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Time / Date: 4/24/2023 13:11:59
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JSP ID: 931
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Scope of Work: LOTO 652 bank and investigate tripped breaker
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Work Order: W0
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Building:
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Person in Charge: Andrew Southward
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Lead / Supervisor: Cameron, Benjamin
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Logged Email: amsouthward@lbl.gov
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Division: Facilities
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QEW Level: QEW 2
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Modes of Work: Mode 0 - Electrically Safe Work Condition, Mode 1 - LOTO & Zero Voltage Verification
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Second Person Requirement: Safety Watch
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Second Person Identified: Ben Cameron
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List Other Participants:
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Affected Persons Notified: Yes
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Switching: Hazardous Switching
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Panel / Equipment ID: 650A, 652A and 652A1A
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System Information Review: Single Line Drawing, Panel Schedules, Arc Flash Labels
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Control of Hazardous Energy: Complex LOTO (requires LP, CLP, FLP)
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Equipment Condition: Properly installed, All doors and covers closed and fully latched, No signs of impending failure, Not energizing equipment for the first time, or after electrical repair
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Sequence of Job Steps
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List basic sequence of steps from start to finish.
Perform flp 329, ZVV at 652A and adjust ground fault setting, access panel 652A1A, ZVV and land ground wire that had previously been left, release LOTO and energize, |
Control of Work Area
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Minimum Approach Boundary: 105
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Barricade Tape / Attendant:
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Shock Risk Assessment
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System Voltage: 120/208 V ac
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Limited Approach Boundary: 42 inches
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Restricted Approach Boundary: 12 inches
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Will the hands enter the RAB: Yes
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Voltage Glove Class: 0
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Will any other part of the body enter the RAB: No
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Arc Flash Risk Assessment
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Incident Energy: 17.2 @650A , 4.7@ 652A cal/cm2
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Arc Flash Boundary: 105 inches @ 650A, 41 inches @ 652A
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Working Distance: 18 inches
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Arc Flash PPE Level: 2
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Incident Energy Reduction Measures: 0
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Capacitor Hazards
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Capacitor Bus Voltage: Na
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Capacitor total stored energy (joules): Na
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Discharge wait time (minutes): Na
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Emergency Response Plan
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Nearest Landline Location: 30-108
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Emergency Number to Call: 911
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Sufficient cell phone signal? Yes
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Clear exit path? Yes
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AED Location: On hand
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Fire Extinguisher Location: Electric room
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Contact release method available and tested: Upstream breaker or switch, Voltage gloves
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Environmental Conditions
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Does the environment present additional hazards that should be addressed?
Lookalike equipment, Noisy environment |
Error Precursors
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Task Demands:
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Work Environment:
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Individual Capabilities:
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Human Nature:
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Error Precursor Mitigations:
None |
PPE Inspections
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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
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Perform Job Breifing
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PIC Conducts the Job Briefing. Cover all the contents of the Job Safety Plan.
A Job Briefing at a minimum must include:
Rev 2023.08.22.1 Form Content and Feedback Contact: Michael Rose -- mvr@lbl.gov |