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Time / Date: 12/20/2022 8:32:41
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JSP ID: 374
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Scope of Work: Preventive Maintenance
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Work Order: W0299266
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Building:
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Person in Charge: Juan Juarez
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Lead / Supervisor: Delgado, Alex
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Logged Email: juanjuarez37@lbl.gov
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Division: Facilities
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QEW Level: QEW 2
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Modes of Work: Mode 1 - LOTO & Zero Voltage Verification
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Second Person Requirement: Standby Person
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Second Person Identified: Justin walker
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List Other Participants:
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Affected Persons Notified: Yes
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Switching: Hazardous Switching
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Panel / Equipment ID: 64ARU005/512A7AD1A
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System Information Review: Arc Flash Labels
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Control of Hazardous Energy: Simple LOTO
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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.
LOTO procedure ZVV ,visual inspection, oil sampling ,electrical tightening,coils inspection and cleanup if needed, after service unit will be return to initial settings and will be tested . |
Control of Work Area
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Minimum Approach Boundary: 42
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Barricade Tape / Attendant: 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: 5.12 cal/cm2
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Arc Flash Boundary: 37
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Working Distance: 18 inches
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Arc Flash PPE Level: 2
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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: Lobby building 54
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Emergency Number to Call: 7911
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Sufficient cell phone signal? Yes
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Clear exit path? Yes
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AED Location: building 54 outside room 142
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Fire Extinguisher Location: building 54 front room 107
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Contact release method available and tested: Rescue hook
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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:
Electrical and cold weather -LOTO and jackets with a rating for flash hazard |
PPE Inspections
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Notes / Other
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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 |