QEW 1 / 2 / 3 Job Safety Plan

General Information

Work Order

W0472944

Building

83

Person in Charge

Alma Armenta

Lead / Supervisor

Cameron, Benjamin

Logged Email

alarmenta@lbl.gov

Division

Facilities

Work Planning

Modes of Work

☑ Mode 0 - Electrically Safe Work Condition
☑ Mode 1 - LOTO & Zero Voltage Verification
☑ Mode 2 - Energized Diagnostics
☑ Testing and Troubleshooting
☑ Visual Inspection

QEW Level

QEW 2

Second Person Requirement

Safety Watch

Second Person Identified

Andrew Southward

Other Participants

Affected Persons Notified

N/A

System / Equipment

Switching

Hazardous Switching

Panel / Equipment ID

M47A1A1A3A

System Information Review

☑ Arc Flash Labels

Control of Hazardous Energy

LOTO Not Required (Mode 2 or 3 only)

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

Sequence of Job Steps

List basic sequence of steps from start to finish

Don appropriate PPE, troubleshoot on roof, troubleshoot at MCC if no power to line on disconnect, report findings.

Control of Work Area

Minimum Approach Boundary

42”

Barricade Tape / Attendant

Danger - Red

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

2.97 cal/cm2

Arc Flash Boundary

32”

Working Distance

18 inches

Arc Flash PPE Level

2

Incident Energy Reduction Measures

0

Capacitor Hazards

Capacitor Bus Voltage

None

Capacitor Total Stored Energy (Joules)

None

Discharge Wait Time (Minutes)

None

Emergency Response Plan

Nearest Landline Location

Cell phone

Emergency Number to Call

5104867911

Sufficient Cell Phone Signal

Yes

Clear Exit Path

Yes

AED Location

On hand

Fire Extinguisher Location

By TK 14

Contact Release Method Available and Tested

Voltage gloves

Environmental Conditions

Does the environment present additional hazards that should be addressed?

Lookalike equipment

Error Precursors

Task Demands

Work Environment

Individual Capabilities

Human Nature

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

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:

Detailed Scope of Work
Shock and arc flash hazards for each task
Controls to mitigate the hazards (procedures, precautions, energy source controls, PPE requirements)
Work area controls (barricades, signs, attendants)
Emergency Response Plan