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Time / Date: 2/2/2023 9:35:44
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JSP ID: 552
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Scope of Work: Perform chiller annual on 50a Aru 005
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Work Order: Wo299248
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Building:
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Person in Charge: Justin walker
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Lead / Supervisor: Delgado, Alex
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Logged Email: jwwalker@lbl.gov
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Division: Facilities
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QEW Level: QEW 2
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Modes of Work: Mode 0 - Electrically Safe Work Condition, Mode 1 - LOTO & Zero Voltage Verification
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Second Person Requirement: Safety Watch
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Second Person Identified: Juan Garcia
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List Other Participants:
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Affected Persons Notified: Yes
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Switching: Hazardous Switching
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Panel / Equipment ID: 35C breaker 11. 50A Aru 005
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System Information Review: Arc Flash Labels, FLP#63
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Control of Hazardous Energy: Complex LOTO (requires LP, CLP, FLP)
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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
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Sequence of Job Steps
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List basic sequence of steps from start to finish.
Go over job scope with HvAC lead. Fill out JSP for along with AFHA, and SHA. Determine proper ppe for switching and zvv. Perform safety briefing. Perform loto and zvv according to FLP. Perform annual pm on chiller. Once pm has been completed. Reassemble chiller. Remove loto, verify proper voltage check chiller operation and return to service. |
Control of Work Area
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Minimum Approach Boundary: 95 inches
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Barricade Tape / Attendant: Warning - Orange
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Shock Risk Assessment
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System Voltage: 120/208 V ac
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Limited Approach Boundary: 42 inches
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Restricted Approach Boundary: 12 inches
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Will the hands enter the RAB: No
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Voltage Glove Class: 0
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Will any other part of the body enter the RAB: No
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Arc Flash Risk Assessment
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Incident Energy: 24.3cal2 cal/cm2
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Arc Flash Boundary: 95
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Working Distance: 18 inches
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Arc Flash PPE Level: 4
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Incident Energy Reduction Measures: 0
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Capacitor Hazards
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Capacitor Bus Voltage: Na
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Capacitor total stored energy (joules): Na
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Discharge wait time (minutes): Na
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Emergency Response Plan
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Nearest Landline Location: 50A room 135
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Emergency Number to Call: 911 or 7911
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Sufficient cell phone signal? Yes
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Clear exit path? Yes
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AED Location: Have HVAC portable AED on site
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Fire Extinguisher Location: 50a room 141
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Contact release method available and tested: Upstream breaker or switch, Voltage gloves,
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Environmental Conditions
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Does the environment present additional hazards that should be addressed?
Noisy environment |
Error Precursors
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Task Demands:
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Work Environment:
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Individual Capabilities:
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Human Nature:
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Error Precursor Mitigations:
No current error precursors. Technicians comfortable with job scope. |
PPE Inspections
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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, Electrical zero voltage proving unit |
Notes / Other
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Perform Job Breifing
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PIC Conducts the Job Briefing. Cover all the contents of the Job Safety Plan.
A Job Briefing at a minimum must include:
Rev 2023.08.22.1 Form Content and Feedback Contact: Michael Rose -- mvr@lbl.gov |