QEW 1 / 2 / 3 Job Safety Plan

Time / Date: 5/12/2025 8:03:55

JSP ID: 3721

Scope of Work: Replace stripped bussing of B phase circuit 9. Ground A0804, A0805, A0806, A0807 to building steel by bonding bare ground to panelboard enclosure using a through-bolt Kerney.

General Information

Work Order

None

Building

Person in Charge

Greg Neidiger

Lead / Supervisor

Combs, Everett

Logged Email

gcn@lbl.gov

Division

Facilities

Work Planning

Modes of Work

☑ Mode 1 - LOTO & Zero Voltage Verification

QEW Level

QEW 2

Second Person Requirement

Not Required

Second Person Identified

Other Participants

Affected Persons Notified

N/A

System / Equipment

Switching

No Switching Required

Panel / Equipment ID

727A39A

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) Hang lock at LOTO 2) ZVV 727A39A 3) Perform work 4) Remove lock

Control of Work Area

Minimum Approach Boundary

42in.

Barricade Tape / 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

Yes

Voltage Glove Class

Will any other part of the body enter the RAB

Arc Flash Risk Assessment

Incident Energy

0.13 cal/cm2

Arc Flash Boundary

5 in.

Working Distance

No Arc Flash Hazard Present

Arc Flash PPE Level

Minimum PPE for Electrical Work

Incident Energy Reduction Measures

Capacitor Hazards

Capacitor Bus Voltage

Capacitor Total Stored Energy (Joules)

Discharge Wait Time (Minutes)

Emergency Response Plan

Nearest Landline Location

Emergency Number to Call

911

Sufficient Cell Phone Signal

Yes

Clear Exit Path

Yes

AED Location

Fire Extinguisher Location

SO824

Contact Release Method Available and Tested

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

Self-reviewed. No switching required. No arc flash hazard for ZVV. No mitigations taken.

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:

Detailed Scope of Work
Shock and arc flash hazards for each task
Controls to mitigate the hazards (procedures, precautions, energy source controls, PPE requirements)
Work area controls (barricades, signs, attendants)
Emergency Response Plan