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Time / Date: 5/7/2025 7:19:18
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JSP ID: 3708
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Scope of Work: Assemble so cable with cord caps.
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Work Order: WO415067
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Building: ALS building 6
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Person in Charge: Mayumi Taylor
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Lead / Supervisor: Keusch, Justen
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Logged Email: mjtaylor@lbl.gov
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Division: Facilities
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QEW Level: QEW 2
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Modes of Work: Mode 2 - Energized Diagnostics, Testing and Troubleshooting, Visual Inspection
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Second Person Requirement: Not Required
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Second Person Identified: Chris Nelson
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List Other Participants: None
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Affected Persons Notified: Yes
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Switching: No Switching Required
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Panel / Equipment ID: Pnl 279A
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System Information Review: Panel Schedules, Arc Flash Labels
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Control of Hazardous Energy: Exclusive Control of Plug
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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
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Sequence of Job Steps
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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
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Minimum Approach Boundary: N/A
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Barricade Tape / Attendant: Attendant
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Shock Risk Assessment
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System Voltage: 120/208 V ac
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Limited Approach Boundary: 42 inches
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Restricted Approach Boundary: 12 inches
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Will the hands enter the RAB: No
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Voltage Glove Class: 0
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Will any other part of the body enter the RAB: No
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Arc Flash Risk Assessment
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Incident Energy: 1.2cal/cm2 cal/cm2
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Arc Flash Boundary: 18”
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Working Distance: 18 inches
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Arc Flash PPE Level: Minimum PPE for Electrical Work
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Incident Energy Reduction Measures: 0
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Capacitor Hazards
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Capacitor Bus Voltage:
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Capacitor total stored energy (joules):
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Discharge wait time (minutes):
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Emergency Response Plan
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Nearest Landline Location: Next to pnl 279A
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Emergency Number to Call: 911
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Sufficient cell phone signal? Yes
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Clear exit path? Yes
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AED Location: Building 6 lobby
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Fire Extinguisher Location: beamline 2.0.1 walkway
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Contact release method available and tested: Voltage gloves
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Environmental Conditions
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Does the environment present additional hazards that should be addressed?
Confined space, Insufficient/cramped/awkward space |
Error Precursors
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Task Demands: Repetitive actions or monotony
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Work Environment: Distractions/interruptions, Changes/departures from routine, Obscure electrical supplies or configurations
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Individual Capabilities:
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Human Nature: Assumptions, Complacency/overconfidence, Mind-set
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Error Precursor Mitigations:
None |
PPE Inspections
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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
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None
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Perform Job Breifing
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PIC Conducts the Job Briefing. Cover all the contents of the Job Safety Plan.
A Job Briefing at a minimum must include:
Rev 2023.08.22.1 Form Content and Feedback Contact: Michael Rose -- mvr@lbl.gov |