QEW 1 / 2 / 3 Job Safety Plan

General Information

Work Order

299295

Building

-

Person in Charge

Justin walker

Lead / Supervisor

Delgado, Alex

Logged Email

jwwalker@lbl.gov

Division

Facilities

Work Planning

Modes of Work

☑ Mode 0 - Electrically Safe Work Condition
☑ Mode 1 - LOTO & Zero Voltage Verification

QEW Level

QEW 2

Second Person Requirement

Standby Person

Second Person Identified

Mike capeto

Other Participants

Plumber

Affected Persons Notified

Yes

System / Equipment

Switching

Hazardous Switching

Panel / Equipment ID

M72E-7J. 77 Aru 003

System Information Review

☑ Panel Schedules
☑ 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
☑ Not energizing equipment for the first time
☑ or after electrical repair

Sequence of Job Steps

List basic sequence of steps from start to finish

Perform job briefing , fill out JSP and submit. Gather proper ppe, perform safety briefing Apply loto and verify zvv. Also perform loto on condensor inlet and outlet. Perform required maintenance. Remove loto and check operation.

Control of Work Area

Minimum Approach Boundary

42 “

Barricade Tape / Attendant

Warning - Orange

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

0

Will any other part of the body enter the RAB

No

Arc Flash Risk Assessment

Incident Energy

3.84cm2 cal/cm2

Arc Flash Boundary

34”

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

77 room E23

Emergency Number to Call

911

Sufficient Cell Phone Signal

Yes

Clear Exit Path

Yes

AED Location

Have HVAC AED in hand

Fire Extinguisher Location

Have truck fire extinguisher in hand at chiller location

Contact Release Method Available and Tested

Upstream breaker or switch, Rescue hook, Voltage gloves

Environmental Conditions

Does the environment present additional hazards that should be addressed?

Wet location

Error Precursors

Task Demands

Work Environment

Individual Capabilities

Human Nature

Error Precursor Mitigations

There are no error precursors at this time. Both technicians are comfortable with job scope and have performed this task before.

PPE Inspections

☑ Rubber insulating gloves and leather protectors

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:

Detailed Scope of Work
Shock and arc flash hazards for each task
Controls to mitigate the hazards (procedures, precautions, energy source controls, PPE requirements)
Work area controls (barricades, signs, attendants)
Emergency Response Plan