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QEW 1 / 2 / 3 Job Safety Plan

Electrical Safety
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Time / Date: 5/2/2025 9:53:09
JSP ID: 3697
Scope of Work: Establish electrically safe work condition on Station B 1430 Helium Compressor for contractor work - LOTO Permit # 5721

General Information

Work Order
None
Building
88
Person in Charge
Scott Small
Lead / Supervisor
Other
Logged Email
smsmall@lbl.gov
Division
Other

Work Planning

Modes of Work
☑ Mode 1 - LOTO & Zero Voltage Verification
QEW Level
QEW 2
Second Person Requirement
Standby Person
Second Person Identified
B. Ford
Other Participants
Roy Kulp and John Cuevas of Negative One-Eighty
Affected Persons Notified
Yes

System / Equipment

Switching
Hazardous Switching
Panel / Equipment ID
Station B 1430
System Information Review
☑ Single Line Drawing
☑ 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
Establish LOTO R2A-4, ZVV

Control of Work Area

Minimum Approach Boundary
116
Barricade Tape / Attendant
Warning - Orange

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
Arc Flash Boundary
116 inches
Working Distance
18 inches
Arc Flash PPE Level
3
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
South Vault Door
Emergency Number to Call
911
Sufficient Cell Phone Signal
Yes
Clear Exit Path
Yes
AED Location
Lobby and Control Room
Fire Extinguisher Location
Outside room 129
Contact Release Method Available and Tested
Rescue hook, Voltage gloves

Environmental Conditions

Does the environment present additional hazards that should be addressed?
None

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

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
Rev 2026.03.17.1
Form Content and Feedback Contact: Michael Rose -- mvr@lbl.gov