QEW 1 / 2 / 3 Job Safety Plan

General Information

Work Order

299269

Building

-

Person in Charge

Mike capeto

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

Safety Watch

Second Person Identified

Justin walker

Other Participants

Plumbers

Affected Persons Notified

Yes

System / Equipment

Switching

Hazardous Switching

Panel / Equipment ID

215A5A-1M

System Information Review

☑ Panel Schedules
☑ Arc Flash Labels

Control of Hazardous Energy

Complex LOTO (requires LP, CLP, FLP)

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

Go over job briefing fill out and submit JSP, put on appropriate ppe, go over safety briefing, apply loto and verify zvv. Perform annual. Restore equipment back to normal. Remove loto and check operations.

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

Yes

Voltage Glove Class

0

Will any other part of the body enter the RAB

No

Arc Flash Risk Assessment

Incident Energy

2.24cal/cm2 cal/cm2

Arc Flash Boundary

27”

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)

Discharge Wait Time (Minutes)

Na

Emergency Response Plan

Nearest Landline Location

Hallway outside mechanical room. Right of mens restroom

Emergency Number to Call

911

Sufficient Cell Phone Signal

Yes

Clear Exit Path

Yes

AED Location

2nd floor main entrance

Fire Extinguisher Location

Inside mechanical room.

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?

Noisy environment

Error Precursors

Task Demands

Work Environment

Individual Capabilities

Human Nature

Error Precursor Mitigations

No current error precursors. Both technicians agave done this job multiple times. Are clear minded and prepared to complete task safely.

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

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