05000298/FIN-2009005-01
From kanterella
Jump to navigation
Jump to search
Finding | |
|---|---|
| Title | Failure to Follow Surveillance Procedure Causes Near Toxic Gas Release |
| Description | A self-revealing noncited violation of Technical Specification 5.4.1.d, Fire Protection Program Implementation was identified for the licensees failure to follow the requirements of Surveillance Procedure 6.FP.306, Fire Detection Systems Semi-Annual Examination. Specifically, licensee technicians actuated the wrong thermal detector during surveillance testing, causing the CO2 fixed flooding system timer to actuate. Technicians recognized the error when the local and remote alarms actuated, and removed the heat source from the detector prior to release of the CO2 gas. The licensee entered this issue in their corrective action program as CR-CNS-2009-07008. The performance deficiency associated with this finding involved the licensees failure to follow the requirements of Surveillance Procedure 6.FP.306, Fire Detection Systems Semi-Annual Examination. Specifically, licensee technicians actuated the wrong thermal detector during surveillance testing, causing the CO2 fixed flooding system timer to actuate. The finding affects the initiating events cornerstone and is more than minor because it could be reasonably viewed as a precursor to a significant event, namely a toxic CO2 release in the Diesel Generator 1 room. Using the Manual Chapter 0609, Appendix F, Phase 1 screening worksheet, the inspectors determined that the finding has very low safety significance because it was associated with a low degradation rating. The finding has a crosscutting aspect in the area of human performance associated with work practices because maintenance technicians failed to use appropriate self or peer checking techniques, and proceeded in the face of uncertainty when unlabeled components were encountered H.4(a) |
| Site: | Cooper  |
|---|---|
| Report | IR 05000298/2009005 Section 1R05 |
| Date counted | Dec 31, 2009 (2009Q4) |
| Type: | NCV: Green |
| cornerstone | Initiating Events |
| Identified by: | Self-revealing |
| Inspection Procedure: | IP 71111.05 |
| Inspectors (proximate) | N Taylor P Elkmann D Stearns V Gaddy M Chambers E Uribe M Bloodgood D Reinert N Okonkwo M Vasquez |
| CCA | H.12, Avoid Complacency |
| INPO aspect | QA.4 |
| ' | |
Finding - Cooper - IR 05000298/2009005 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Finding List (Cooper) @ 2009Q4
Self-Identified List (Cooper)
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||