QEW 1 / 2 / 3 Job Safety Plan

Time / Date: 5/15/2025 12:27:05

JSP ID: 3742

Scope of Work: Loto, ZVV, investigate existing branch circuit wiring and install new raceways and jboxes for cubicle rearrangement. Pull in new conductors, inspect.

General Information

Work Order

404719

Building

Person in Charge

Shane Miller

Lead / Supervisor

Secheck, Stephen

Logged Email

spmiller@lbl.gov

Division

Facilities

Work Planning

Modes of Work

☑ Mode 1 - LOTO & Zero Voltage Verification

QEW Level

QEW 2

Second Person Requirement

Standby Person

Second Person Identified

Alex Lopez

Other Participants

Steve Sechak

Affected Persons Notified

Yes

System / Equipment

Switching

Non-Hazardous Switching

Panel / Equipment ID

217A1A3A

System Information Review

☑ Panel Schedules
☑ Arc Flash Labels

Control of Hazardous Energy

Simple LOTO

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

Sequence of Job Steps

List basic sequence of steps from start to finish

1. Dawn the proper PPE 2. Apply Loto at panel 217A1A3A ckt 4 3. Hang red locks 4. ZVV at panel 233A 5. Investigate existing branch circuits 6. Install new raceways/jboxes 7. Pull in new branch circuit wiring 8. Add new breakers to panel 233A and tie in new branch circuit wires. 9. Inspect rough in and megger wire 10. Leave all new wiring in electrical safe condition. Hang blue admin. Locks on newly installed breakers. 11. Release LOTO at panel 217A1A3A 12. Clean up and wait for new cubicles to be installed.

Control of Work Area

Minimum Approach Boundary

42”

Barricade Tape / Attendant

Attendant

Shock Risk Assessment

System Voltage

277/480 V ac

Limited Approach Boundary

42 inches

Restricted Approach Boundary

12 inches

Will the hands enter the RAB

Voltage Glove Class

Will any other part of the body enter the RAB

Arc Flash Risk Assessment

Incident Energy

4.09cal/cm2 cal/cm2

Arc Flash Boundary

35”

Working Distance

18 inches

Arc Flash PPE Level

Incident Energy Reduction Measures

Capacitor Hazards

Capacitor Bus Voltage

Capacitor Total Stored Energy (Joules)

Discharge Wait Time (Minutes)

Emergency Response Plan

Nearest Landline Location

Using cell phone with good signal

Emergency Number to Call

X6999

Sufficient Cell Phone Signal

Yes

Clear Exit Path

Yes

AED Location

In Vehicle outside building, 100’ away

Fire Extinguisher Location

In break room 35’ away

Contact Release Method Available and Tested

Voltage gloves

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

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:

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