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QEW 1 / 2 / 3 Job Safety Plan

Electrical Safety
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Time / Date: 5/7/2025 7:19:18
JSP ID: 3708
Scope of Work: Assemble so cable with cord caps.

General Information

Work Order
WO415067
Building
ALS building 6
Person in Charge
Mayumi Taylor
Lead / Supervisor
Keusch, Justen
Logged Email
mjtaylor@lbl.gov
Division
Facilities

Work Planning

Modes of Work
☑ Mode 2 - Energized Diagnostics
☑ Testing and Troubleshooting
☑ Visual Inspection
QEW Level
QEW 2
Second Person Requirement
Not Required
Second Person Identified
Chris Nelson
Other Participants
None
Affected Persons Notified
Yes

System / Equipment

Switching
No Switching Required
Panel / Equipment ID
Pnl 279A
System Information Review
☑ Panel Schedules
☑ Arc Flash Labels
Control of Hazardous Energy
Exclusive Control of Plug
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
Megger cable, feed cord through labyrinth black box, attach caps, plug male end cord into receptacle in rack BL0211, test female end, unplug cord. TESTING Cord only, no switching.

Control of Work Area

Minimum Approach Boundary
N/A
Barricade Tape / Attendant
Attendant

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
1.2cal/cm2 cal/cm2
Arc Flash Boundary
18”
Working Distance
18 inches
Arc Flash PPE Level
Minimum PPE for Electrical Work
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
Next to pnl 279A
Emergency Number to Call
911
Sufficient Cell Phone Signal
Yes
Clear Exit Path
Yes
AED Location
Building 6 lobby
Fire Extinguisher Location
beamline 2.0.1 walkway
Contact Release Method Available and Tested
Voltage gloves

Environmental Conditions

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

Error Precursors

Task Demands
Repetitive actions or monotony
Work Environment
Distractions/interruptions, Changes/departures from routine, Obscure electrical supplies or configurations
Individual Capabilities
Human Nature
Assumptions, Complacency/overconfidence, Mind-set
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
Rev 2026.03.17.1
Form Content and Feedback Contact: Michael Rose -- mvr@lbl.gov