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<p class="MsoNormal"><span style="font-family: Times;">All,<br>
</span></p>
<p class="MsoNormal"><span style="font-family: Times;"><br>
I want to share some recent events that have taken place at the
Lab:<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: Times;"><o:p> </o:p></span></p>
<p class="MsoListParagraph" style="margin-left: 0.25in; text-indent:
-0.25in;"><!--[if !supportLists]--><span style="font-family:
Times;"><span style="">1)<span style="font: 7pt "Times New
Roman";"> </span></span></span><!--[endif]--><span
style="font-family: Times;">Last week, an employee was observed
working from a scissors lift that was 15 feet above the ground.<span
style=""> </span>The employee was stretched out between the
cross braces of the lift in order to work on the equipment.<span
style=""> </span>The original work plan called for the
employee to wear fall protection because the employee had to
lean over a railing.<span style=""> </span>However the harness
was pressing on the chest, causing pain.<span style=""> </span>The
employee and co-workers stopped wearing the harness and
continued to work outside the protection of the scissors lift.<o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 0.25in;"><span
style="font-family: Times;"><o:p> </o:p></span></p>
<p class="MsoListParagraph" style="margin-left: 0.25in; text-indent:
-0.25in;"><!--[if !supportLists]--><span style="font-family:
Times;"><span style="">2)<span style="font: 7pt "Times New
Roman";"> </span></span></span><!--[endif]--><span
style="font-family: Times;">A few weeks earlier, an employee was
securing the stored energy on a piece of equipment in order to </span><span
style="font-family: Times;">trouble shoot it. Following
procedure, the worker secured the main power, the local power,
and equalized the stored energy. The next step was to insert a
pin (locking bar) into the flywheel. The employee was unable to
align the wheel to insert the security pin per the procedure.
They then stepped away to obtain PPE for the team that was
scheduled to arrive shortly. While the employee was gone from
the room, the supervisor entered and discovered that hazardous
energy control of the fly-wheel had been lost. <o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 0.25in;"><span
style="font-family: Times;"><o:p> </o:p></span></p>
<p class="MsoListParagraph" style="margin-left: 0.25in; text-indent:
-0.25in;"><!--[if !supportLists]--><span style="font-family:
Times;"><span style="">3)<span style=""> </span></span></span><span
style="font-family: Times;">Earlier this year, an employee
stepped from a rolling step-ladder onto a support frame instead
of using the designed and installed worker platform.<span
style=""> </span>When stepping down, the worker missed the
step ladder, fell, and striking their back on the support
structure, causing a vertebrae fracture.<span style=""> </span><o:p></o:p></span></p>
<p class="MsoNormal" style="margin-left: 0.25in;"><span
style="font-family: Times;"><o:p> </o:p></span></p>
<p class="Default" style="margin-left: 0.25in; text-indent:
-0.25in;"><!--[if !supportLists]--><span style="font-family:
Times;"><span style="">4)<span style=""> </span></span></span><span
style="font-family: Times;">The carbon vessel in CHL 1 is a
large filter for the warm helium system.<span style=""> </span>The
vessel is 7 feet in diameter and 20 feet high.<span style=""> </span>It
is filled with pellet-sized activated carbon, and requires
replacement.<span style=""> </span>Last week the workers
started the job, but discovered that additional vacuum pumps
would be needed and relocated. The work was stopped while the
plan was reviewed and additional mitigations were identified.<span
style=""> </span>A TOSP was written, the workers were
re-briefed, and work was re-started.<span style=""> </span></span><span
style="font-family: Times;"><o:p></o:p></span></p>
<p class="MsoNormal" style=""><span style="font-size: 13pt;
font-family: Times;"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family: Times;">These events
have a few things in common:<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: Times;"><o:p> </o:p></span></p>
<p class="MsoListParagraphCxSpFirst" style="text-indent: -0.25in;"><!--[if !supportLists]--><span
style="font-family: Symbol;"><span style="">·<span style="font:
7pt "Times New Roman";"> </span></span></span><!--[endif]--><span
style="font-family: Times;">There were well understood
expectations of how to work safely that were reinforced by
training and/or written procedure<o:p></o:p></span></p>
<p class="MsoListParagraphCxSpMiddle" style="text-indent: -0.25in;"><!--[if !supportLists]--><span
style="font-family: Symbol;"><span style="">·<span style="font:
7pt "Times New Roman";"> </span></span></span><!--[endif]--><span
style="font-family: Times;">Workers encountered difficulties in
meeting those expectations<o:p></o:p></span></p>
<p class="MsoListParagraphCxSpLast" style="text-indent: -0.25in;"><!--[if !supportLists]--><span
style="font-family: Symbol;"><span style="">·<span style="font:
7pt "Times New Roman";"> </span></span></span><!--[endif]--><span
style="font-family: Times;">With the exception of #4, workers
chose to take action inconsistent with their training and/or
procedures.<span style=""> </span>Their evaluation of the
situation and path forward lost sight of safety<o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: Times;"><o:p> </o:p></span></p>
<p class="MsoNormal"><span style="font-family: Times;">Our policy is
that nothing we do is so important that we will compromise our
safety. <br>
</span></p>
<p class="MsoNormal"><br>
<span style="font-family: Times;"><o:p></o:p></span></p>
<p class="MsoNormal"><span style="font-family: Times;">Bottom line:
personal safety is both a condition for, and an expected outcome
of any successful work here at Jefferson Lab, not an option. If
the work cannot be done without compromising your safety, it has
not been planned correctly or is not being implemented
effectively. <u>Stop, and do it righ</u></span><u><span
style="">t.<br>
</span></u></p>
<p class="MsoNormal"><br>
-Mont</p>
<p class="MsoNormal"><br>
<br>
<u><span style=""></span><o:p></o:p></u></p>
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