05000265/LER-2003-003, Re Low Pressure Coolant Injection Differential Pressure Instrument Inoperable Due to Misposition of Instrument Valve
| ML032380558 | |
| Person / Time | |
|---|---|
| Site: | Quad Cities  |
| Issue date: | 08/18/2003 |
| From: | Tulon T Exelon Generation Co, Exelon Nuclear |
| To: | Document Control Desk, Office of Nuclear Reactor Regulation |
| References | |
| SVP-03-090 LER 03-003-00 | |
| Download: ML032380558 (4) | |
| Event date: | |
|---|---|
| Report date: | |
| Reporting criterion: | 10 CFR 50.73(a)(2)(i)(B), Prohibited by Technical Specifications |
| 2652003003R00 - NRC Website | |
text
Exek bn, Exelon Generation Company, LLC www.exeloncorp.com Nuclear Quad Cities Nuclear Power Station 22710 206 Avenue North Cordova, IL 61242-9740 August 18, 2003 SVP-03-090 U. S. Nuclear Regulatory Commission ATTN: Document Control Desk Washington, D.C. 20555 Quad Cities Nuclear Power Station, Unit 2 Facility Operating License No. DPR-30 NRC Docket No. 50-265
Subject:
Licensee Event Report 265/03-003, "Low Pressure Coolant Injection Differential Pressure Instrument Inoperable due to Misposition of Instrument Valve" Enclosed is Licensee Event Report (LER) 265103-003, Low Pressure Coolant Injection Differential Pressure Instrument Inoperable due to Misposition of Instrument Valve,' for Quad Cities Nuclear Power Station, Unit 2.
This report is submitted in accordance with the requirements of the Code of Federal Regulations, Title 10, Part 50.73(a)(2)(i)(B), which requires reporting of any operation or condition which was prohibited by the plant's Technical Specifications.
Should you have any questions concerning this report, please contact Mr. W. J. Beck at (309) 227-2800.
Respectfully, 6~__
TiothyJ Tulon Site Vice President Quad Cities Nuclear Power Station cc:
Regional Administrator - NRC Region IlIl NRC Senior Resident Inspector - Quad Cities Nuclear Power Station
Abstract
On June 20, 2003, a differential pressure instrument isolation valve was found isolated, rendering the instrument inoperable. The other three differential pressure switches that provide the one-out-of-two-twice logic to direct injection of the Low Pressure Coolant Injection system to the intact reactor recirculation pipe during a loss of coolant event were verified to be operable.
The surveillance in progress was completed, the switch was tested satisfactorily and the manifold valves were returned to the in-service position.
A work history review identified that the valve was left closed following a March 24, 2003, surveillance. A search of the work history involving the individuals that performed the March 24, 2003, surveillance did not identify any discrepancies.
The safety significance of this event was minimal.
were operable and capable of providing the required was no loss of safety function associated with this The remaining three switches logic signal.
Therefore, there event.
The root cause for this event is a breakdown in the use of human performance tools.
Corrective actions include a revision to Human Performance training and development of a human performance improvement program for the nstrument Maintenance Department.
NRC1PRM 366A U.S. NUCLEAR REGULATORY COMMISSION (7-2001)
LICENSEE EVENT REPORT (LER)
TEXTCONTINUATION FACILITY NAME (1)
DOCKET NUMBER 2)
LER NUMBER (6)
PAGE (3)
YEAR SEQUENTLI.
REVISION Quad Cities Nuclear Power Station Unit 2 05000265 NUMBER NUMBER 2003 003 00 2 of 3 If more space Is required, use additional copies of NRC Form 366AX17)
PLANT AND SYSTEM-IDENTIFICATION General Electric - Boiling Water Reactor, 2957 Megawatts Thermal Rated Core Power Energy Industry Identification System EIIS) codes are identified in the text as [XXI.
EVENT IDENTIFICATION Low Pressure Coolant Injection Differential Pressure Instrument Inoperable due to Misposition of Instrument Valve A.
CONDITION PRIOR TO EVENT
Unit: 2 Event Date: March 24, 2003 Event Time: 2013 hours0.0233 days <br />0.559 hours <br />0.00333 weeks <br />7.659465e-4 months <br /> Reactor Mode: 1 Mode Name: Power Operation Power Level: 100%
Power Operation (1) - Mode switch in the RUN position with average reactor coolant temperature at any temperature.
B.
DESCRIPTION OF EVENT
On June 20, 2003, during performance of a functional test on the Low Pressure Coolant Injection (LPCI) (BO] recirculation riser differential pressure switches 163], it was discovered that the high-side isolation valve ISV] for one of the differential pressure switches was closed, rendering the instrument inoperable.
There are four of these differential pressure switches, and they provide a one-out-of-two-twice logic for the LPCI Loop Select System.
This system directs the LPCI system to inject to the intact reactor recirculation pipe during a loss of coolant event.
The positions of the manifold valves on the other three switches were inspected, and the valves were found to be in their proper positions.
Also, it was determined that no work was performed on these switches between March 24, 2003 and June 20, 2003.
Therefore, with the other three switches operable, the function was not lost.
The surveillance in progress was completed, the switch was tested satisfactorily and the manifold valves were returned to the in-service position.
A work history review identified that the last work performed that would have affected the mispositioned valve was completed on March 24, 2003; therefore, this event is reportable as a condition prohibited by Technical Specifications, since the instrument was inoperable longer than the allowed outage time.
A review of the March 24, 2003 surveillance test found that the steps for restoration and verification of proper restoration were signed.
The two individuals who performed the surveillance on March 24, 2003, could not be interviewed, as they were no longer employed with Exelon Generation Company, LLC.
A search of the work history involving these two individuals for any safety related work where they acted alone in the field or together with no other support was conducted. This review went back one year.
No discrepancies were identified.
KRC FORM 366A 7-2001)U.S. NUCLEAR REGULATORY COMMISSION 7.1)
LICENSEE EVENT REPORT (LER)
~~~~~~~~~~~T CONTINUATION FACIUTY NAMEE l
DOCKET NUMBER 2)
LER NUMBER 6 PAGE 3 YEAR SEQUENTL REVISION Quad Cities Nuclear Power Station UnIt 2 05000265 NUMBER NLIMBER 2003 003 00 3 of 3 (If more space Is required, use additional copies of NRC Form 366AX17)
C.
CAUSE OF EVENT
The root cause for this event has been determined to be a breakdown in the use of human performance tools.
Specifically, concurrent verification practices were not adequately utilized in this case.
D.
SAFETY ANALYSIS
The safety significance of this event was minimal.
The remaining three switches were operable and capable of providing the required logic signal.
Therefore, there was no loss of safety function associated with this event.
E.
CORRECTIVE ACTIONS
Immediate Actions The instrument valves on all eight of the differential pressure switches on Unit 1 and Unit 2 were verified to be in the correct position.
All Instrument Maintenance crews were briefed on this issue as they came on shift.
Corrective Actions to be Completed Instrument Maintenance Department (IMD) Management will review and revise the IMD Human Performance Training Program and Dynamic Learning Activities to include more stringent guidelines and more stringent pass/fail criteria.
IMD Management will conduct paired field observations and provide remediation to personnel upon discovery of inadequate performance in use of the human performance tools.
IMD Management will develop a Human Performance improvement plan to include IMD first-line supervisor performance.
F.
PREVIOUS OCCURRENCES
No reportable events were identified during the last two years that involved a failure in the IMD to utilize human performance tools.
G.
COMPONENT FAILURE DATh There were no component failures associated with this event.