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QEW 1 / 2 / 3 Job Safety Plan

Electrical Safety
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Time / Date: 12/1/2025 12:35:14
JSP ID: 4356
Scope of Work: Turn off circuit breaker 9 and 15 in Panel 312 A and perform ZVV on S1205 and S1207.

General Information

Work Order
415067
Building
Building 6
Person in Charge
Jevon Mattiassi
Lead / Supervisor
Keusch, Justen
Logged Email
jmmattiassi@lbl.gov
Division
ALS

Work Planning

Modes of Work
☑ Mode 0 - Electrically Safe Work Condition
☑ Mode 1 - LOTO & Zero Voltage Verification
QEW Level
QEW 2
Second Person Requirement
Standby Person
Second Person Identified
Chris Nelson
Other Participants
IT, ALS
Affected Persons Notified
Yes

System / Equipment

Switching
Hazardous Switching
Panel / Equipment ID
Panel 312A/ s1205 and s1207
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. Put up barricades and signs. Inform ALS control room and EM shop and affected personnel. When ready for switching wear proper PPE. Stand to side and turn off circuit breaker 9 after approval has been given. Apply LOTO. Do same for circuit breaker 15. Perform ZVV with Chris. When ZVV is complete, put panel back together and keep breakers LOTO until work is complete and LOTO can be released so panel can be energized.

Control of Work Area

Minimum Approach Boundary
89
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
15.6 cal/cm2
Arc Flash Boundary
89”
Working Distance
18 inches
Arc Flash PPE Level
4
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
Behind 31122 on booster wall
Emergency Number to Call
911
Sufficient Cell Phone Signal
Yes
Clear Exit Path
Yes
AED Location
Mounted on cabinet L123
Fire Extinguisher Location
On panel 312A
Contact Release Method Available and Tested
Voltage gloves

Environmental Conditions

Does the environment present additional hazards that should be addressed?
Insufficient/cramped/awkward space, Heavy traffic, Noisy environment

Error Precursors

Task Demands
Time pressure (in a hurry), High workload (memory requirements), Simultaneous or multiple tasks
Work Environment
Individual Capabilities
Human Nature
Stress (limits attention)
Error Precursor Mitigations
Stay focused

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

Stay focused on task and communicate with my standby. Will release LOTO to reenergize racks 12/2/2025

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