Construction Subcontractor Qualified Electrical Worker Request
You have indicated that your company would like to be approved to perform their own electrical work for the purposes of working at Berkeley Lab.
All construction subcontractors who perform electrical work as defined in Work Process D:(
) shall be required to be accepted by the Electrical Authority Having Jurisdiction (AHJ) for Safe Work Practices as Subcontractor Qualified Electrical Workers (QEWs). This includes both live and deenergized work for installing, building, servicing, maintaining, and repairing equipment.
A QEW is required for all connected work, even if under Lockout/Tagout (LOTO). This is because they need to know how and when to Test Before Touch for themselves.
The following steps will need to be completed for any company to be approved to perform electrical work at LBNL:
1 Construction Subcontractors must have an established JHA in accordance with the Berkeley Lab Sub-Contractor Construction –
. This process will trigger the requirement for a Subcontractor LOTO Permit or Energized Electrical Work Permit. Your LBNL P/M, C/M or LBNL contact can guide you thru this process.
2. Subcontractors must submit their Electrical Safety Program, This will be evaluated for conformance to NFPA 70E (2012 or later) and suitable controls for the type of work to be performed. Specific attention will be paid to the following areas:
- QEW approval process
- QEW training content and periodicity
- Shock approach boundaries and PPE selection
- Arc flash boundaries and PPE selection
- Voltage glove testing program
Regulatory requirement [2012 NFPA 70E 110.3]
3. Your company must provide documentation for each employee that will be applying for Qualified Electrical Worker (QEW) status. See section titled "Employee Documentation" below.
Regulatory requirement [2012 NFPA 70E 110.2]
These requirements cascade down to all sub-tiered contractors of a general contractor, including vendors, Original Equipment Manufacturer (OEM) representatives, etc.
Sub-tiered contractors and others may apply for AHJ acceptance under another subcontractor’s electrical safety program only if they were trained and qualified by that subcontractor under the same plan. If this is not the case, then the sub-tiered contractors must also submit their own electrical safety program for review.
Full text of requirements can be found in Pub. 3000, Chapter 8, Work Process F:
Please remember, you are NOT qualified for electrical work until you have been formally authorized by the ESG and by your PM/CM or other Authorized Project Lead. Once authorized, you will be added to the Subcontractor QEW Database managed by the LBNL ESG.
Company Safety Information
Please provide some information about your company and your company Electrical Safety Plan/Program.
Subcontractor to the Following General
Company Safety Information
Phone number and email of the subcontractor’s safety representative who can address questions and concerns that might come up during the course of work at Berkeley Lab.
Safety Information Submitted Previously
Check this box and select "No" when asked for program submission, if your company information has previously been submitted to the Electrical Safety Department.
A copy of the company Electrical Safety Program is attached at the bottom of this form.
No, please see the box below
Explanation if "No" was checked above:
In order to verify construction subcontractor QEW credentials, the subcontractor employer shall provide documentation for each employees who is applying. These will then be reviewed by the Electrical AHJ for Safe Work Practices.
Statement of Electrical Qualifications:
For any employee that will be performing work as a QEW, you MUST attach a statement of electrical qualifications ON COMPANY LETTERHEAD, and signed by appropriate management. You can download a statement template here:
A statement of training is attached at the bottom of this form.
Confirmation of NFPA 70E electrical safety training:
For each employee applying, please attach proof of training with date and hours taken. The training shall consist of classroom or on-the-job instruction, a minimum of 8 hours, and taken within the last 36 months. Training shall also include a practical demonstration of the absence of voltage verification, with the selection of an appropriately rated voltage detector and appropriately rated PPE.
A copy of each employees certificated has been attached below:
No, see box below for explanation
Explain if "No" was checked for certificates above:
Confirmation of current First Aid/Cardiopulmonary Resuscitation (CPR)/Automated External Defibrillator (AED) training
A minimum of 50% of QEWs from any given subcontractor on any given scope of work must be current in CPR/FA. In all cases, there shall be at least one Subcontractor QEW with current First Aid/CPR/AED training available to provide rescue in the case of an incident. Further, CPR/AED training shall comply with the American Heart Association or American Red Cross CPR and AED guidelines and shall include a competency demonstration of skills on a manikin, directly observed by an instructor (see California Code of Regulations [CCR] Title 22 Division 9 Sections 100038 and 100039).
A copy of CPR/FA cards with expirations dates have been attached for at least 50% of the QEW's applying
No, see box below for explaination
Explain if "No" was checked for cards above
Please submit the requested documents here
Send me a copy of my responses
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