TITLE:

ES&H Manual

 

DOCUMENT ID:

6230 Electrical Safety Manual - Appendices

 

 

 

Appendices

 

Appendix A Electrical Safety Inspection Form and Information

 

Appendix B Electrical Safety Personal Protection Equipment  

 

Appendix C Electrical Code Equivalency and Form 

 

Appendix D Energized Electrical Work Permit (EEWP) 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


 

 

 

 

 

 

 

 

 

 

 

APPENDIX A

ELECTRICAL SAFETY INSPECTION FORM

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

APPENDIX A- Electrical Safety Inspection Form and Information

 

Electrical Safety Inspection Process

 

1.0           Purpose

Jefferson Lab requires the use of appropriate electrical documentation to protect the worker from harm while work is being performed. This procedure complies with the requirements of NFPA 70E (2015 Edition)– Standard for Electrical Safety in the Workplace and OSHA 1910 and 1926 requirements for when work is performed with electrical equipment. This is especially important within a shock and/or an arc flash protection boundary.

2.0           Scope

This document provides guidance to ensure that the appropriate electrical hazards are addressed for the equipment being used. The most effective way to reduce the risk associated with an electrical hazard is elimination.

3.0           Responsibilities

NOTE:        Management authority may be delegated at the discretion of the responsible manager

3.1            Everyone at Jefferson

 

3.1.1       Be aware of the electrical hazards in your workplace. Stay clear of electrical hazard boundaries that are identified by red with white stripe tape.

3.1.2       Pay attention to all labeling on and around equipment. Electrical Safety Inspection labels are maintained by ESH. Owners of specific equipment is responsible for Arc Flash labels and Electrical Equipment Maintenance labels.

 

3.2            Qualified Electrical Workers (QEW) or those working with Electrical/Electronic Equipment

 

3.2.1       Ensure that correct Inspection stickers are placed on the equipment being used. They shall not be more than one year old. If they are, please contact appropriate personnel so that the equipment used is properly inspected and up-to-date. Labeling may include the following:

 

3.2.1.1  Any damaged equipment shall be locked out and tagged out until an inspection can be performed.

3.2.5.1  Any equipment with inspection stickers found outside its maximum interval date shall not be used.

3.2.5.2  When arc-rated labeling is applied to equipment, arc-rated clothing will need to be donned.

 

3.3            There are two types of inspection stickers on electrical equipment and usually only one on electronics equipment racks. In addition, an Arc Flash rating sticker (not on most electronics equipment) will be applied. On disconnects, power feed junction boxes, breaker panels, portable power supplies, and knife switches shall have an Arc Flash sticker (with the exception of junction boxes), an Electrical Safety inspection sticker, and a Maintenance sticker.

 

3.4            Electrical Safety Coordinator

 

3.4.1       Inspects lab-wide electrical and electronics equipment for safety.

3.4.2       Maintains inspection records.

3.4.3       Provides on-the-spot inspections and on-the-job training (OJT) for electrical hazards.

 

3.5            Electrical Safety Engineer/Program Manager

3.5.1       Provides the documentation for inspections.

3.5.2       Provides electrical personnel upon request/need to lab employees to perform on-the-spot inspections for safety.

3.5.3       Communicate lab-wide electrical safety information.

 

4.0           Electrical Safety Inspections

 

                      4.1          Inspections will occur once a year and will be repeated each year. Equipment inspection are good for one year. Equipment due for inspection or is out of date from the last inspection can be brought to the attention of the Electrical Safety Coordinator or Electrical Safety Program Manager. This will include NRTL and non-NRTL equipment.

 

                      4.2          Electrical Safety Inspection labels will have ESH as the maintainer, a date, equipment number, and initials/signature of the inspector. Furthermore, the labels will have one of three color dots affixed to them:

 

4.2.1       GREEN- Passed Inspection, No Hazards

4.2.2       YELLOW- Passed but needs to fix certain non-critical hazardous items before next scheduled inspections

4.2.3       RED- REJECTED, has MAJOR hazards and will need to be fixed IMMEDIATELY

 

                      4.3          Inspection hazards that will become CATS items include the following:

 

4.3.1       Secured by a minimum of 4 screws and the equipment/panels are secured in place.

 

                                                             a.               One screw on each side, one on top, and one on the bottom for electronic cabinets (ex. CPS rear panels) and all disconnect and distribution panels.

                                                            b.               Four screws, two on each side for electronics cabinet equipment and equipment chassis.

 

4.3.2       Voltage Verification Units (VVU) are calibrated and in working order.

4.3.3       Knockouts/holes on the side equipment or boxes for penetrations are blanked off and sealed to prevent shock or other hazards.

4.3.4       Door latches are in working order and can be fully closed and easily opened.

4.3.5       Electrical items that are sitting on the bottoms of cabinets (or on top of other cables) shall be mounted properly in the cabinet to prevent shock or fire hazards. This includes power supplies and power strips.

4.3.6       Inspection labels are in clear view and Arc Flash labels are current.

4.3.7       Voltages and panel numbers are correct and equipment is labeled.

4.3.8       All doors on equipment can shut properly and shall not be removed or open without prior authorization. Door modifications can be approved with a safety inspection.

4.3.9       Dead-ended cables, especially ones that are electrically LIVE (even low voltage), shall be taped off, tagged, and set in the box or cabinet. Cables that have connectors shall be either removed (if not using again) or properly capped and labeled to prevent a hazard. Dead-ended cables must follow the LOTO program, if being reused, unless approved by Electrical Safety Coordinators or Electrical Safety Program Manager. This must be documented.

4.3.10    All spaces in front of and around access spaces such as doors, panels, disconnects, walkways, and electronics racks must be clear in order to safely gain access to equipment, especially in case of an emergency.

4.3.11    All spaces in front of and around equipment must be free of fall, trip, and slip hazards.

4.3.12    Housekeeping of cables, trash, equipment parts, and other items is imperative to the safety of electrical and electronic equipment and spaces. These areas should remain clean for good working order and fire prevention (i.e. dust and paper).

4.3.13    All extension cords, receptacles, power supplies, and power strips are safe and being used for their intended purposes. Proper loads will be followed. Extension cords are NOT to be used for permanent power. Extension cords must be out of the way and routed correctly to prevent hazards. There are NOT to be cut and used a hard-wired cable for power. There is a 90-day maximum for use. (OSHA 1910.305)

4.3.14    General electrical safety for shock hazards will be inspected.

5.0           References

5.1            NFPA 70E (2015 Edition) – Standards for Electrical Safety in the Workplace

5.2            NFPA 70 (2020 Edition) – National Electric Code

5.3            OSHA Regulation 29 CFR 1910 and 29 CFR 1926

5.4            DOE Electrical Safety Handbook

 

6.0           Revision Summary

                                           

Revision .01 - 01/29/2021 – New content written. Director and ES&H Director approved.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Electrical Equipment Safety Inspection

Rectangle: Rounded Corners: Click 
for
 .pdf Form

 

 

1.0             Equipment/Installation Identification

 

 

 

Equipment Description

 

 

 

 

 

 

 

 

 

Unique Identifier #:

 

Manufacturer:

 

 

 

 

Equipment Location:

Model Number:

 

 

 

 

Division:

Serial Number:

 

 

 

 

Equipment Owner:

JLAB Property #:

 

 

 

 

 

IF THIS EQUIPMENT IS MODIFIED, DAMAGED, OR UTILIZED FOR OTHER THAN ITS INTENDED USE, AFTER THE INSPECTION DATE, APPROVAL IS VOID, PENDING RE-INSPECTION.

 

 

 

 

*** To Be Completed by the Qualified Electrical Inspector***

 

 

Equipment is:

Equipment requires:

 

Under Warranty:

       Yes

 

       No

AND

 

 Approved 

 

 Rejected

 

 No Action

OR

 

 Corrective Actions

See 3.0 Equipment Inspection Summary

 Code Equivalency*

* Contact Jefferson Lab’s Electrical Authority Having Jurisdiction

 

Inspection Date:

Inspector Name:                                                                        Inspector Signature:

 

 

2.0       INSPECTION CRITERIA

 

Enclosure

Approve

N/A

 

 

Operator not exposed to any hazard

 

 

 

Not damaged

 

 

 

Appropriate material used

 

 

 

Protects contents from operating environment

 

 

 

Adequate shock protection (components well secured)

 

 

 

Will contain relevant/ applicable arcs, sparks and electrical explosions

 

 

 

 

 

 

Power Source – Cord and Plug

Approve

N/A

 

 

Proper voltage and ampacity for plug and cord

 

 

 

Grounding conductor included

 

 

 

Not frayed or damaged

 

 

 

Proper wiring of plug

 

 

 

Strain relief on cord

 

 

 

 

 

 

Power Source – Direct Wired

Approve

N/A

 

 

Proper voltage and ampacity rating for wiring method

 

 

 

Installation according to the NEC

 

 

 

Proper loading and overcurrent protection in branch circuit

 

 

 

 

 

 

Foreign Power Supplies and Equipment

Approve

N/A

 

 

Connected to facility power with appropriate adapters

 

 

 

Correct voltage, frequency and phasing

 

 

 

Correct wire ampacity for United States use

 

 

 

 

 

 

Grounding

Approve

N/A

 

 

Ground is properly connected

 

 

 

All non-current carrying exposed metal is properly bonded

 

 

 

All non-current carrying internal subsystems are properly bonded

 

 

 

Equipment ground is run with circuit conductors

 

 

 

Auxiliary ground is permitted

 

 

 

 

 

 

Internal Wiring

Approve

N/A

 

 

Polarity correct

 

 

 

Phasing correct

 

 

 

Landing of ground correct

 

 

 

Separate line / high voltage from low voltage

 

 

 

Wiring terminals and leads ok (no tension on terminals)

 

 

 

Proper wire size

 

 

 

No loose parts (mechanical bracing)

 

 

 

Proper overcurrent protection

 

 

 

 

 

 

Marking Requirements

Approve

N/A

 

 

Power requirements (voltage, current, frequency)

 

 

 

Restrictions and limitations of use

 

 

 

Make, model and serial number

 

 

 

Hazards, including stored energy

 

 

 

Requirements for access (LOTO, stored energy, PPE)

 

 

 

 

 

 

Test Performed

Approve

N/A

 

 

Ground continuity

 

 

 

Leakage current to ground

 

Polarization of cord and plug

 

Functional tests (GFCI, Emergency shutoff)

 

 

 

Automatic discharge of high voltage capacitor

 

 

 

 

 

 

Other Issues

Approve

N/A

 

 

Neat workmanship

 

 

 

Proper management of conductors

 

 

 

Free from sharp edges

 

 

 

Proper cooling (review equipment owner’s tests or analysis)

 

 

 

Switches and controls readily accessible

 

 

 

Any safety issues with access and maintenance

 

 

 

 

 

 

Secondary Hazards

Approve

N/A

 

 

RF hazards

 

 

 

DC electric or magnetic fields

 

 

 

IR, visible or UV

 

 

 

X-Rays

 

 

 

Fire or electrical explosion

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Documentation

Approve

N/A

 

 

Documentation adequate

 

 

 

Operating procedures

 

 

 

Training and qualifications requirements

 

 

 

 

 

3.0           EQUIPMENT INSPECTION SUMMARY

If rejected, include any corrective actions that need to be satisfied before rescheduling an inspection. 

 

 

 

Distribution:  Equipment Owner, System Owner

 

Form Revision Summary

Revision 2.0                     01/29/21- Removed the reference to ES&H Manual 6200 T1 in the form title.

Periodic Review              11/14/18 – No changes per TPOC

Revision 1.2                     02/19/14- Deleted Section 2 “Standards or Codes used for the Inspection”

Revision 1.1                     11/17/13- Deleted “Department Head” from “Distribution”

Revision 1.0                     10/31/13- Updated to reflect current laboratory operations; most notable - department retain records of inspections

Revision 0.0                     10/01/09 – Updated to reflect current laboratory requirements

 

ISSUING AUTHORITY

TECHNICAL POINT-OF-CONTACT

APPROVAL DATE

REVIEW DATE

REV.

 

 

ES&H Division

Rick Adrover

01/29/2021

01/29/2024

2.0

 

This document is controlled as an online file.  It may be printed but the print copy is not a controlled document.  It is the user’s responsibility to ensure that the document is the same revision as the current online file.  This copy was printed on 11/3/2022.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

APPENDIX B

ELECTRICAL SAFETY PERSONAL PROTECTION EQUIPMENT

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

APPENDIX B- Electrical Safety Personal Protection Equipment

 

1.0           Purpose

Jefferson Lab requires the use of appropriate electrical protective equipment to protect the worker from harm while work is being performed. This procedure complies with the requirements of NFPA 70E (2015 Edition) – Standard for Electrical Safety in the Workplace regarding personal protective equipment (PPE) requirements for when work is performed with electrical equipment. This is especially important within a shock and/or an arc flash protection boundary.

2.0           Scope

This document provides guidance to ensure that the appropriate electrical PPE, for the assigned task, is selected and used while performing electrical work. 

PPE is the last line of defense in protecting from an electrical hazard before an incident happens and therefore ranks as the lowest level of control for reducing the risk. The most effective way to reduce the risk associated with an electrical hazard is elimination (working on de-energized systems).

3.0           Responsibilities

3.1            Everyone at Jefferson

 

3.1.1       Be aware of the electrical hazards in your workplace. Stay clear of electrical hazard boundaries that are identified by red with white stripe tape.

3.1.2       Pay attention to all labeling on and around equipment.

 

3.2            Qualified Individuals

 

3.2.1       Establish and monitor shock approach and/or arc flash protection boundaries.

3.2.2       Select and use appropriate PPE while exposed to electrical hazards.

3.2.3       Wear no conductive articles of jewelry or clothing that could present an electrical contact hazard.

3.2.4       Do not wear any fabric underlayers next to the skin that are considered to be meltable fibers such as acetate, nylon, polyester, polypropylene, and spandex while performing work inside the arc flash boundary.

3.2.5       Ensure PPE is inspected, tested, and cared for in accordance with manufacturer’s instructions before each use:

 

3.2.5.3  Any damaged PPE shall be turned in to be discarded and replaced.

3.2.5.4  Any PPE found outside its maximum test interval date shall not be used and turned in to be replaced with PPE that is within its testing interval date.

3.2.5.5  When arc-rated clothing is cleaned, manufacturer’s instructions shall be followed.

3.2.5.6  An employee can self-launder their arc rated clothing or make arrangements with the Electrical Safety Engineer/Program Manager to have it cleaned at a commercial laundry site.

 

3.2.6       Electrical Safety Engineer/Program Manager

 

3.2.6.1  Provide an electrical PPE evaluation, upon request, for shock and arc flash hazards.

3.2.6.2  Provide electrical PPE upon request/need to lab employees.

3.2.6.3  Administer the lab-wide electrical rated glove change out every six months.

3.2.6.4  Provide a means for cleaning/laundering arc-rated clothing.

 

4.0           Process Steps

Follow the process steps outlined below to determine the appropriate electrical PPE to be worn in a shock approach or arc flash protection boundary.

Step 1:                                Determine the task to be performed and the specific equipment to be worked on. Different PPE levels may be required for different tasks on the same piece of equipment.

Step 2:                                Refer to the equipment specific arc flash and shock hazard label on the equipment to be worked on. If the equipment does not have a label, go to Step 6.

Step 3:                                Determine the Approach Boundaries for shock protection with using the nominal system voltage as displayed on the arc flash and shock hazard label. Refer to table NFPA 70E (2015 Edition), Article 130.4(D)(a) for alternating current systems & table NFPA 70E (2015 Edition), Article 130.4(D)(b) for direct current systems for the approach boundaries to energized electrical conductors or circuit parts for shock protection.

a.        Establish shock and/or arc flash boundaries at correct distances with ES&H approved boundary tape.

b.        Meltable fibers such as acetate, nylon, polyester, polypropylene, and spandex shall not be permitted in fabric underlayers (underwear) next to the skin.

Step 4:                                Determine the Approach Boundary for arc flash protection by referring to the calculated distance displayed on the arc flash and shock hazard label.

 

a.        When crossing the arc flash boundary where the calculated incident energy is greater than 1.2cal/cm^2 then arc rated clothing shall be worn; the arc flash rating of the PPE shall be equal to or greater than the incident energy rating (cal/cm ^2) displayed on the arc flash and shock hazard label.

 

Step 5:                    Go to Step 9 if the arc flash boundary is Class 1.

Step 6:                                Determine the Approach Boundaries for shock protection using the nominal system voltage of the equipment. Refer to the NFPA 70E (2015 Edition) table 130.4(D)(a) for alternating current systems & the NFPA 70E (2015 Edition) table 130.4(D)(b) for direct current systems for the approach boundaries to energized electrical conductors or circuit parts for shock protection.

 

a.        Establish shock boundary at the correct distance with ES&H approved boundary tape.

b.        When crossing the restricted approach boundary, where circuit parts greater than 50 volts are exposed, then shock protection PPE shall be worn; the PPE rating shall be equal to or greater than the exposed voltages.

 

Step 7:                                Determine the arc flash PPE category of the work task being performed. Refer to the NFPA 70E (2015 Edition) Table 130.7(C)(15)(A)(a) for arc-flash hazard categories for alternating current systems and NFPA 70E (2015 Edition) table 130.7(C)(15)(A)(b) for arc-flash hazard categories for direct current systems.

Step 8:                                Refer to the NFPA 70E (2015 Edition) Table 130.7(C)(16) for a list and rating of the PPE to be worn for each arc flash PPE category.

Step 9:                                Inspect and don the appropriate PPE.

a.      Meltable fibers such as acetate, nylon, polyester, polypropylene, and spandex shall not be permitted in fabric underlayers (underwear) next to the skin.

NOTE: PPE is the last line of defense in protecting an employee from an electrical hazard before an incident happens. The potential electrical hazards are electrical shock, arc flash, arc blast, and burns from hot electrical equipment. Electrical PPE does not protect against arc blast and thermal burn hazards.

5.0           References

5.5  NFPA 70E (2015 Edition) – Standards for Electrical Safety in the Workplace

5.6  NFPA 70 (2020 Edition) – National Electric Code

5.7  OSHA Regulation 29 CFR 1910 and 29 CFR 1926

5.8  DOE Electrical Safety Handbook

 

6.0           Revision Summary

Revision 1.0 - 09/11/2020 - Added this to the new 6230 Appendix

Revision 0.6 - 08/20/2020 - Updated Purpose statement. Updated numbering. Removed “NOTE” in 3.0. On 3.2.b and 4.0 step 3.b, corrected spelling on “meltable.” On 4.0, Step 3, added the reference to where the table was located. Added most current year to references. Streamlined revisions and reformatted.

Revision 0.5 - 01/31/20 – Updated Responsibilities and Process Steps 3 and 6 to include establishing shock boundaries at the correct distance per CATS#NE-2019-05-04-01and CATS#NE-2019-05-08-01 

Revision 0.4 - 11/14/18 – Developed process for laundering arc rated PPE per CATS#STR-2017-12-04-02; deleted reference to NFPA-70E (2004 edition) per CATS# STR-2017-12-06-01; updated 3.0 Responsibilities; updated 4.0 Process Steps; updated 5.0 References

Periodic Review - 10/05/16 – No changes per TPOC

          Revision 0.3 - 11/03/14 – Edits per T.Kujawa with no substantive changes

Revision 0.2 - 11/14/13 – Changed review required date from 07/31/16 to coincide with review date of main chapter.

Revision 0.1 - 07/31/13 – Periodic Review; clarified purpose, scope, responsibilities, and process steps; added new responsibility for Facilities Management Electrical Engineer; updated references; added note and revision summary.

Revision 0.0 - 10/01/09 – New content written to reflect current laboratory operations

 

 


 

 

 

 

 

 

 

 

 

 

 

 

APPENDIX C

ELECTRICAL EQUIVALENCY

 

 

 

 

 

 

 

 

 

 

 

 


 

Appendix C - Electrical Code Equivalency Form

 

1.0           Purpose

When compliance with electrical codes or standards will create additional hazards, increased risk, or be infeasible, Jefferson Lab allows alternative mitigation to be considered. This mitigation can waive specific requirements or permit alternative methods in NFPA 70 (2017 Edition) and NFPA 70E (2015 Edition) where it is assured that equivalent objectives can be achieved by establishing and maintaining effective safety. This procedure provides the process steps for initiating a request, and its review and approval, to ensure the same or greater level of safety.

2.0           Scope

The Electrical Authority Having Jurisdiction (EAHJ) uses this procedure to waive specific requirements or permit alternative methods where it is assured that equivalent objectives can be achieved by establishing and maintaining effective safety.

This procedure is used for granting special permissions (equivalencies) regarding implementation of rules and practices of the National Fire Protection Association (NFPA).

The EAHJ’s authority does not extend to regulation, standards or codes that fall under the regulatory authority of Occupational Safety and Health Authority (OSHA) unless incorporated by reference and includes an EAHJ, or similar, provision. All equivalencies have to be approved by the TJSO.

Perform the process steps for this procedure in coordination with Chapter 6200, Electrical Safety Manual and Chapter 6220, Non-NRTL Equipment Design and Construction.

3.0           Responsibilities

NOTE:  Management authority may be delegated at the discretion of the responsible manager. EAHJ responsibilities cannot be delegated without TJSO acceptance.

3.1            Anyone at Jefferson Lab

Initiate an electrical code equivalency request using the Electrical Code Equivalency Request Form.

3.2            Electrical Authority Having Jurisdiction (EAHJ)

3.2.1        Provide a determination for Electrical Code Equivalency Requests.

3.2.2        Distribute the completed form as appropriate.

3.3            Electrical Safety Committee (ESC)

3.3.1        Review and provide comments, as warranted, to requests.

3.3.2        Discuss and record equivalency determinations as part of ESC Minutes.

3.4            ES&H Director

Review and approve Electrical Code Equivalency

 

4.0     Initiate the Request

 

4.1       Identify the equipment, installation, or process

Be as specific as possible. Include diagrams, pictures, etc. if appropriate, to identify the issue.

4.2       Location of the work

Be as specific as possible. Include the building number, room number, or distance from the nearest landmark.

4.3       Description of the work

Provide details as to the work assignment and its objective.

4.4       State the specific problem or question; list the specific code and section(s) requiring equivalency.

Describe why the work will create additional hazards, increased risk, or be infeasible.

4.5       Describe the proposed mitigation to satisfy the electrical safety equivalency.

Provide a description of what could be done to mitigate the hazard to a level at or below that provided by the Code.

4.6       Sign and submit

The Requestor then signs the form and submits it to the EAHJ for determination.

5.0           Determination

Review the request. Provide copies to members of the Electrical Safety Committee for review and comment if appropriate. Peer benchmarking of prospective equivalencies will be performed for consideration in the final determination; discuss the results in section 2.0 DETERMINATION on the equivalency form.

5.1       Process

            5.1.1    Scope Statement

Grant or deny the request for the identified equipment, installation, or process. If the request is applicable to other issues, describe.

5.1.2    Specific Code and Section(s) Used

Provide a justification for the determination whether “Recommended” or “Denied”.

5.1.3    Explain Determination

 

IF the Request is:

THEN

Recommended

First

Include an explanation of the electrical safety aspects.

Second

Develop draft actions and associated completion dates to be entered into the Jefferson Lab Corrective Action Tracking System (CATS) upon equivalency approval.

Denied

Provide reasoning and, if applicable, alternative(s).

 

5.2            Approval

5.2.1       The EAHJ signs and date the “Determination” to denote an adequate review.

5.2.2       If denied, return to the submitter with justification

5.2.3       If recommended:

5.2.3.1  Submit the determination package, including the draft corrective action and all supporting information, to the TJSO.

5.2.3.2  The TJSO will then review, comment, and/or approve recommended equivalency.

5.2.4       Following receipt of TJSO approval, the ES&H Director signs and dates the Equivalency.

5.2.5       The requestor or EAHJ makes the appropriate entries into the JSA Corrective Action Tracking System.

5.3            Distribution

5.3.1        The EAHJ retains the final requests. (These records are available at https://jlabdoc.jlab.org/docushare/dsweb/View/Collection-19892).

5.3.2       Distribute copies of the completed form to individuals listed under the Distribution section on the Electrical Code Equivalency Request Form.

5.4            Chapter 6230, Appendix A: Electrical Safety Inspection Form and Instructions

Note: This form is for non-NRTL Equipment.

5.4.1      Once the Request has been approved, go over the Inspection Checklist for non-NRTL equipment and fill out the sheet in the appropriate blocks. Provide proper documentation (THA, OSP, and diagrams).

5.4.2      When the proper documentation and completed form has been sent to ES&H Electrical Safety Manager or Electrical Safety Coordinators, then ES&H will review documentation and diagrams. Once these have been reviewed and all changes (if needed) are made, ES&H will make an appointment for a physical inspection using the form and documentation previously provided.

5.4.3      Once a physical inspection has been done and reviewed in conjunction with provided documentation, the inspector may APPROVE or DENY the form. If APPROVED, the equipment has been deemed safe to use and must maintain all precautions listed on the Electrical Safety Inspection Form. If DENIED, then the items denied by ES&H must be fixed for APPROVAL. If denied, the form must be resubmitted with the changes.

 

6.0           Revision Summary

 

Revision 1.2 10/18/2022 - Clarified process for including TJSO in equivalency determinations; fixed general formatting issues (ES&HM Editor); fixed hyperlinks

Revision 1.1 07/12/21 - Updated hyperlinks and references.

Revision 1.0 08/20/20 - Added current reference dates. Adjusted formatting.

Revision 0.1 11/14/18 – Deleted reference to NFPA-70E (2004 edition) per CATS# STR-2017-12-06-01; updated Purpose, Scope, 4.3, 4.4

Periodic Review 10/05/16 – No changes per TPOC

Revision 0.0  10/31/13 – New content to reflect current laboratory operations

 

 

Electrical Code Equivalency Request Form

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for
 Word doc

 

 

////////////////////////////////////To be completed by the Electrical Authority Having Jurisdiction/////////////////////////////////////

DETERMINATION:

(Electrical Safety Committee vote)

 Approved      Denied     CATS No.

 

////////////////////////////////////To be completed by the Electrical Authority Having Jurisdiction/////////////////////////////////////

Signatures

Print

 

Signature

 

Date

Electrical Authority Having Jurisdiction

 

 

 

 

 

Associate Director, ESH&Q

 

 

 

 

 

 

1.0           INITIATE REQUEST (To be completed by Requestor)

1.1            Identify Equipment, Installation, or Process

 

 

1.2            Location of the Work

 

 

1.3            Description of the Work

 

 

1.4            State the Specific Question or Problem. List the specific code and section(s) that requires equivalency. 

(How does the code create an additional hazard, increase risk, or is infeasible)

 

 

1.5            Describe the Proposed Mitigation– to satisfy the electrical safety equivalency.

 

 

1.6            Signature

Print

 

Signature

 

Date

Requestor

 

 

 

 

 

2.0           DETERMINATION (To be completed by Electrical Authority Having Jurisdiction)

2.1            Scope Statement (i.e. only for the specific equipment identified in the request; for broader application to similar equipment; or for general application at Jefferson Lab.) Include here the results of any benchmarking performed.

 

 

2.2            Specific Code and Section(s) Used - to justify the Determination.

 

 

2.3            Explain Determination: 

·        If the request is approved, include an explanation of the electrical safety aspects. 

·       If the request is denied provide reasoning and, if applicable, alternative(s).

 

 

 

Distribution:

IF

Code Equivalency is:

THEN

Approved

Associate Director-ESH&Q; Associate Director/Division Manager (of group requesting the equivalency); Thomas Jefferson Site Office Representative; Supervisor; Requestor; Electrical Authority Having Jurisdiction; Electrical Safety Committee Chair

Denied

Requestor; Electrical Authority Having Jurisdiction; Electrical Safety Committee Chair

 

Form Revision Summary

Revision 1.1    10/26/2022  Changed TPOC from TFitzgerald to RAdrover

Revision 1.0    01/29/21- Removed the reference and moved to ES&H Manual 6230.

Revision 0. 1   11/14/18 – Added Associate Director, ESH&Q signature for electrical safety committee vote determination; deleted supervisor signature to initiate request

Periodic Review  10/05/16 – No changes per TPOC

Revision 0.0     10/31/13 - New content to reflect current laboratory operations

ISSUING AUTHORITY

TECHNICAL POINT-OF-CONTACT

APPROVAL DATE

REVIEW DATE

REV.

ES&H Division

Rick Adrover

01/29/2021

01/29/2024

0.1

This document is controlled as an online file.  It may be printed but the print copy is not a controlled document.  It is the user’s responsibility to ensure that the document is the same revision as the current online file.  This copy was printed on 11/3/2022.

 

 

 

 

 

 

 

 

 

 

 

 

APPENDIX D

ENERGIZED ELECTRICAL WORK PERMIT (EEWP)

 

 

 

 

 

 

 

 

 

 

Appendix D Energized Electrical Work Permit (EEWP)

 

Energized Electrical Work Permit Form

 

 

 

PART 1 – Description of Work

(To Be Completed by the Requestor) (Include attachments as necessary)

Description of Circuit/Equipment and Location

 

Description of work to be performed

 

Justification to Perform Work while Equipment is Energized: (Attach Documentation)

SIGNATURES

               PRINT                                                              SIGNATURE

DATE

Requestor

 

 

Preliminary Approval

(Laboratory Director)

 

 

 

PART 2 – Development

(To Be Developed by Subject Matter Expert and Electrically Qualified Workers)

REQUIRED ATTACHMENTS

Description of Circuit, Equipment and Location

Means to Restrict Unqualified Workers from the Area

Results of Shock Hazard Analysis

Determination of Shock Hazard Boundaries

Results of Flash Hazard Analysis

Determination of Flash Hazard Boundary

Job Briefing and Hazard Analysis

List PPE to Perform Work Safely

Description of Safe Work Practices to be Employed

 

 

APPROVALS

PRINT                                                              SIGNATURE

DATE

Qualified Worker(s)

 

 

Electrical Safety Engineer

 

 

Associate Director/Division Manager (of group requesting the EEWP)

 

 

Laboratory Director

 

 

Director, ES&H&Q Division

 

 

Distribution: Laboratory Director; Associate Director/Division Manager (of group requesting the EEWP); Electrical Safety Engineer

 

 

Form Revision Summary

 

Revision 2.0                     08/20/20- Removed the reference to ES&S Manual 6220 T1.Created a new Appendices 

                                          section.

Periodic Review              12/10/18 – No changes per TPOC

Revision 1.2                     06/29/18 – Periodic Review; updated to include AD, ESH&Q approval per CATS#MOA-

                                          2018-02-01-01

Periodic Review              01/20/12 – Updated format

Revision 1.1                     10/19/10 – Updated to clarify content per P.Powers and T.Kujawa

Revision 0.0                     02/23/09 – Initial Form

 

 

ISSUING AUTHORITY

FORM TECHNICAL POINT-OF-CONTACT

APPROVAL DATE

REVIEW DATE

REV.

 

 

ESH&Q Division

Rick Adrover

12/10/18

12/10/21

1.2

 

This document is controlled as an online file.  It may be printed but the print copy is not a controlled document.  It is the user’s responsibility to ensure that the document is the same revision as the current online file.  This copy was printed on 11/3/2022.

 

Revision Summary

Revision 0.2, 10/26/2022  Updated Appendix C

Revision 0.1–01/29/2021 Initial chapter that has all forms in one location.  Director and ES&H Director approved.