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QEW 1 / 2 / 3 Job Safety Plan

Electrical Safety
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Time / Date: 3/30/2026 9:08:49
JSP ID: 4669
Scope of Work: Swapping out breaker in bank 80.

General Information

Work Order
None
Building
88
Person in Charge
Erik Line
Lead / Supervisor
Keusch, Justen
Logged Email
eline@lbl.gov
Division
Facilities

Work Planning

Modes of Work
☑ Mode 0 - Electrically Safe Work Condition
QEW Level
QEW 2
Second Person Requirement
Standby Person
Second Person Identified
Brendan Ford
Other Participants
Affected Persons Notified
Yes

System / Equipment

Switching
No Switching Required
Panel / Equipment ID
80A12
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
1. Have the control room remotely open breaker 80A12. 2. Verify breaker open. 3. Rack out with remote rack out. 4. Remove and place in the spare cell 5. Install and rack in new breaker to 80A12 6. Notify the control room

Control of Work Area

Minimum Approach Boundary
134”
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
No
Voltage Glove Class
Not Required
Will any other part of the body enter the RAB
No

Arc Flash Risk Assessment

Incident Energy
27.1 cal/cm2
Arc Flash Boundary
134in
Working Distance
24 inches
Arc Flash PPE Level
Minimum PPE for Electrical Work
Incident Energy Reduction Measures
Not Required

Capacitor Hazards

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

Emergency Response Plan

Nearest Landline Location
N/A
Emergency Number to Call
510-486-6999
Sufficient Cell Phone Signal
Yes
Clear Exit Path
Yes
AED Location
Control RooM
Fire Extinguisher Location
Bottom of the stairs
Contact Release Method Available and Tested
Rescue hook

Environmental Conditions

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

Error Precursors

Task Demands
Work Environment
Individual Capabilities
Human Nature
Error Precursor Mitigations
N/A

PPE Inspections

☑ Safety glasses (ANSI Z87)
☑ Arc-rated clothing (flash suit
☑ daily wear) including face shield
☑ balaclava
☑ hood.
☑ Hearing protection
☑ Non-melting footwear that fully covers the feet

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