Logo

QEW 1 / 2 / 3 Job Safety Plan

Electrical Safety
Back to Index
Time / Date: 3/25/2026 6:49:54
JSP ID: 4651
Scope of Work: Loto circuit in order to move two lights up 6 inches for clearance

General Information

Work Order
W0415067
Building
53
Person in Charge
Mayumi Taylor
Lead / Supervisor
Keusch, Justen
Logged Email
mjtaylor@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
Armand Uribe
Other Participants
N/A
Affected Persons Notified
Yes

System / Equipment

Switching
Hazardous Switching
Panel / Equipment ID
15a15a57a
System Information Review
☑ Arc Flash Labels
Control of Hazardous Energy
Simple LOTO
Equipment Condition
☑ Properly installed
☑ Properly maintained
☑ All doors and covers closed and fully latched
☑ No signs of impending failure

Sequence of Job Steps

List basic sequence of steps from start to finish
Wear appropriate PPE for the task and verify the proper condition and operation of all required PPE and test equipment before beginning. Loto and ZVV, turn off all relevant breakers and apply lockout/tagout devices to prevent unauthorized re-energizing. Use Zero Voltage Tester (ZVV) multimeter to confirm there is no voltage before performing any work. Troubleshooting may require toggling breakers on and off. Once work is complete, remove lockout/tagout device(s) and re-energize.

Control of Work Area

Minimum Approach Boundary
18”
Barricade Tape / Attendant
Warning - Orange

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
No
Voltage Glove Class
0
Will any other part of the body enter the RAB
No

Arc Flash Risk Assessment

Incident Energy
2.20cal/cm2 cal/cm2
Arc Flash Boundary
26”
Working Distance
18 inches
Arc Flash PPE Level
2
Incident Energy Reduction Measures
0

Capacitor Hazards

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

Emergency Response Plan

Nearest Landline Location
53 office
Emergency Number to Call
911
Sufficient Cell Phone Signal
Yes
Clear Exit Path
Yes
AED Location
Building 6 ALS
Fire Extinguisher Location
53 workshop lower floor
Contact Release Method Available and Tested
Voltage gloves

Environmental Conditions

Does the environment present additional hazards that should be addressed?
Insufficient lighting, Confined space, Insufficient/cramped/awkward space, Lookalike equipment

Error Precursors

Task Demands
Time pressure (in a hurry), High workload (memory requirements), Simultaneous or multiple tasks, Repetitive actions or monotony, Critical steps or irreversible acts
Work Environment
Distractions/interruptions, Changes/departures from routine, Obscure electrical supplies or configurations
Individual Capabilities
Human Nature
Stress (limits attention), Habit patterns, Assumptions, Complacency/overconfidence
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

N/A

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