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QEW 1 / 2 / 3 Job Safety Plan

Electrical Safety
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Time / Date: 3/2/2026 12:28:23
JSP ID: 4605
Scope of Work: LINAC Modulator 1 LOTO for switch replacement

General Information

Work Order
None
Building
06
Person in Charge
Christian Lopez
Lead / Supervisor
Bashaw, Doug
Logged Email
cslopez@lbl.gov
Division
ALS

Work Planning

Modes of Work
☑ Mode 0 - Electrically Safe Work Condition
☑ Mode 1 - LOTO & Zero Voltage Verification
QEW Level
QEW 1
Second Person Requirement
Standby Person
Second Person Identified
Michael Green
Other Participants
Affected Persons Notified
Yes

System / Equipment

Switching
Non-Hazardous Switching
Panel / Equipment ID
MOD#1 LI-18 DISC
System Information Review
☑
Control of Hazardous Energy
Complex LOTO w/ RI
Equipment Condition
☑ Properly installed
☑ Properly maintained

Sequence of Job Steps

List basic sequence of steps from start to finish
Shut off 208VAC 3 phase Disconnect switch for MOD 1 (310A-28B). Shut off 120VAC single phase breaker (LI1817-CB16). Discharge stored energy in internal Switch units and high voltage capacitors. Perform ZVV on AC main locations inside PDU. Perform ZVV on output of high voltage capacitors bank and Switch Unit Outputs. After work is completed, release LOTO. Verify function if needed.

Control of Work Area

Minimum Approach Boundary
36
Barricade Tape / Attendant

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
00
Will any other part of the body enter the RAB
No

Arc Flash Risk Assessment

Incident Energy
< 1.2 cal/cm2 cal/cm2
Arc Flash Boundary
18 in
Working Distance
No Arc Flash Hazard Present
Arc Flash PPE Level
2+
Incident Energy Reduction Measures
00

Capacitor Hazards

Capacitor Bus Voltage
1000 VDC
Capacitor Total Stored Energy (Joules)
3600
Discharge Wait Time (Minutes)
10

Emergency Response Plan

Nearest Landline Location
Between LI05 and LI06
Emergency Number to Call
911
Sufficient Cell Phone Signal
Yes
Clear Exit Path
Yes
AED Location
LI23
Fire Extinguisher Location
Mounted on PS5 locker
Contact Release Method Available and Tested
Voltage gloves

Environmental Conditions

Does the environment present additional hazards that should be addressed?
None

Error Precursors

Task Demands
Time pressure (in a hurry), Interpretation requirements
Work Environment
Distractions/interruptions, Changes/departures from routine
Individual Capabilities
Unfamiliar with, or first time performing task
Human Nature
Stress (limits attention)
Error Precursor Mitigations
Reduce overall risk. Develop and adhere to a written Electrical safe work plan. Self-check with verbalization (STAR). Establish clear communications. Stop when unsure. Flagging equipment that will be worked on and blocking equipment that should not be operated on.

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