05000440/LER-1996-001, :on 960209,CR Emergency Recirculation Sys TS Time Limit Exceeded Due to Personnel Error.Shift Supervisor & Unit Supervisor Counseled.Licensed Operators & STAs Will Be Trained on Lessons Learned from Event

:on 960209,CR Emergency Recirculation Sys TS Time Limit Exceeded Due to Personnel Error.Shift Supervisor & Unit Supervisor Counseled.Licensed Operators & STAs Will Be Trained on Lessons Learned from Event

ML20100Q734
Person / Time
Site:	Perry
Issue date:	03/08/1996
From:	Jury K, Shelton D CENTERIOR ENERGY
To:	NRC OFFICE OF INFORMATION RESOURCES MANAGEMENT (IRM)
References
LER-96-001, LER-96-1, PY-CEI-NRR-2035, NUDOCS 9603120109
Download: ML20100Q734 (5)

LER-1996-001, on 960209,CR Emergency Recirculation Sys TS Time Limit Exceeded Due to Personnel Error.Shift Supervisor & Unit Supervisor Counseled.Licensed Operators & STAs Will Be Trained on Lessons Learned from Event

Event date:
Report date:
Reporting criterion:	10 CFR 50.73(a)(2) 10 CFR 50.73(a)(2)(x) 10 CFR 50.73(a)(2)(v), Loss of Safety Function 10 CFR 50.73(a)(2)(vii), Common Cause Inoperability 10 CFR 50.73(a)(2)(i)(B), Prohibited by Technical Specifications
4401996001R00 - NRC Website

text

l cgiCTERDOR ENERGY PERRY NUCLEAR POWER PLANT Mail Address:

Donald C. Shelton 10 CENTER ROAD SENIOR VICE PRESIDENT RR, O 10 44081 PERRY, OHIO 44081 NUCLEAR (216) 259-3737 March 8, 1996 PY-CEI/NRR-2035L United States Nuclear Regulatory Commission Document Control Desk Washington, D.C.

20555 Perry Nuclear Power Plant Docket No. 50-440 LER 96-001 Gentlemen:

Enclosed is Licensee Event Report 96-001, Control Room Emergency Recirculation System Technical Specification Time Limit Exceeded.

If you have questions or require additional information, please contact Mr. James D. Kloosterman, Manager - Regulatory Affairs at (216) 280-5833.

Very truly yours, vy for Donald C. Shelton JRV:sc

Enclosure:

LER 96-001 cc:

NRC Project Manager NRC Resident Inspector Office NRC Region III l

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digits / characters for each block)

FACILITY NAME (1)

DoGALI NUmstM (2)

FAGE (3)

Parry Nuclear Power Plant, Unit 1 05000440 1OF4 TITLE (4)

Control Room Emergency Recirculation System Technical Specification Time Limit Exceeded EVENT DATE (5)

LER NUMtstM (5)

HEPORT DATE (7)

OTHER FACILilits INVOLVED (5)

MUNIH DAY YLAR REAR SLUULNIIAL REkiNUN MUNIH DAY YEAR FAGILITY NAML DOLEt i NVMtitM NUMBER NUMBER 05000 02 09 96 96 -- 001 00 03 08 96

'^' I Y NAM L DOL Ak i NUMtitM OPERATING THIS HEPURI 15 SUBMIT iEU PUHbUANT T ) THE R EQUIMtMENTS OF 10 CFR 5: (Check one or more) (11)

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POWER 20.2203(a)(1) 20.2203(a)(3)(s) 50.73(a)(2Hn) 50.73(a)(2)(x) i LEVEL (10) 000 20.2203(a)(2)(i) 20.2203(a)(3)(n) 50.73(a)(2)(m) 73.7i 2o.2203(a)(2)(n) 20.2203(a)(4) 50.73(a)(2)(IV)

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Specify in Abstract below N

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20.2203(a)(2)(iv) 50.36(c)(2) 50.73(a)(2)(vii)

LNENSEE CONTACT FOR THIS LER (12i NAME TELEPHONil NUMBER (include A,ea Code)

Keith R. Jury, Supervisor - Compliance (216) 280-5594 l

COMPLETE ONE LINE FOR EACH COMPONENT FAILURE DE5GalBED IN THIS REPORT (13)

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UUPPLEMENTA, REPORT EXPEL.;TED (14)

EXPECTED MUNIH DA1 YEAR SUBMISSION YES x

No (if yes. complete EXPECTED SUBMISSION DATE).

AESTRACT (Limit to 1400 spaces,i.e.. approximately 15 single-spaced typewritten lines) 616)

On February 9,1996, at 1145 hours0.0133 days <br />0.318 hours <br />0.00189 weeks <br />4.356725e-4 months <br />, the Perry Nuclear Power Plant, Unit 1, was in a refueling outage with core alterations in progress. One of the two trains of the Control Room Emergency Recirculation system had been inoperable for seven days. Operations personnel failed to place the operable train in the Emergency Recirculation mode of operation as required by Technical Specification 3.7.2, Action b.1.

This event was caused by personnel error on the part of the Shift Supervisor and the Unit Supervisor. The Shift Supervisor was aware that additional action would be required at the end of seven days but failed to recognize that ths end of the seven day period had been reached. The Unit Supervisor deviated from the normal practice of reviewing the applicable documentation, and as a result, did not recognize that additional action would be required at the end of the seven day period.

The Shift Supervisor and the Unit Supervisor have been counseled on their respective roles in the event. Licensed opsrators and Shift Technical Advisors will be trained on lessons learned from the event.

This event is being reported in accordance with 10CFR50.73(a)(2)(i)(B), as operation prohibited by Technical Specifications.

I i

l NRc FORM,366A U.S. NUCLEAR REaVLAToRY CoMMISsloN 84 95)

I LICENSEE EVENT REPORT (LER)

TEXT CONTINUATION FACluTY NAME (1)

DOCKET LER NUMBER 16)

PAGE (3)

Psrry Nuclear Power Plant, Unit 1 05000440 YEAR 5tWULNHAL MtVLMU" 2

OF 4

NUMBER NUMBER 96 -- 001 00 TEXi (11 more space is required, use additional copies of NRC Form 366A) (11)

1. Introduction

l On February 9,1996, at 1145 hours0.0133 days <br />0.318 hours <br />0.00189 weeks <br />4.356725e-4 months <br />, operations personnel failed to place the operable subsystem (i.e., train) of the Control Room Emergency Recirculation system [Vl] in the Emergency Recirculation mode of operation in accordance i

with Technical Specification (TS) 3.7.2, Action 5.1. This event is being reported in accordance with 10CFR50.73(a)(2)(i)(B), as operation prohibited by Technical Specifications.

At the time of the event, the plant was in Operational Condition 5 (i.e., Refueling), with the reactor [RCT) at atmospheric pressure, and reactor coolant temperature at approximately 100 degrees Fahrenheit. Core alterations i

wers in progress.

l

11. Event Description

On February 2,1996, at 1145 hours0.0133 days <br />0.318 hours <br />0.00189 weeks <br />4.356725e-4 months <br />, Operations Team 3 removed train A of the Emergency Closed Cocling and the Control Complex Chilled Water systems from service for outage-related maintenance. Removal of these trains from ssrvice rendered train A of the Control Room Emergency Recirculation system inoperable. Train B remained operable.

With one train of the Control Room Emergency Recirculation system inoperable and the plant in Operational Condition 5, TS 3.7.2, Action b.1 requires that the inoperable train be restored to an operable status within seven days, or that the operable train be placed and maintained operating in the Emergency Recirculation mode.

Accordingly, Operations Team 3 initiated an Active Limiting Condition for Operation (ALCO) tracking sheet in accordance with Operations Administrative Instruction (OAI)-1701, " Tracking of LCOs." These tracking sheets j

contcin a section for recording an " impact time," which is defined as the time and date when the respective LCO j

Action becomes required. An impact time of 1145 hours0.0133 days <br />0.318 hours <br />0.00189 weeks <br />4.356725e-4 months <br /> on February 9,1996, was appropriately entered on the ALCO tracking sheet. The Action Requirement section of the tracking sheet indicated that train A of the Control Room Emergency Recirculation system had to be returned to service within seven days, otherwise train B had to be placed in the Emargency Recirculation rnode.

During shift turnover later the same day, this ALCO was reviewed by the oncoming Operations Team 1 Shift Supsrvisor and Unit Supervisor in accordance with OAl-1701, and Plant Administrative Procedure (PAP)-0126, " Shift Rslist and Turnover." The Shift Supervisor immediately recognized that, unless train A of the Control Room Emsrgency Recirculation system was returned to an operable status in seven days, train B would have to be placed in the Emergency Recirculation mode. The Unit Supervisor recognized that train A of the Control Room Emergency I

Rscirculation system was inoperable, but did not review the Action Requirement section as was his normal practice, and as a result, did not recognize that additional action would be required in seven days.

During the period that this ALCO was in effect, Operations Team 1 rotated to the day shift. On February 9,1996, whsn Operations Team 1 reviewed the ALCOs during shift turnover, the Operations Team 1 Shift Supervisor did not rscognize that the impect time for TS 3.7.2 Action b.1 would occur during the current shift, and the Operations Tcem 1 Unit Supervisor still did not recognize that any further action was required for the Control Room Emergency Rscirculation system. At approximately 1600 hours0.0185 days <br />0.444 hours <br />0.00265 weeks <br />6.088e-4 months <br /> while reviewing the ALCO file for other reasons, the Shift Supsrvisor noted the ALCO pertaining to the Control Room Emergency Recirculation system, and realized that train B should have been placed in the Emergency Recirculation mode no later than 1145 hours0.0133 days <br />0.318 hours <br />0.00189 weeks <br />4.356725e-4 months <br />. The Shift Supervisor directed that Control Room Emergency Recirculation train B be placed in the Emergency Recirculation mode of opsration, which was completed at 1638 hours0.019 days <br />0.455 hours <br />0.00271 weeks <br />6.23259e-4 months <br />.

i NRC FORM,366A u.s. NUCLEAR REGULATORY Commission 14 951 l

UCENSEE EVENT REPORT (LER)

TEXT CONTINUATION FACILITY NAME (1)

DOCKET LER NUMBER (6)

PAGE (3)

Perry Nuclear Power Plant, Unit 1 05000440 YEAR lR 3

OF 4

96 - 001 00 j

TEXT Uf more space is required, use additional copies of NRC Form 366A) (17>

Ill. Cause This event was caused by personnel error on the part of the Shift Supervisor and the Unit Supervisor. The Shift Supervisor was aware that wHonal action would be required at the end of seven days but failed to recognize that ths end of the seven day cod ud been reached. The Unit Supervisor did not review the Action Requirement s:ction of the ALCO, and a o asult, did not recognize that additional action would be required at the end of the savan day period.

Th:re were secondary barriers that could have identified the needed action but did not. Although OAl-1701 assigns responsibility for LCO tracking and compliance to the Shift Supervisor and the Unit Supervisor, the Supervising Optrator and Shift Technical Advisor (STA) are also procedurally required to review the ALCOs during shift turnover.

Th3 Shift Technical Advisor turnover checklist includes specific provisions for tracking ALCOs and their impact time.

However, the initial STA checklist entry for this ALCO was incorrect, in that the LCO entry time was listed rather than the impact time. Although the Supervising Operator's primary responsibility is to assure that Control Room retivities do not compromise the operability of redundant equipment, his review of the ALCO did not identify the impact time.

One additional discrepancy was identified that could have contributed to the Unit Supervisor's failure to recognize ths need for additional action. The " Equipment Out of Service" section of the Unit Supervisor Turnover Checklist did not specifically identify train A of the Control Room Emergency Recirculation system as being out of service. Only ths Emergency Closed Cooling and the Control Complex Chilled Water trains needed to support operation of train A of the Control Room Emergency Recirculation system were identified on the checklist. If the Equipment Out of Szrvice section had included train A of the Control Room Emergency Recirculation system as being out of service,it mLy have caused the Unit Supervisor to conduct further investigations during the seven days that elapsed prior to exceeding the impact time.

IV. Safety Analysis

The function of the Control Room Heating, Ventilation, and Air Conditioning system is to provide cooling, heating, vantilation, and when required, smoke removal for the control room equipment areas and office in the Emergency Racirculation mode, the Control Room Emergency Recirculation system provides protection for Control Room psrsonnel against toxic gas, and against airborne radiation hazards in accordance with the requirements of 10 CFR 50 Appendix A, Criterion 19. Operation in the Emergency Recirculation mode is initiated automatically upon receipt of en emergency signal, such as a loss of coolant accident, loss of offsite power, or high airborne radiation levels, or can be initiated manually. Although an automatic initiation will actuate both the A and B trains, only one train is r: quired for adequate protection.

Th3 events described in this LER, resulted in a period of less than five hours during which train B should have been optrating in the Emergency Recirculation mode but was not. During this time, train B remained fully operable and was capable of automatically fulfilling it's design function of maintaining the control room habitable if a fuel handling recident had occurred. Even if operation in the Emergency Recirculation mode failed to initiate automatically, opsrators would have been procedurally alerted tc. the failure a4 could have initiated Emergency Recirculation manually. Therefore, this event had minimal safety significance.

NRc FORM,366A U.S. NUCLEAR REGULATORY Commission 14 951 UCENSEE EVENT REPORT (LER)

TEXT CONTINUATION FACILITY NAME (1)

DOCKET LER NUMBER (6)

PAGE (3)

P rry Nuclear Power Plant, Unit 1 05000440 m

g GAL Hg 4

op 4

96 -- 001 00 TEXT (11more space os required, use additional copies of NRC Form 366A) (11) l V.

Similar Events

Similar events were identified in two other LERs.

l LER 92-021-00 documents an event in which an Average Power Range Monitor [ MON] calibration was not performed within 12 hours1.388889e-4 days <br />0.00333 hours <br />1.984127e-5 weeks <br />4.566e-6 months <br /> after exceeding 25% power, in accordance with Technical Specifications. The event was caused by th3 temporary misplacement of a Potential LCO tracking sheet combined with poor communication, inattention to i

dsttil, and failure to follow procedure. The current event did not result from a lost tracking sheet, but did involve inattention to detail. The corrective action for the current event includes emphasizing the need for thorough reviews.

LER 94-013-00 documents an event in which a containment isolation valve [ISV), which had been closed and diznergized in preparation for core alterations, was subsequently re-energized for testing but was not re-deenergized ts rsquired prior to actually starting core alterations. The event was caused by a weakness in the program for tracking LCOs. This differs from the current event which resulted from personnel error rather than from a l

programmatic weakness. The differences between this event and the current event are such that the previous corrective actions could not reasonably have been expected to prevent the current event.

VI. Corrective Actions

1. The Shift Supervisor has been counseled on the need to thoroughly fulfill his assigned responsibilities without rsli:nce on the Unit Supervisor, even though the Unit Supervisor may have identical responsibilities.

2. The Unit Supervisor has been counseled on the need to thoroughly review and research issues prior to deciding whsther additional actions are required, particularly if incomplete or distracting information has been provided.

3. Training on this event will be provided to licensed operators and STAS. The training will emphasize the need to thoroughly review and understand ALCOs and any associated impact times, and the actions needed to assure compliance with Technical Specifications. It will also stress the need to maintain independence when conducting revisws. This training will be incorporated into the next licensed operator requalification training cycle, and will be completed no later than May 31,1996.

4 Enstgy Industry identification System (Ells) codes are identified in the text as [XX].

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