S02 - Attachment D4 - Shutdown Checklist.pdf
PDF 199 KB Posted
- Solicitation number
- 36C25026Q0069
- Issued by
-
Department of Veterans Affairs
About this file
This document is an Electrical Lock Out/Tag Out/Shutdown Safety Checklist for a VA (Veterans Affairs) project. The checklist provides a detailed, step-by-step procedure for safely shutting down and working on electrical panels, specifically focusing on the PDP (Panel Distribution Panel) in switchboard-2, room 1-B260C. The document includes sections for VA employees present, engineering approval signatures, and a comprehensive 27-step safety protocol that covers equipment verification, power shutdown, temporary power arrangements, voltage confirmation, breaker management, and reinstallation procedures.
Key safety steps include verifying lockout/tagout equipment, checking arc flash labels for proper PPE, confirming no other contractors are working in the area, turning off normal power equipment, notifying relevant departments (switchboard, boiler plant), and meticulously documenting breaker positions, wire sizes, and lengths. The checklist requires signatures from VA electricians and engineers, and provides a structured approach to electrical system maintenance with an emphasis on safety, voltage verification, and systematic equipment handling.
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Text version
Expected Start Date:
Scheduled Start Time
Schedule End Time
Expected Completion Date
Actual Start Time
Actual End Time
X
X
Signature
Signature
X CHECK BOX
Fed From Mechanical Lockout / I-LINE
Equipment Location Personal Lock Out ID Tag's
Area Affected
Contractor:
Foreman:
Lockout/Tagout Equipment Required
Equipment to be Shutdown Padlocks
ELECTRICAL LOCK OUT/TAG OUT/SHUTDOWN SAFETY CHECKLIST
Date:
Project:
Contract Number:
General Contractor:
Project Manager or Superintendent:
Jacob Jebb, VA Engineer
VERIFY AND CHECK LOCKOUT/TAGOUT EQUIPMENT IS READY AND AVAILABLE
CHECK PANEL ARC FLASH LABEL FOR PROPER PPE AND DON CORRECT PPE, DOCUMENT LABEL INFO ON PROTECTIVE DEVICE LIST
VA Employees Present, Title Engineering Approval Signatures, Title
Scott Bank, VA Electrician Tom Belongia, VA Engineer
Phil Marentette, VA Electrician
Scott Kern, VA Electrician
VERIFY WITH ENG. DEPT. THAT NO OTHER CONTRACTORS ARE WORKING IN AREA
CONFIRM NO VOLTAGE AT PANEL PDP
VERIFY BREAKER SETTINGS VIA BREAKER MENU AND DOCUMENT ON DRAWINGS, SHEET EP-100 & EP-102
DOCUMENT ALL BREAKER POSITIONS FOR PANEL PDP ON NEXT PAGE
OPEN ALL BREAKERS IN PANEL PDP
REQUEST HVAC TECHNICIAN TO TURN OFF NORMAL POWER EQUIPMENT WITH CONTROL SYSTEM
CONFIRM TEMP POWER FOR SPS IS IN PLACE FOR PANELS BD ABD BD-1
CONFIRM DIETETICS STAFF ARE FINISHED FOR THE DAY AND TEMP PROVISIONS HAVE BEEN MADE, THEY FINISH AT 7PM.
CONFIRM TEMPORARY POWER IS AVAILABLE FOR OTHER CONTRACTORS.
INFORM SWITCHBOARD OF SCHEDULED SHUTDOWN AND REQUEST OVERHEAD ANNOUNCEMENT AT EXT 13875
NOTIFY BOILER PLANT EXT 13880 OR REQUEST SWITCHBOARD TO CALL THEM.
Contractor Completion Sign-Off, Title
Printed Name:
ENERGIZE ALL PDP FEEDER BREAKERS INDIVIDUALLY.
CONFIRM ALL BREAKERS ARE IN AS FOUND STATE (NEXT PAGE)
INSTALL ALL TESTING LABELS ON GEAR AND ON EACH BREAKER.
REMOVE LOCKS AND TAGS FROM PDP FEEDER BREAKER IN SWITCHBOARD-2 AND RE-ENERGIZE
VERIFY CORRECT VOLTAGE ON PANEL PDP BUS WITH MULTIMETER
RE-INSTALL PANEL COVER
REINSTALL ALL BREAKERS AND TORQUE LUGS
VERIFY ALL RE-INSTALLED BREAKERS ARE IN THE OFF POSITION EXCEPT FOR PDP MAIN (LEAVE MAIN ON FOR VOLTAGE VERIFICATION)
REINSTALL DEAD FRONT
TAG/LABEL/OR OTHERWISE IDENTIFY BREAKER LOCATIONS AND REMOVE FOR TESTING
DOCUMENT ALL WIRE SIZES, LENGTHS, AND QUANTITY FROM EVERY BREAKER ON DRAWINGS, SHEETS EP102 & EP-111
PERFORM TESTING AND MAINTENANCE
REMOVE PANEL COVER AND VERIFY VOLTAGE
OPEN AND LOCK OUT FEEDER BREAKER PDP LOCATED IN SWBD-2 ROOM 1-B260C
File details come from the government source that posted it. Updated .