QEW 1 / 2 / 3 Job Safety Plan

General Information

Work Order

440896

Building

30

Person in Charge

greg Neidiger

Lead / Supervisor

Ramer, Robert

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

Non-Hazardous Switching

Panel / Equipment ID

E657A-9

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) LOTO/ZVV 2) Perform work 3) Release LOTO and verify voltage

Control of Work Area

Minimum Approach Boundary

42"

Barricade Tape / Attendant

Shock Risk Assessment

System Voltage

120 Vac

Limited Approach Boundary

42 inches

Restricted Approach Boundary

3 inches

Will the hands enter the RAB

Yes

Voltage Glove Class

0

Will any other part of the body enter the RAB

No

Arc Flash Risk Assessment

Incident Energy

0.13 cal/cm2

Arc Flash Boundary

5in.

Working Distance

No Arc Flash Hazard Present

Arc Flash PPE Level

Minimum PPE for Electrical Work

Incident Energy Reduction Measures

0

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

Contact Release Method Available and Tested

Upstream breaker or switch

Environmental Conditions

Does the environment present additional hazards that should be addressed?

None

Error Precursors

Task Demands

Work Environment

Lack of alternative indication

Individual Capabilities

Human Nature

Error Precursor Mitigations

Because GFCI has failed receptacle must be removed to verify zero voltage. To avoid potential shock rubber gloves with leather protectors will be used to remove outlet and ZVV.

PPE Inspections

☑ Safety glasses (ANSI Z87)
☑ Arc-rated clothing (flash suit
☑ daily wear) including face shield
☑ balaclava
☑ hood.
☑ 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