Time / Date: 7/23/2025 9:49:05
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JSP ID: 3953
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Scope of Work: Replace controllers for 92-IHPT-001 & 92-DHPT-001
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Work Order: 448376
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Building: 92
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Person in Charge: Gerald Fowler
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Lead / Supervisor: Delgado, Alex
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Logged Email: gdfowler@lbl.gov
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Division: Facilities
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QEW Level: QEW 2
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Modes of Work: Mode 0 - Electrically Safe Work Condition, 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: Contractors
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Affected Persons Notified: Yes
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Switching: Non-Hazardous Switching
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Panel / Equipment ID: E700A1A4A9A/92-DHPT-001/92-IHTP-001
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System Information Review: Panel Schedules, Arc Flash Labels
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Control of Hazardous Energy: Complex LOTO (requires LP, CLP, FLP)
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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
List basic sequence of steps from start to finish.
Place units under Loto then verify both units are absent of any voltage prior to performing any work. |
Control of Work Area
Minimum Approach Boundary: 42 inches
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Barricade Tape / Attendant: Warning - Orange
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Shock Risk Assessment
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
Incident Energy: .15 cal cm2 cal/cm2
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Arc Flash Boundary: 6 inches
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Working Distance: 18 inches
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Arc Flash PPE Level: Minimum PPE for Electrical Work
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Incident Energy Reduction Measures: 0
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Capacitor Hazards
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
Nearest Landline Location: Elevator lobby
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Emergency Number to Call: 510-486-6999/7911
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Sufficient cell phone signal? Yes
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Clear exit path? Yes
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AED Location: Main entrance
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Fire Extinguisher Location: Same room
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Contact release method available and tested: Upstream breaker or switch, Voltage gloves
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Environmental Conditions
Does the environment present additional hazards that should be addressed?
Lookalike equipment |
Error Precursors
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:
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
Work being done under FLP5806 & FLP 5807
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Perform Job Breifing
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 |