Time / Date: 3/13/2023 8:59:30
JSP ID: 736
Scope of Work: Perform annual maintenance on 77Aru 004.
Work Order: 299295
Building:
Person in Charge: Justin walker
Lead / Supervisor: Delgado, Alex
Logged Email: jwwalker@lbl.gov
Division: Facilities
QEW Level: QEW 2
Modes of Work: Mode 0 - Electrically Safe Work Condition, Mode 1 - LOTO & Zero Voltage Verification
Second Person Requirement: Standby Person
Second Person Identified: Mike capeto
List Other Participants: Plumber
Affected Persons Notified: Yes
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 Breifing

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 2023.08.22.1
Form Content and Feedback Contact: Michael Rose -- mvr@lbl.gov