Activity Hazard Analysis (AHA)
ACTIVITY/WORK TASK:
LOCKOUT/TAGOUT (LOTO) – E/F Subs
PWD/OICC/ROICC OFFICE
W912DY-15-D-0005-0003
Probability
TASK ORDER/DELIVERY #:
PRIME CONTRACTOR:
SUBCONTRACTOR:
DATE OF PREPARATORY MEETING:
DATE OF INITIAL INSPECTION:
COMPETENT PERSON
SITE SAFETY & HEALTH OFFICER:
Severity
Schneider Electric
Berwick Electric Co.
Glenn Kapu, Mike Fernandez
Randy Sleight, Schneider Electric
2. Identify, Isolate, Lock & Tag.
Likely
Occasional
Seldom
E
E
H
H
Catastrophic
H
H
M
E
Critical
H
M
M
L
Marginal
M
L
L
L
Negligible
Review each “HAZARD” with identified safety “CONTROLS” and determine (RAC)
Unlikel
y
M
L
L
L
“Severity” is the outcome/degree if an incident, near miss, or accident did occur and identified as:
Catastrophic, Critical, Marginal, or Negligible after controls are in place.
“Probability” is the likelihood to cause an incident, near miss, or accident did occur and
L = LOW RISK (ET or PAR)
LockOut & TagOut Substations E/F
Main at the Temporary HVL gear in
Room 0106.
Frequent
Identify the RAC (Probability/Severity) as E, H, M or L for each “HAZARD” Place the highest RAC
at the top of AHA. This is the overall risk assessment code for this activity.
E = EXTREMELY HIGH
(PWO/OICC/ROICC)
H = HIGH RISK (FEAD
DIRECTOR)
M = MODERATE RISK (CM
or ET or PAR)
Job Steps
1. Prepare for shutdown – necessary
notifications to be made by Schneider
Electric and MC Dean to EVANS
Hospital (Aaron Hicks) in advance of
shutdown.
AHA #
Risk Assessment Code (RAC) Matrix
NAME & DATE ACCEPTED BY GDA:
CONTRACT NUMBER
M
Overall Risk Assessment Code (RAC) (Use highest code)
Activity #
identified as: Frequency, likely, Occasional, Seldom, or Unlikely after controls are put in
place.
Hazards
Controls
RAC
Unanticipated power outage affecting critical Notifications have already been made and approved by Hicks.
power, life safety systems and patient care.
M
Unanticipated release of hazardous energy
(electrical).
Verify that the correct energy source is de-energized. A Salisbury
proximity tester, Model #4744, will be attached to a Hubbell hot
stick, Model #H1760-1 and will be used to verify de-energization.
Install grounding cluster on MV feeder cables. Wear 40 cal arc
flash suit with hood and arc flash rated shield, and class 2/20Kv
rated rubber gloves with leather covers. A multimeter will be
used to verify zero-voltage from phase to phase and phase to
ground.
M
If the medium volt switch that feeds the
transformer doesn’t have a viable isolation
device, lockout/tagout procedures are not
complete; control of hazardous energy has
not been achieved. Incidental contact with
energy source can cause electrical failure,
shock, arc flash, etc.
4. Applying lockout/tagout devices – Injury to personnel that are not aware of the
group lockout boxes shall be utilized potential of contact with energized sources.
for absolute control of the lockout lock Inadvertent re-energizing of equipment.
keys. A dedicated lock will be used,
with tags equipped with fasteners that
can securely attach the tag to the
equipment. Only for personnel who
are working directly on the
device/gear.
3. Isolation of equipment to be locked
out.
Use approved isolation devices when implementing
lockout/tagout procedures. See USACE EM385.1.1 Section 12,
Control of Hazardous Energy.
Only authorized employees that have met the training
requirements of HEC and LOTO procedures are permitted to be
engaged in those activities. Devices to be used in this LO/TO
are locks, a group lockout box for multiple locks, and tags with
a fastener that will securely attach a tag to equipment. The tag
will note the authorized person’s name, date of application,
and contact information. One individual will control each
group lock box to ensure the premature energization does not
occur.
Use LO/TO Log to identify each lock and individual who is
Unintentional contact with electricity can
cause serious physical harm i.e., electric shock, authorized to work on the system as is governed by this AHA.
Only for personnel who are working directly on the
arc flash.
device/gear.
6. Changing cable type and reworking Cuts, eye injuries, strains, abrasions, head
Use appropriate PPE while performing task to include eye
existing cables.
knockers, slips, trips, falls. Pinch Points, heavy protection, gloves appropriate to the task, i.e., cut resistant
lifting, fatigue, dehydration and working from gloves, hard hat. Utilize proper body mechanics when lifting,
pushing, pulling and carrying, etc. Use personal fall arrest
heights.
system when working at heights greater than 6’. Use rest/work
cycles, drink water and ensure they are working on a solid
steady surface.
7. Restoring equipment to normal
Electrocution, electric shock, arc flash, tools Upon completion of the outage, obtain approval for temporary
service.
left in equipment.
or permanent restoration of the equipment. Survey the work
area to ensure that all tools/material are removed and will not
create a hazard during energization. When energizing, wear 40
cal arc flash suit with hood and arc flash rated shield, and class
2/20Kv rated rubber gloves with leather covers.
8. Clean up
Slips/Trips and tools left in equipment
Practice periodic housekeeping throughout the day and do a
final clean up at the end of the day. Do not leave any
equipment/materials/tools inside the electrical equipment.
M
M
5. Control of systems that are locked
and tagged out.
M
M
M
M
L
Equipment to be Used
Training
Hardhat/Safety Glasses/Safety Shoes/Gloves
Pre-Construction safety orientation
Locks and tags, LO/TO log, LO/TO box
AHA review for LOTO, LOTO training
Voltmeter/multi-meter
Qualified employee
Hand tools/power tools
OTJ training
Communication devices
OTJ training
Inspection Requirements
Inspect all tools, material and equipment prior
to use. Remove anything from service found to
be defective. Do not leave tools/materials inside
equipment after LOTO is completed.
Activities Requiring a Competent or Qualified Person – Attach Proof of Competency
Activity
Isolate and control of hazardous energy
Designated Competent or Qualified Person
Glenn Kapu, Berwick Electric
Mike Fernandez, Berwick Electric
Signatures / Verification of Review - Activity/Work Task: Lockout & Tagout (LOTO)
Name (Print)
Signature
Date