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QEW 1 / 2 / 3 Job Safety Plan

Electrical Safety
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Time / Date: 4/10/2023 12:06:45
JSP ID: 866
Scope of Work: Replace PDU -22 display that went dark and related circuit boards

General Information

Work Order
NA
Building
-
Person in Charge
Ernie Jew
Lead / Supervisor
Grounds, Jeff
Logged Email
ejew@lbl.gov
Division
Facilities

Work Planning

Modes of Work
☑ Mode 1 - LOTO & Zero Voltage Verification
QEW Level
QEW 2
Second Person Requirement
Standby Person
Second Person Identified
Jeff Grounds
Other Participants
Vertiv (Christian Delarosa)
Affected Persons Notified
Yes

System / Equipment

Switching
Hazardous Switching
Panel / Equipment ID
590A22A-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 590A22A-1,3,5 for PDU-22 ZVV at PDU-22 Have Vertiv hang LOTO lock and tag at 590A22A-1,3,5 Perform work Notify Operations of re-energization of PDU-22 Remove LOTO Swithc power on at 590A22A-1,3,5 Verify display functions as intended End of jog

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
Control 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, Voltage gloves

Environmental Conditions

Does the environment present additional hazards that should be addressed?
None

Error Precursors

Task Demands
Simultaneous or multiple tasks
Work Environment
Individual Capabilities
Human Nature
Error Precursor Mitigations
Have Eric Lucas take care of extra assignments 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 Briefing

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 2026.03.17.1
Form Content and Feedback Contact: Michael Rose -- mvr@lbl.gov