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Time / Date: 5/14/2025 8:14:54
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JSP ID: 3731
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Scope of Work: Dawn the proper PPE and set up barricades, Loto @panel 66A2A14A ckt9, hang red locks. ZVV at bank 96 and panel 96A. Check connection/terminals. Mode 2 release loto and live voltage reading from each phase to neutral and ground at bank 96. Close and secure bank 96. Release LOTO
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Work Order: WO372559
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Building: 62
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Person in Charge: Shane Miller
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Lead / Supervisor: Secheck, Stephen
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Logged Email: spmiller@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: Safety Watch
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Second Person Identified: Alex Lopez
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List Other Participants: Steve Sechak
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Affected Persons Notified: Yes
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Switching: Hazardous Switching
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Panel / Equipment ID: 66A2A14A
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System Information Review: Panel Schedules, Arc Flash Labels
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Control of Hazardous Energy: Simple LOTO
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Equipment Condition: Properly installed, 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.
1. Set up barricades for mode 2 work(red tape) 2. Dawn the proper PPE 3.switch at panel 66A2A14A ckt 9 4. Hang red locks 5. ZVV at bank 96 and panel 96A 6. Check connections/ terminals at bank 96 document with photos 7. Mode 2 release Loto and check live voltage readings for every combo of phases to neutral and ground. 8. Apply Loto again at panel 66A2A14A ckt 9 9. Replace covers on bank 96 and at panel 96A 10. Release Loto and clean up |
Control of Work Area
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Minimum Approach Boundary: 111 inches
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Barricade Tape / Attendant: Danger - Red, Attendant
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Shock Risk Assessment
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System Voltage: 277/480 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: Yes
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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: 32.4cal/cm2 cal/cm2
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Arc Flash Boundary: 111 inches
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Working Distance: 18 inches
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Arc Flash PPE Level: 4
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Incident Energy Reduction Measures: 0
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Capacitor Hazards
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Capacitor Bus Voltage: N/A
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Capacitor total stored energy (joules): N/A
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Discharge wait time (minutes): N/A
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Emergency Response Plan
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Nearest Landline Location: Using cell with good signal
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Emergency Number to Call: X6999
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Sufficient cell phone signal? Yes
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Clear exit path? Yes
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AED Location: In vehicle at back door of 62 100’ away
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Fire Extinguisher Location: Outside room 101 40’ away
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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?
None |
Error Precursors
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Task Demands:
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Work Environment:
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Individual Capabilities:
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Human Nature:
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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 |