05000397/FIN-2011008-01
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Finding | |
|---|---|
| Title | Failure to Follow Clearance Order Instructions |
| Description | The team documented a Green self-revealing violation of Technical Specification 5.4.1(a), Procedures, because operators failed to meet the conditions of a plant clearance order before opening main steam line drain valves. Consequently, operators inadvertently drained approximately 4300 gallons of reactor coolant to the under-vessel sump. Contributors to the violation included: 1) the reactor vessel assembly procedure was inadequate, in that it permitted maintenance personnel to place the reactor vessel level instruments in an uncalibrated condition; and 2) plant operators failed to follow operational performance standards when they were advised of the condition and proceeded to lower reactor vessel level for approximately 40 hours4.62963e-4 days <br />0.0111 hours <br />6.613757e-5 weeks <br />1.522e-5 months <br /> with inaccurate reactor vessel level instruments. The licensee entered the violation into the corrective action program as Action Request 245507. The finding was more than minor because it affected the human performance attribute of the Mitigating Systems Cornerstone and affected the cornerstone objective to ensure the availability, reliability, and capability of reactor vessel level instruments that are used to respond to initiating events to prevent undesirable consequences (i.e., core damage). The inspectors used NRC Inspection Manual 0609, Appendix G, Shutdown Operations Significance Determination Process, to evaluate the significance of the finding. The finding did not require a quantitative assessment because adequate mitigating equipment remained available and the finding did not constitute a loss of control, as defined in Appendix G. Therefore, the finding screened as Green. The finding had a crosscutting aspect in the area of human performance associated with Work Practices because plant personnel, once faced with unexpected circumstances, continued to proceed in the face of uncertainty. |
| Site: | Columbia  |
|---|---|
| Report | IR 05000397/2011008 Section 4OA3 |
| Date counted | Dec 31, 2011 (2011Q4) |
| Type: | NCV: Green |
| cornerstone | Mitigating Systems |
| Identified by: | Self-revealing |
| Inspection Procedure: | IP 71153 |
| Inspectors (proximate) | G Replogle W Walker G Apger J Groom M Hayes C Henderson |
| CCA | H.12, Avoid Complacency |
| INPO aspect | QA.4 |
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Finding - Columbia - IR 05000397/2011008 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Finding List (Columbia) @ 2011Q4
Self-Identified List (Columbia)
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