This Workbook is required of
any subcontractor or vendor doing any work that can expose an employee
to potential electrical hazards. An employee is considered to be exposed if they are within the NFPA 70E Limited Approach Boundary (typically 42”), to an uninsulated energized part, or
if they are within the NFPA 70E Flash Protection Boundary (typically
48”). Some examples of exposed energized work are testing,
troubleshooting, inspecting, and performing incidental work inside of
electrical equipment.
The purpose of this Workbook
is to describe your electrical work, hazards, and controls, while working
at LBNL. The information in this Workbook supplements your company’s
safety plan. The goal is to produce an electrical safety plan that meets
LBNL criteria and closely correlates to the work you will be doing.
Your electrical safety plan
will be approved faster if you fill out this Workbook completely and
provide as much detail as possible.
The following regulations apply
to electrical safety at LBNL (where there is a conflict between regulations
the more stringent regulation shall apply): Federal OSHA; 29 CFR 1910 Subparts
J (Lockout - Tagout) and S (Electrical); NFPA 70 NEC, NFPA 70E Standard
for Electrical Safety in the Workplace, and if applicable, ANSI C2 NESC
and 29CFR 1910.269; LBNL PUB-3000, Chapter 8.
A signed ENERGIZED ELECTRICAL
WORK PERMIT is required to be posted at the job site.
SCOPE OF WORK
Equipment to be
worked on?
Manufacturer &
model (if applicable)
Description of equipment
type, variations of equipment if jobs cover different types.
Supply voltage rating.
Supply current rating.
Maximum voltage
inside equipment.
Maximum current
inside equipment
Maximum capacitor
(voltage / Joule rating)
Describe the tasks
that will be done while equipment is energized and covers removed. Please
be specific.
Why is necessary
for the equipment to remain energized while covers are removed?
_____________________________________________________________________________________________
_____________________________________________________________________________________________
How close will any
worker be to the equipment with covers removed?
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Will you be probing
live equipment with test instruments? YES
NO
Describe any work
other than testing, measurement, probing, troubleshooting, calibrating
that will be done while the equipment is energized with the covers removed.
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
What is the highest
voltage present within your work area?
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
What specific practices
/ procedures are used to mitigate the electrical hazards?
Are temporary insulating
barriers installed to shield exposures?
Do you use a safety
watch?
Other?
What are the NFPA
70E Table 130.2(c) shock protection boundaries associated with
your work?
What is the available
incident energy for any arc flash produced by the equipment?
_____________________________________________________________________________________________
How will the Approach
Boundaries be established and maintained to prevent exposure to unauthorized
personnel?
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Describe the electrical
work experience, qualifications and certifications of all workers doing
electrical work.
_____________________________________________________________________________________________
_____________________________________________________________________________________________
What emergency
procedures and training does your company require of the qualified electrical
workers and non-electrical workers doing the work at LBNL? Who is the
emergency contact for your company, list name, phone, cell?
_____________________________________________________________________________________________
_____________________________________________________________________________________________
What personal protective
equipment will each worker use?
What electrically
insulated tools will be required for the work?
_____________________________________________________________________________________________
Make, model and
IEC/ANSI 61010 CAT rating of all test instruments:
_____________________________________________________________________________________________
Will you be using
subcontractors to perform electrical work at LBNL? What qualifications,
training requirements, and electrical procedures does your company require
of subcontractors? What roles, responsibilities, authorities and accountabilities
does your company have with the subcontractor?
_____________________________________________________________________________________________
_____________________________________________________________________________________________
Completed by ____________________________________________________
Date: _______________ Company Representative