05000346/FIN-2013004-01
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Finding | |
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Title | Inadequate Operations Crew Turnover |
Description | The inspectors identified a finding of very low safety significance for the licensees failure to perform an accurate and detailed shift turnover to ensure oncoming plant operators were aware of plant status. Specifically, cracks identified in two control power fuses associated with High Pressure Injection (HPI) Pump No. 2 were not communicated in the unit log or during shift turnover to the oncoming operations crew. As a result, the oncoming operating crew was unaware of the status of the cracked close control power fuses until after being questioned by the inspectors on the status of the fuses several hours into their shift. The HPI pump was subsequently declared inoperable to facilitate replacement of the control power fuses. No corresponding violation of NRC requirements was identified. The finding was determined to be of more than minor significance because it was associated with the Mitigating Systems Cornerstone and directly impacted the cornerstone objective to ensure the availability, reliability, and capability of systems that respond to initiating events to prevent undesirable consequences. Specifically, as a result of the inadequate shift crew turnover, HPI Pump No. 2 was rendered inoperable for an additional period of time to facilitate replacement of control power fuses. The inspectors evaluated the finding using IMC 0609, Appendix A, The Significance Determination Process for Findings At-Power. Using Exhibit 2, which contains the screening questions for the Mitigating Systems Cornerstone of Reactor Safety, the inspectors determined that the finding screened as very low safety significance (Green) because: it was not a deficiency affecting the design or qualification of HPI Pump No. 2; it did not represent a loss of system or function; it did not represent the loss of function for any technical specification (TS) system, train, or component beyond the allowed TS outage time; and it did not represent an actual loss of function of any non-TS trains of equipment designated as high safety-significant in accordance with the licensees maintenance rule program. This finding has a cross-cutting aspect in the area of human performance, decision making component, because the licensee failed to communicate decisions and the basis for decisions to personnel who have a need to know the information in order to perform work safely, in a timely manner. Specifically, the night shift crew made an operability decision on the impacts of the cracked close control power fuses on HPI Train 2 without documenting or informing the oncoming crew the basis of that decision. |
Site: | Davis Besse |
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Report | IR 05000346/2013004 Section 1R11 |
Date counted | Sep 30, 2013 (2013Q3) |
Type: | Finding: Green |
cornerstone | Mitigating Systems |
Identified by: | NRC identified |
Inspection Procedure: | IP 71111.11 |
Inspectors (proximate) | A Dunlop J Neurauter P Pelke D Kimble T Briley J Steffes |
CCA | H.10, Bases for Decisions |
INPO aspect | CO.2 |
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Finding - Davis Besse - IR 05000346/2013004 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Finding List (Davis Besse) @ 2013Q3
Self-Identified List (Davis Besse)
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