05000255/FIN-2014002-01
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Finding | |
|---|---|
| Title | Inadequate Installation of Steam Generator Nozzle Dams |
| Description | A finding of very low safety significance and an associated non-citied violation of 10 CFR 50, Appendix B, Criterion V, Instructions, Procedures, and Drawings, was selfrevealed when licensee personnel failed to have an adequate procedure and work order (WO) to install steam generator nozzle dams. The licensee entered this issue in their Corrective Action Program (CAP) as Condition Report (CR) PLP-2014-00770, Improper Routing of Nozzle Dam Air Supply. As part of their corrective actions, the licensee planned to revise the nozzle dam installation procedure and the WO. The inspectors determined that this finding was more than minor in accordance with IMC 0612, Appendix B, Issue Screening, because the finding was associated with the Procedure Quality attribute of the Initiating Events cornerstone and adversely impacted the cornerstone objective of limiting the likelihood of events that upset plant stability and challenge critical safety functions during shutdown as well as power operations, and was similar to the more than minor criteria in Example 5.a of IMC 0612, Appendix E, Examples of Minor Issues. As it related to this finding, the intended design of the nozzle dam air supply system was not correctly translated into the installation procedure or the work instructions. Further, the nozzle dam air system was not properly tested prior to being placed into service. Since the plant was shutdown in Mode 6, the inspectors assessed the risk significance of the event in accordance with IMC 0609, Appendix G, Shutdown Operations Significance Determination Process. A Phase 2 risk evaluation was required that determined the total event risk was 3.6E-8 and was therefore of very low safety significance (Green). This finding had an associated crosscutting aspect in the Change Management (H.3) component of the Human Performance cross-cutting area. In particular, issues during the previous refueling outage led the steam generator project management team to review the configuration of the nozzle dam air system. Through this review, the licensee identified that changes to the alignment of air to the nozzle dams was required. However, due to turnover within the project management group and inadequate communications and documentation, the licensee failed to appropriately evaluate and implement those changes. |
| Site: | Palisades  |
|---|---|
| Report | IR 05000255/2014002 Section 1R04 |
| Date counted | Mar 31, 2014 (2014Q1) |
| Type: | NCV: Green |
| cornerstone | Initiating Events |
| Identified by: | Self-revealing |
| Inspection Procedure: | IP 71111.04 |
| Inspectors (proximate) | A Garmoe A Scarbeary E Duncan E Sanchez Santiago G Hansen J Cassidy J Lennartz M Jones M Phalen T Bilik T Taylor |
| Violation of: | 10 CFR 50 Appendix B Criterion V |
| CCA | H.3, Change Management |
| INPO aspect | LA.5 |
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Finding - Palisades - IR 05000255/2014002 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Finding List (Palisades) @ 2014Q1
Self-Identified List (Palisades)
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