Time / Date: 4/10/2023 11:56:46
JSP ID: 865
Scope of Work: Replace PDU displays that went dark and related circuit boards
Work Order: NA
Building:
Person in Charge: Ernie Jew
Lead / Supervisor: Grounds, Jeff
Logged Email: ejew@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: Jeff Grounds
List Other Participants: Vertiv (Christian Delarosa)
Affected Persons Notified: Yes
Switching: Hazardous Switching
Panel / Equipment ID: 590A21A-1,3,5
System Information Review: Panel Schedules, Arc Flash Labels
Control of Hazardous Energy: Complex LOTO w/ RI
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.

Notify Operations of power disruption for PDU repairs Set up LOTO work zone with warning tape and signage Perform LOTO briefing Switch power off and hang lock and tag at 590A21A-1,3,5 for PDU 30 ZVV at PDU 30 Have Vertiv hang LOTO lock and tag at 590A21A-1.3.5 Perform work Notify Operations of re-energization of PDU-30 Remove LOTO Switch power on at 590A21A-1,3,5 Verify display functions as intended End of job

Control of Work Area

Minimum Approach Boundary: 102
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: 20.7 cal/cm2
Arc Flash Boundary: 102
Working Distance: 18 inches
Arc Flash PPE Level: 3
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: Operations Room
Emergency Number to Call: 911
Sufficient cell phone signal? Yes
Clear exit path? Yes
AED Location: 3rd floor next to mens room
Fire Extinguisher Location: On wall next to double door to elevator lobby
Contact release method available and tested: Rescue hook

Environmental Conditions

Does the environment present additional hazards that should be addressed?

Noisy environment

Error Precursors

Task Demands: Simultaneous or multiple tasks
Work Environment:
Individual Capabilities:
Human Nature:
Error Precursor Mitigations:

Have Eric Lucas take over extra tasks so I can focus on task at hand

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

NA

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