov
Division
ALS

Work Planning

Modes of Work
☑ Mode 1 - LOTO & Zero Voltage Verification
QEW Level
QEW 2
Second Person Requirement
Safety Watch
Second Person Identified
Anthony Pilz
Other Participants
None
Affected Persons Notified
Yes

System / Equipment

Switching
Hazardous Switching
Panel / Equipment ID
319A
System Information Review
☑ Panel Schedules
☑ Arc Flash Labels
Control of Hazardous Energy
Complex LOTO w/ RI
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
Wear appropriate ppe, Loto, zvv. May require troubleshooting. Trace cables, loto, remove Loto and reenergize.

Control of Work Area

Minimum Approach Boundary
113”
Barricade Tape / Attendant
Warning - Orange

Shock Risk Assessment

System Voltage
120/208 V ac
Limited Approach Boundary
42 inches
Restricted Approach Boundary
12 inches
Will the hands enter the RAB
No
Voltage Glove Class
0
Will any other part of the body enter the RAB
No

Arc Flash Risk Assessment

Incident Energy
22.5cal/cm2 cal/cm2
Arc Flash Boundary
113”
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
Sr6 door
Emergency Number to Call
911
Sufficient Cell Phone Signal
Yes
Clear Exit Path
Yes
AED Location
Bld6 als lobby
Fire Extinguisher Location
Sr6 door
Contact Release Method Available and Tested
Voltage gloves

Environmental Conditions

Does the environment present additional hazards that should be addressed?
Insufficient lighting, Confined space, Insufficient/cramped/awkward space

Error Precursors

Task Demands
Simultaneous or multiple tasks, Repetitive actions or monotony
Work Environment
Distractions/interruptions, Changes/departures from routine
Individual Capabilities
Human Nature
Habit patterns, Assumptions, Complacency/overconfidence
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:
  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