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QEW 1 / 2 / 3 Job Safety Plan

Electrical Safety
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Time / Date: 7/1/2025 7:06:54
JSP ID: 3888
Scope of Work: Switch panel and ZVV panel to enter conduit in panel pull in new circuit for Sharp Lathe

General Information

Work Order
4472737
Building
80
Person in Charge
Christopher Nelson
Lead / Supervisor
Combs, Everett
Logged Email
cnelson@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
Robert Ralph
Other Participants
Affected Persons Notified
Yes

System / Equipment

Switching
Hazardous Switching
Panel / Equipment ID
342A1A19A And. 342A1A19A51A
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
Fill out JSP select PPE and inspect tools/ppe set up warning barrier get permission to switch panel off. Switch LOTO and ZVV. Do the work when ZVV is established. When done and everything is in safe condition remove LOTO and re Energized the panel.

Control of Work Area

Minimum Approach Boundary
72
Barricade Tape / Attendant
Warning - Orange

Shock Risk Assessment

System Voltage
120/240 V ac
Limited Approach Boundary
42 inches
Restricted Approach Boundary
12 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
11 and 9.68 cal/cm2
Arc Flash Boundary
72 inches and 66”
Working Distance
18 inches
Arc Flash PPE Level
4
Incident Energy Reduction Measures
0

Capacitor Hazards

Capacitor Bus Voltage
Na
Capacitor Total Stored Energy (Joules)
Na
Discharge Wait Time (Minutes)
Na

Emergency Response Plan

Nearest Landline Location
Next to panel we are to zvv
Emergency Number to Call
911
Sufficient Cell Phone Signal
Yes
Clear Exit Path
Yes
AED Location
In lobby of 15
Fire Extinguisher Location
On opposite wall
Contact Release Method Available and Tested
Voltage gloves

Environmental Conditions

Does the environment present additional hazards that should be addressed?
Noisy environment

Error Precursors

Task Demands
Simultaneous or multiple tasks
Work Environment
Distractions/interruptions
Individual Capabilities
Inappropriate values
Human Nature
Stress (limits attention)
Error Precursor Mitigations
Keep on task no distractions or outside stress

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

Switching panel 342A1A19A circuit 51 for. ZVV of panel 342A1A19A51A

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:
  1. Detailed Scope of Work
  2. Shock and arc flash hazards for each task
  3. Controls to mitigate the hazards (procedures, precautions, energy source controls, PPE requirements)
  4. Work area controls (barricades, signs, attendants)
  5. Emergency Response Plan
Rev 2026.03.17.1
Form Content and Feedback Contact: Michael Rose -- mvr@lbl.gov