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QEW 1 / 2 / 3 Job Safety Plan

Electrical Safety
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Time / Date: 7/8/2025 10:09:58
JSP ID: 3907
Scope of Work: Complex LOTO ZVV for ba panels cable catalog/cable removal

General Information

Work Order
439968
Building
6 sec 2 pit
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
Nick gripe
Other Participants
Ems
Affected Persons Notified
Yes

System / Equipment

Switching
Hazardous Switching
Panel / Equipment ID
313A 28, 27, 34
System Information Review
☑ Panel Schedules
☑ Arc Flash Labels
Control of Hazardous Energy
Complex LOTO (requires LP, CLP, FLP)
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
ALS Complex LOTO form and JSP switch get em lock on ZVV when established turn over to the ri

Control of Work Area

Minimum Approach Boundary
95”
Barricade Tape / Attendant
Warning - Orange

Shock Risk Assessment

System Voltage
120/208 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
17 cal/cm2
Arc Flash Boundary
95”
Working Distance
18 inches
Arc Flash PPE Level
2+
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
On equipment we are zvv
Emergency Number to Call
911
Sufficient Cell Phone Signal
Yes
Clear Exit Path
Yes
AED Location
50’ away
Fire Extinguisher Location
On panel 312A 50’
Contact Release Method Available and Tested
Voltage gloves

Environmental Conditions

Does the environment present additional hazards that should be addressed?
Heavy traffic, Lookalike equipment, Noisy environment

Error Precursors

Task Demands
Time pressure (in a hurry), High workload (memory requirements), Simultaneous or multiple tasks
Work Environment
Distractions/interruptions
Individual Capabilities
Human Nature
Stress (limits attention)
Error Precursor Mitigations
Be aware of equipment that looks alike

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

ALS complex LOTO form filled out

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