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QEW 1 / 2 / 3 Job Safety Plan

Electrical Safety
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Time / Date: 3/16/2026 7:16:01
JSP ID: 4628
Scope of Work: Switching MCC for VFD 20 Feeder conduit re route Mode 1 work

General Information

Work Order
415062 ALSU Routine WO
Building
6 ALS Boiler room 2nd floor mezzanine
Person in Charge
Christopher Nelson
Lead / Supervisor
Keusch, Justen
Logged Email
cnelsom@lbl.gov
Division
Facilities

Work Planning

Modes of Work
☑ Mode 1 - LOTO & Zero Voltage Verification
QEW Level
QEW 2
Second Person Requirement
Standby Person
Second Person Identified
Everett Combs
Other Participants
FATSE2 FMCS RI Justen Keusch
Affected Persons Notified
Yes

System / Equipment

Switching
Non-Hazardous Switching
Panel / Equipment ID
M304A3A26A
System Information Review
☑ Panel Schedules
☑ Arc Flash Labels
Control of Hazardous Energy
Complex LOTO w/ RI
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. set up warning tape signs and barriers. Contact control room before switching. Place LOTO Lock on and perform ZVV. When The ZVV has been Performed and LOTO is established hold a Loto briefing with other trades involved. Then begin work.

Control of Work Area

Minimum Approach Boundary
42 inches
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
No
Voltage Glove Class
0
Will any other part of the body enter the RAB
No

Arc Flash Risk Assessment

Incident Energy
,27 cal/cm2 cal/cm2
Arc Flash Boundary
7 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
B 15 second floor room 230
Emergency Number to Call
911
Sufficient Cell Phone Signal
Yes
Clear Exit Path
Yes
AED Location
Fire Extinguisher Location
Right next to the MCC to the left one ft
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
Time pressure (in a hurry)
Work Environment
Distractions/interruptions, Changes/departures from routine
Individual Capabilities
Human Nature
Stress (limits attention)
Error Precursor Mitigations
Be stress free be aware and have a good communication with others don’t let distractions get you off task

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

Filled out second JSP for ZVV of VFD 06-11 AHU-20

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