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Time / Date: 1/13/2023 7:16:13
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JSP ID: 441
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Scope of Work: Remove logger from 243A
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Work Order: W0304539
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Building:
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Person in Charge: Andrew Southward
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Lead / Supervisor: Cameron, Benjamin
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Logged Email: amsouthward@lbl.gov
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Division: Facilities
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QEW Level: QEW 2
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Modes of Work: Mode 2 - Energized Diagnostics, Testing and Troubleshooting, Visual Inspection
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Second Person Requirement: Safety Watch
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Second Person Identified: Ben Cameron
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List Other Participants:
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Affected Persons Notified: N/A
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Switching: No Switching Required
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Panel / Equipment ID: 243A
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System Information Review: Panel Schedules, Arc Flash Labels
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Control of Hazardous Energy: LOTO Not Required (Mode 2 or 3 only)
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Equipment Condition: Properly installed, 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
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List basic sequence of steps from start to finish.
Establish safe work zone, access panel, remove logger, close up panel |
Control of Work Area
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Minimum Approach Boundary: 148
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Barricade Tape / Attendant: Attendant
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Shock Risk Assessment
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System Voltage: 120/208 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
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Incident Energy: 38 calories cal/cm2
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Arc Flash Boundary: 148
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Working Distance: 18 inches
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Arc Flash PPE Level: 4
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Incident Energy Reduction Measures: 0
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Capacitor Hazards
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Capacitor Bus Voltage: Na
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Capacitor total stored energy (joules): Na
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Discharge wait time (minutes): Na
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Emergency Response Plan
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Nearest Landline Location: 2
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Emergency Number to Call: 911
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Sufficient cell phone signal? Yes
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Clear exit path? Yes
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AED Location: On hand
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Fire Extinguisher Location: 2
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Contact release method available and tested: Upstream breaker or switch, Voltage gloves
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Environmental Conditions
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Does the environment present additional hazards that should be addressed?
Insufficient/cramped/awkward space, Noisy environment |
Error Precursors
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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
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Notes / Other
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Perform Job Breifing
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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 |