LBNL Qualified Electrical Worker - Application for PQEW Approval

You have indicated that you would like to become a Qualified Electrical Worker (QEW) for the purposes of working at the Berkeley Lab. This is the first step! Authorization to perform electrical work may only be granted through the WPC/Activity Manager system. You must be formally approved as a QEW by the Electrical AHJ and authorized through WPC/Activity Manager by your Activity Lead. AHJ approval will first require Provisional QEW approval (for skills and knowledge) and then completion of all applicable electrical safety training. Activity Lead authorization requires a complete, approved Activity that fully describes your scope of work, the hazards involved, and the controls required to perform the job safety. The purpose of this application form is to: 1 - Get you on our radar so we can talk to you. 2 - Find out more about your normal scope of electrical work, and to what hazards you may be exposed. 3 - Get information from you about your “skills and knowledge” background. 4 - If sufficient information is provided, grant “PQEW” status and ensure you are signed up for the necessary electrical safety training. More information about this process can be found in PUB-3000, Chapter 8, Electrical Safety Program. Click on the following link to see Work Process D, Electrical Work and Requirement for a Qualified Electrical Worker (QEW): (http://www2.lbl.gov/ehs/pub3000/CH08/CH8.html#wpD) Key Definitions: A QUALIFIED ELECTRICAL WORKER (QEW) is a person with demonstrated skills and knowledge related to the construction and operation of electrical equipment and installations, and who has received safety training to identify and avoid the hazards involved, and has been approved by the Electrical AHJ for Safe Work Practices. Only a Qualified Electrical Worker (QEW) may perform electrical work. ELECTRICAL WORK is defined as any task that involves a shock or arc flash hazard or could create potential shock or arc flash hazards for future users. This includes both live and deenergized work for building, servicing, maintaining, and repairing equipment. Another important item is to understand precisely what types of electrical hazards trigger this QEW requirement. Thresholds are summarized in Work Process D (see link above). If it is above the threshold, then you need to be a QEW to perform work on this equipment. If you have any questions about this form or process, please contact the Electrical Safety Group (Stephanie Collins x4914 or Mark Scott x4694) or email us at electricalsafety@lbl.gov. Please remember, completion of this form does not authorize electrical work!

About You

Select or enter value
Caret IconCaret symbol
Select or enter value
Caret IconCaret symbol

Tell Us About the Electrical Work You Will be Performing

Pick the drop down and check marks that BEST describe the electrical work that you will be performing.

1. Equipment

Select or enter value
Caret IconCaret symbol

2a. Electrical Work

Check the electrical work which you perform:

3a. Voltage

Check the voltages in which you will be exposed to:

Summary of Skills & Knowledge

Please upload attachments that demonstrate your work experience and/or educational background pertaining to electrical systems and equipment and the voltages you have experience with. Although resumes may be submitted for a general background, we look for independent forms of work experience validation. This can include: - Journeyman diplomas - Licenses - Trade school diplomas or certifications - Employer-specific training records, certifications or licenses - Transcripts from educational institutions (unofficial copies OK) - Professional certifications (PE, P.Eng or equivalent) - Military experience documents, such as the DD214 (block out SSN!) - Signed letters from previous or current supervisors stating that they have observed your work and can attest to your skills and knowledge. Up to 10 attachments can be included in the "File Attachments" section below. If you have questions on what will be accepted, please contact Stephanie Collins at x4914. IMPORTANT NOTE: Please do not submit documents that show Protected Identifiable Information (PII) such as your social security number, driver’s license number or California state ID number. Make sure these numbers are blanked out on the documents you submit.

Drag and drop files here or
Powered by Smartsheet Modern Logo On Light
Privacy Notice|Report Abuse