05000255/FIN-2009004-04
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Finding | |
|---|---|
| Title | Reduction in Containment Spray Header Level During Maintenance |
| Description | A finding of very low safety significance (Green) and associated NCV of TS 5.4.1, Procedures, was self-revealed when operators incorrectly implemented a procedure that connected a temporary pump to a containment spray header while attempting to fill the header. Specifically, the suction and discharge connections were swapped so that when the pump was turned on, water was pumped out of the header instead of into the header, reducing level below the TS required minimum value. The licensee corrected the connections and refilled the header to an acceptable level. Additionally, the issue was placed in the corrective action program as CR-PLP-2009-04080. The inspectors determined the issue was more than minor per IMC 0612 Appendix B because it affected the Configuration Control attribute of the Mitigating Systems cornerstone in that it affected the cornerstone objective of ensuring the availability, reliability, and capability of systems that respond to initiating events. Specifically, the improper connection of the pump lowered header level below the TS allowed value which resulted in an inadvertent TS action statement entry. The finding screened as Green, or very low safety significance, in IMC 0609 Appendix A, Determining the Significance of Reactor Inspection Findings for At-Power Situations, using the Phase 1worksheets based on answering no to all questions under the Mitigating Systems cornerstone in Table 4a. The finding had an associated cross-cutting aspect in the Work Practices component of the Human Performance cross-cutting area; namely, the licensee failed to appropriately communicate and use proper human error prevention techniques. (H.4(a)) |
| Site: | Palisades  |
|---|---|
| Report | IR 05000255/2009004 Section 4OA2 |
| Date counted | Sep 30, 2009 (2009Q3) |
| Type: | NCV: Green |
| cornerstone | Mitigating Systems |
| Identified by: | Self-revealing |
| Inspection Procedure: | IP 71152 |
| Inspectors (proximate) | P Laflamme T Taylor J Cassidy J Lennartz J Neurauter J Ellegood D Betancourt J Giessner |
| CCA | H.12, Avoid Complacency |
| INPO aspect | QA.4 |
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Finding - Palisades - IR 05000255/2009004 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Finding List (Palisades) @ 2009Q3
Self-Identified List (Palisades)
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