Logo

QEW 1 / 2 / 3 Job Safety Plan

Electrical Safety
Back to Index
Time / Date: 1/28/2026 11:05:14
JSP ID: 4489
Scope of Work: Open Panel M304A3A5A32A to troubleshoot dome lights that are not on. Visually look t circuits 17 and 19 and test voltage on the load side of Beakers.

General Information

Work Order
415067 ALS Routine
Building
6 ALS
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 2 - Energized Diagnostics
☑ Testing and Troubleshooting
☑ Visual Inspection
QEW Level
QEW 2
Second Person Requirement
Standby Person
Second Person Identified
Kevin Hope
Other Participants
Affected Persons Notified
Yes

System / Equipment

Switching
No Switching Required
Panel / Equipment ID
M304A3A5A32A
System Information Review
☑ Panel Schedules
☑ Arc Flash Labels
Control of Hazardous Energy
LOTO Not Required (Mode 2 or 3 only)
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 and inspect it barricade area and when we are ready perform opening hinged panel carefully. Inspect and proceed to measure voltage on load side of breakers 17 and 19

Control of Work Area

Minimum Approach Boundary
42
Barricade Tape / Attendant
Warning - Orange

Shock Risk Assessment

System Voltage
277/480 V ac
Limited Approach Boundary
42 inches
Restricted Approach Boundary
3 feet, 6 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
.49 cal/cm^2 cal/cm2
Arc Flash Boundary
10 inches
Working Distance
18 inches
Arc Flash PPE Level
2
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
Next to hutch 12.2.2
Emergency Number to Call
911
Sufficient Cell Phone Signal
Yes
Clear Exit Path
Yes
AED Location
Bldg 15 lobby 6 lobby
Fire Extinguisher Location
Near column 24
Contact Release Method Available and Tested
Upstream breaker or switch, Voltage gloves

Environmental Conditions

Does the environment present additional hazards that should be addressed?
Heavy traffic, Lookalike equipment

Error Precursors

Task Demands
Work Environment
Unexpected equipment conditions
Individual Capabilities
Human Nature
Habit patterns, Mind-set
Error Precursor Mitigations
Keep a good mind set keep on task and be aware of changes

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:
  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