05000298/FIN-2011008-03
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Finding | |
|---|---|
| Title | Failure to Implement Human Performance Procedure |
| Description | The inspectors identified a finding for a failure to implement human performance procedures. Specifically, the licensee failed to implement procedures that provided guidance on conducting pre-job briefs, preparing work in the field, and informing technicians on what to do when the workers encountered a problem. This contributed to three instrumentation and control technicians receiving an unexpected radiation dose. A site stand-down was held to discuss the lessons learned from the event. This was entered into the licensees corrective action program as Condition Report CR-CNS-2011-4258. The finding was more than minor because it is associated with the human performance attribute of the Occupational Radiation Safety Cornerstone and affected the cornerstone objective to ensure the adequate protection of the worker health and safety from exposure to radiation from radioactive material during routine civilian nuclear reactor operation. The inspectors evaluated this finding using Inspection Manual Chapter 0609, Appendix C, Occupational Radiation Safety Significance Determination Process. The inspectors determined that the finding is of very low safety significance (Green) because it was not associated with ALARA planning or work controls, there was no overexposure, there was no substantial potential for an overexposure, and the licensees ability to assess dose was not compromised. The inspectors determined that the apparent cause of this finding was the licensees failure to promote the use of human performance tools to ensure job tasks were properly completed. Therefore, this finding has a cross-cutting aspect in the work practices component of the human performance area because the licensee did not adequately communicate human error prevention techniques such that work activities are completed safely. |
| Site: | Cooper  |
|---|---|
| Report | IR 05000298/2011008 Section 4OA5 |
| Date counted | Jun 30, 2011 (2011Q2) |
| Type: | Finding: Green |
| cornerstone | Or Safety |
| Identified by: | NRC identified |
| Inspection Procedure: | IP 93812 |
| Inspectors (proximate) | B Tharakan D Overland V Gaddy |
| CCA | H.12, Avoid Complacency |
| INPO aspect | QA.4 |
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Finding - Cooper - IR 05000298/2011008 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Finding List (Cooper) @ 2011Q2
Self-Identified List (Cooper)
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