Location via proxy:   [ UP ]  
[Report a bug]   [Manage cookies]                
Download as pdf or txt
Download as pdf or txt
You are on page 1of 1

TESTING, TROUBLESHOOTING, AND VOLTAGE MEASURING ELECTRICAL WORK PERMIT

Department Code: HP
Permit # HP -003
PART I: TO BE COMPLETED BY THE REQUESTER:
(1)

Description of circuit/equipment/job location: __Power Panel SS-4, breaker 4/ 480 V heat pump/ Building 348_High Bay_

(2)

Description of work to be done: _____Remove existing heat pump and replace with Carrier type___

(3)

Justification of why the circuit/equipment cannot be de-energized or the work deferred until the next scheduled outage:
__High Bay requires temperature range of 68 deg to 74 deg
_______________

___Jim Durnan/ LESO


Requester/Title

February 30, 2007


Date

PART II: HAZARD ANALYSIS:


(1)
Detailed job description procedure to be used in performing the above detailed work: ___Remove wires from PP SS-4 and
install 2/0 wires for new unit.__
______________________________________________________________________________________________________

(2)

(3)

LOTO
Reason not to LOTO ____Calibration source requires
Description of the Safe Work Practices to be employed:
stable temperature.
_____________________________________________________________________________________________________
Flash Boundary
Shock Hazard

4
480V

Flash Hazard
Limited Approach
Restricted Approach
Prohibited Approach

4
3-6
1-0
0-6

Working Distance
Glove Class

4
0

(4)

Protective Equipment
None
Earplugs
Leather Gloves
Leather Shoes
Cotton Clothing
Face shield
Voltage-rated Gloves
Voltage-rated Shoes
Fr Clothing
Flash suit
Hard Hat
Safety Glasses/Goggles
_____________________________________________________________________________________________________

(5)

Means employed to restrict the access of unqualified persons from the work area: ______caution tape_____
______________________________________________________________________________________________________

PART III: APPROVAL(S) TO PERFORM THE WORK WHILE ELECTRICALLY ENERGIZED:


_____Bo Sieman_____________________
Group Leader/Supervisor

_____2-30-07______
Date

_______Smart Guy____________________________
Electrically Knowledgeable Person/Lead Engineer

_______2-31-07________
Date

________Des Jockey____________________
Chief Engineer/Delegate

______2-32-07________
Date

PART IV: WORK


N/A
Evidence of completion of Job Briefing including discussion of any job-related hazards:
Daily pre-work briefing
Post work feedback, if required
PART V: AUTHORIZED WORKERS:

Name
_________________________

Life #
______

Name
_______________________

Life #
______

_________________________

______

_______________________

______

_________________________

______

_______________________

______

_________________________

______

_______________________

______

_________________________

______

_______________________

______

_________________________

______

_______________________

______

_________________________

______

_______________________

______

_________________________

______

_______________________

______

_________________________

______

_______________________

______

_________________________

___________

Authorizing Supervisor
Date
Supervisor acknowledges the above personnel are properly trained, knowledgeable and experienced to work under the permit.
Forward a copy to group's safety department.
1.1/19204e021.doc

(02/2007)

You might also like