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QEW 1 / 2 / 3 Job Safety Plan

Electrical Safety
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Time / Date: 2/23/2026 11:58:09
JSP ID: 4578
Scope of Work: Set tripped CB 77-CB-001 to Off.

General Information

Work Order
N/A
Building
77-123
Person in Charge
Jaime Romo
Lead / Supervisor
Other
Logged Email
jromo@lbl.gov
Division
Other

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
Ohmar Sowle
Other Participants
Ari Harding
Affected Persons Notified
Yes

System / Equipment

Switching
Non-Hazardous Switching
Panel / Equipment ID
77-CB-001
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
☑ Not energizing equipment for the first time
☑ or after electrical repair

Sequence of Job Steps

List basic sequence of steps from start to finish
ZVV at machine electrical cabinet. Brief Ari Harding and have him lock on to the LOTO . Ari Harding will perform a visual inspection and may perform tug tests on conducts.

Control of Work Area

Minimum Approach Boundary
42
Barricade Tape / Attendant
Attendant

Shock Risk Assessment

System Voltage
277/480 V ac
Limited Approach Boundary
42 inches
Restricted Approach Boundary
12 inches
Will the hands enter the RAB
Yes
Voltage Glove Class
1
Will any other part of the body enter the RAB
No

Arc Flash Risk Assessment

Incident Energy
0.7 cal/cm2
Arc Flash Boundary
13
Working Distance
No Arc Flash Hazard Present
Arc Flash PPE Level
Minimum PPE for Electrical Work
Incident Energy Reduction Measures
1

Capacitor Hazards

Capacitor Bus Voltage
Unknown
Capacitor Total Stored Energy (Joules)
Unknown
Discharge Wait Time (Minutes)
20

Emergency Response Plan

Nearest Landline Location
Leads office.
Emergency Number to Call
911
Sufficient Cell Phone Signal
Yes
Clear Exit Path
Yes
AED Location
East wall.
Fire Extinguisher Location
Walk way post.
Contact Release Method Available and Tested
Voltage gloves

Environmental Conditions

Does the environment present additional hazards that should be addressed?
Noisy environment, Comunicate louder.

Error Precursors

Task Demands
Work Environment
Unexpected equipment conditions
Individual Capabilities
Human Nature
Error Precursor Mitigations
Be courteous and attentive to detail.

PPE Inspections

☑ Safety glasses (ANSI Z87)
☑ Arc-rated clothing (flash suit
☑ daily wear) including face shield
☑ balaclava
☑ hood.
☑ 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