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QEW 1 / 2 / 3 Job Safety Plan

Electrical Safety
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Time / Date: 12/2/2025 14:17:45
JSP ID: 4367
Scope of Work: Replace Bad Breaker #15 in Panel 320A

General Information

Work Order
415067
Building
ALS B6 Sector 8 pit
Person in Charge
Christopher Nelson
Lead / Supervisor
Keusch, Justen
Logged Email
cnelson@lbl.gov
Division
Facilities

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
Jevon Mattiassi
Other Participants
ALS EM and Kevin Hope
Affected Persons Notified
Yes

System / Equipment

Switching
Hazardous Switching
Panel / Equipment ID
302A4A circuit 2 panel 320A
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 from JSP Switch and Loto panel 302A4A circuit 2 Transformer 320. Carefully open panel 320A and perform a ZVV. When ZVV has been established. Begin replacing bad breaker #15. When work is done and we are in mode 0 release LOTO and Re Energize panel 320A.

Control of Work Area

Minimum Approach Boundary
95 in
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
17.1 cal/cm2
Arc Flash Boundary
95 in
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
On Rack S0825
Emergency Number to Call
911
Sufficient Cell Phone Signal
Yes
Clear Exit Path
Yes
AED Location
B6 lobby min entrance
Fire Extinguisher Location
On Rack S0824
Contact Release Method Available and Tested
Voltage gloves

Environmental Conditions

Does the environment present additional hazards that should be addressed?
Insufficient lighting

Error Precursors

Task Demands
Time pressure (in a hurry)
Work Environment
Distractions/interruptions
Individual Capabilities
Human Nature
Mind-set
Error Precursor Mitigations
Keep a good mind set don’t rush use task lights

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 and ZVV

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