IR 05000275/1987006
| ML20211M205 | |
| Person / Time | |
|---|---|
| Site: | Diablo Canyon  |
| Issue date: | 02/06/1987 |
| From: | Fish R, Good G NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION V) |
| To: | |
| Shared Package | |
| ML20211M160 | List: |
| References | |
| 50-275-87-06, 50-275-87-6, NUDOCS 8702270231 | |
| Download: ML20211M205 (8) | |
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U. S. NUCLEAR REGULATORY COMMISSION.
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REGION V
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' Report No.~50-27'5/87'-06
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' Docket No' 50-275
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Lic6nse No. DPR-80
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Lice ~nsee: ~ Pacific Gas 'and Electric Company
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-77 Beale Street, Room 1451
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San Francisco, California 94106
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Facility Name:
Diablo Canyon Nuclear Power Plant, Unit 1
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Inspection at:
Diablo Canyon Nuclear Power Plant, San Luis Obispo County, Californiat
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Inspection Conducted:' ' January,:12-13, 1987 f
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, Inspector:
S'. T ; h b 2/bl @
Date Signec G.L4. Gdad ' -.i
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Emergency, Preparedness" Analyst
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J/d I7 Approved by':
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s R. F4 Fish, Clief,.
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Date Signed
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Emergency. Preparedness,Section
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Summary:
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Inspection on January 12-13, 1987 (Report No:- 50-275/87-06)
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Areas Inspected': Announced,'special inspection of the licensee's-implementation of the Emergency Plan during the January 2, 1987-Unusual Event.
f Inspection Procedure 92700 was used during thi,s inspection.
Results: One violation of NRC requireme'nts was identified.
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} DETAILS.
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1; Persons Contacted
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B. Briley,' Shift Foreman,. Unit 1
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G. Goelzer,1 Shift Foremafe, UTiit 2.
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,,'c W.' Keyworth, Senior Power Production Engineer / Supervisor,1 Emergency
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Planning ~ f-
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S." Smith,' Control ' Room Apsistant.
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Ba'cknround
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On January'2,1987, Diablo Canyon experienced an oil fire in theIUnit 1
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,high^ pressure turbine insulation.' The fire was the result of oil soaked o
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'ifdulation coming'into contact with hot steam piping.
The fire occurred.
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9 :at aboGC1715 PST.
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~1,.AnUnusualEventwasdeclaiedat1742PSTbytheUnit]ShiftForeman
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An Auxiliary Operator (A0) was
.transpoited, vi'a offsite' ambulance, to a hospital due to heat exhaustion.
No discharge of radioactive materials to the environment occurred.
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unit was shutdown:at 1818 PST and the fire was reported out at 1850 PST.
~Thel Unusual,Eventwasterminatedat1916PST.
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50n:Jahuary 5,1987, a'licenssa meeting was held at the' site to discuss the ' ire... The NRC-Resident Inspector was present at this meeting.
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During the. meeting,'the NRC was informed that notification of the County Sheriff's Office was.not accomplished until about 90 minutes after the
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declaration of the UnusuaLEvent.
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Scope of Inspection
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Theinspectionconsistedofdlscussionswiththelicensee'sstaffwho'
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'were on shift at the~t'ime of the fire,. discussions with the licensee's Emergency Planning Supervisor and a' review of the following procedures
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.and' documents:.
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' Section 4 of the Emergency Plan (EP)
" Emergency Conditions"
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Section 5 of.the EP," Organizational. Control of Emergencies"
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Section 6 of the EP -c" Emergency Measures" J*
Emergency Plan Implementing Procedure (EPIP) G-1, " Accident f
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Classification and Emergency Plan Activation"
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EPIP G-3, " Notification of Offsite Organizations" Notification forms completed during the. Unusual Event
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' Selected' training summaries (3)
Technical Review Group (TRG) Data Sheet Non-Conformance Report (NCR)
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DC/-87-0P-N 003 (Notification)
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LNCR DC1-87-0P-N001 (Oil Fire)
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Correspondence - Pacific Gas and Electric (PG&E) Company to County of San Luis Obispo (SLO), dated January 5, 1987
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' Correspondence-SLO to$PG&E, dated January'8,.1987'
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SLO Sheriff's Office; Report,-dated! January 2,11987, Subject:
" Lack-of Notification of Unusual Event'at Diablo Canyon Power Plant Unit
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. Technical Specifications s;
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Notifications!,;.
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According tol e-Unittl Shift Foreman, following the declaration of_the th Unusual Event'andTthe' request.for assistance from CDF, he delegated his-notification.responsibilitiestojtheUnit2.ShiftForeman.
This was done to allow the Unit l' Shift. Foreman to focus-his full attention on bringing-the plant downLin' power.
The Unit-2 Shift Foreman stated that he then completed the Event
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Notification Form'(event. description which is verbally l transmitted to outside agencies),'had it reviewed by the Unit 1 Shift' Foreman and turned the notification package,over_ to, the Control Room Assistant (CRA) to make'
the " Unusual Event notifications", stating that he would make the notifications to the'NRC. The notification package (attachment to procedure EP G-3) consists of three forms, the Event Notification Form,.
Form 69-10365 and Form 69-10298.
Form 69-10365, "Significant-Event / Unusual Event Notifications", includes such notifications as the NRC' Operations Center, the Plant' Manager,'the Plant Superintendent, the Operations Manager and the NRC resident inspectors. ~ Form 69-10298 includes notifications to the SLO County Sheriff's Operations Center, the Corporate Emergency Response Organization, the San Francisco Energy Dispatch Control Center, the California Office of Emergency Services and the NRC Operations; Center (redundant, only one call is made).
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. copies of these forms are stapled together and kept in the Shift Foreman's desk for ready access during emergencies. The Unit 1 Shift Foreman stated that'it is not unusual to separate the forms so that notifications can be accomplished by more than one individual.
A review of the notification forms which were used during the Unusual Event showed that notification calls were made at'the following times:
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Form 69-10365 1806 (24 minutes after the NRC Operations Center event was declared)
1812 NRC Resident Inspector 1816 Plant Manager 1818 J. Gisclon 1821 L. Womack 1825 W. Raymond-1835 Keyworth 7g
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1840 J. Kilpatrick
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1917._(95 minutes after the San ~Luis<0bispo County
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Sheriff's Operations Center 194N
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San Francisco Energy
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Dispatch-Control Center 2009 California Office of
, Emergency Services According to $he SLO Sheriff's Office Report, their official notification
occurred when the Sheriff's Office initiated a call to the Diablo Canyon
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Control Room at 1916 hours0.0222 days <br />0.532 hours <br />0.00317 weeks <br />7.29038e-4 months <br /> "to find out if there had been some problem with the Sheriffs' Department being notified of a potential problem".
During this call, the Sheriff's Office spoke with the Unit 2 Shift Foreman.
The report further states that the CDF had notified the
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Sheriff's Department at 1745 hours0.0202 days <br />0.485 hours <br />0.00289 weeks <br />6.639725e-4 months <br /> that they were'" responding to Diablo
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Canyon to= assist PG&E with a fi u in Unit #1".
The report also states that at 1838 hours0.0213 days <br />0.511 hours <br />0.00304 weeks <br />6.99359e-4 months <br />, the. Shift Security Supervisor at Diablo Canyon
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Later, the Sheriff's Office was contacted by the SLO Police. Department and the news media, both of whom were trying to obtain details about the fire.
Technical Specification 6.8.1 requires that procedures for the emergency plan implementation be established, implemented and maintained.
EPIP G-3 requires that notification of San Luis Obispo County be made within 15 minutes for an Unusual Event.
Since it took 95 minutes to notify the SLO County Sheriff, it appears that this technical specification and the procedure were violated.
(87-06-01)
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Supplementatal Information During an interview with the CRA who was on shift at the time of the event, the CRA stated that the Unit 2 Shift Foreman gave her the Event
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Notification Form and Form 69-10365 (NRC and various plant personnel) and told her to make these notifications, with the exception of the NRC
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(Operations Center and Residents) which he would complete himself.
According to the CRA, she was not given the form to make the offsite notifications (Form 69-10298) until later.
She did not know the exact time; however, she stated that it was about the time the event was terminated (1916 hours0.0222 days <br />0.532 hours <br />0.00317 weeks <br />7.29038e-4 months <br />).
This is not consistent with information obtained from the Unit 2 Shift Foreman.
Both the Unit 2 Shift Foreman and the CRA stated that the level of incoming calls to the Control Room inhibited the completion of the notifications.
They explained that every day at approximately 1800 hours0.0208 days <br />0.5 hours <br />0.00298 weeks <br />6.849e-4 months <br />, the plant switchboard is transferred to the Control Room.
Normally there are not many calls to the plant after this time; however, on this evening the incoming calls were nearly continuous.
The increase in the level of incoming calls was attributed to the media's monitoring
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of the offsite radio transmissions.
The media became aware of the fire
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via the CDF radio-transmission.
Information about the fire was
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subsequently made available to the public.
The resultant telephone calls were from the media, concerned employees and concerned relatives.
Both
'the Unit 2 Shift Foreman and the CRA stated that they were involved in
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answering these incoming calls, in addition to the other actions with which they were involved.
For example, the Unit 2 Shift Foreman stated that he was very busy arranging site access for the fire engines and the ambulance.
He further stated that he. remembered -asking the CRA if she had completed the~ notifications (the response was yes).
The CRA stated that she was trying to read the notification procedure (EPIP G-3) and make the notifications on Form 69-10365 in between the incoming calls.
.Also, the CRA stated that she was delayed in completing the calls on Form 69-10365 due to the number of questions being asked by those she was notifying (plant management).
The CRA stated that on occasion, she had to put the telephone down and chase down an answer to a question.
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The subject'of thh Control Room acting as the main switchboard for the station.during off hours was discussed and evaluated during the Emergency
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Response Facilities (ERF). Appraisal., This appraisal was conducted on
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June 3-7, 1985 and documented in Inspection Report Number 50-275/85-24.
Section 1.3 of the ERF Appraisal Report suggested that as an improvement to the emergency preparedness program, the Control Room be removed from the ficw of routine phone calls during off-' hours.
' Licensee personnel stated that'the priority of notifications over incoming calls.was being addressed in training; however, this guidance has not been included in the EPIP (G-3). On Feburary 3, 1987 the NRC Resident Inspector was informed that the pertinent training lesson plans did not specifically contain this information. Therefore, the licensee could not verify that the Control Room staff had ever been informed that
.the notifications were to take priority over any incoming calls.
To further investigate the Control Room Staff's knowledge on the subject of notification, the inspector examined the training records (computer status summaries) for these.three individuals and asked specific questions regarding regulations which are pertinent to this subject.
The records disclosed that all three of the individuals were current in their EP training, including training on notifications during emergencies.
Although the CRA was current in her training and had participated in a few communication drills (only Form 69-10298 is used for these drills)
she stated that she was not totally " comfortable" with her knowledge of the notification process.
She stated that she had never had to complete the calls on both forms.
Regarding the regulations, none of the three Control Room staff who were-interviewed were aware that 10 CFR 50.72(a)(3) required that notifications to the NRC be made "immediately after notification of the
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appropriate State or local agencies (emphasis added) and not later than one hour...."
The two Shift Foremen were aware that the NRC needed to be notified within one hour.
The CRA knew that there was a time requirement to notify the NRC; however, she did not know the time requirement.
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Both of the S'hift Foremen knew that there was a 15 minute requirement for:
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notifying the County Sheriff's Office.~ The CRA stated on January 13, 1986 (11 days after the event) that she-was not aware of this requirement.
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During theJinspection the inspector was led to believe that the title of Form,69-10365 may havetbeen misleading to a member or members of the Control Room staff..No specific names were mentioned; however, the Unit.
2. Shift Foreman mentioned this as a potential problem and the licensee's summary report to 'the SLO County Administrator also alluded to this matter.
The summary report states in part that." Notifications were-initially conducted to organizations as appropriate for a Significant Event, rather than an Unusual Event and resulted in a delay...." ~As previously mentioned, Form 69-10365 is entitled "Significant Event / Unusual Event Notification". The inspector verified that there was never any confusion in the Control Room regarding an Unusual Event versus a Significant Event declaration.
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Corrective Actions During thislinspectica, the inspector discussed with the Supervisor, Emergency Planning what actions had been taken, subsequent to this event, to prevent'a recurrence of the notification problem.
This individual stated that as an interim solution, an incident report would be reviewed
.by all Control Room shift personnel.
An incident. report is a post incident / reactor trip informational document which is prepared by'the Operations Manager.
Incident reports describe what occurred and address any ". lessons learned".
Incident reports are used to brief each shift.
These briefings routinely occur on Fridays.
Subsequent to the inspection, the NRC Resident Inspector obtained a copy of the incident report which was' prepared for this Unusual Event.
It was dated January 15, 1987, 13 days after the event.
As a permanent solution, the licensee is considering the following actions:
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Improve the. forms used to make the notifications.
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Re"-emphasize the need'to make the notifications before answering incoming calls.
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Utilize / assign additional personnel to make notifications and answer calls as necessary.
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Exit Interview An exit interview was conducted on January 13, 1987 te discuss the preliminary findings of this inspection.
The attachment to this report identifies the licensee personnel who were present at the meeting.
Mr.
Paul Narbut, NRC Senior Resident InsSector, was also present.
During the meeting, the licensee was informed tlat it appeared that there had been a violation of the notification requirements contained within 10 CFR Part 50, since they had'not correctly implemented the procedures that they had developed to meet these regulations.
Parts 50.47(b)(5), IV.D.3 of Appendix E and 50.72(a)(3) were specifically mentioned.
The contributing factors contained in Section 5 of this report were discussed.
These
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discussions disclosed that the licensee's investigation'of this matter
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had not revealed the apparent discrepancy regarding what forms had
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actually been provided to the CRA'(see Section 5).
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- During the exit interview, the licensee requested that Regional
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Management-discussions related to the issuance of-a notice of violation, include the criteria of Section V.A of Appendix C to 10 CFR Part 2.
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should not be issued a notice of violation.
The review:of the inspection findings by Regional management included
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consideration of the above licensee request.
Information obtained
during the. inspection appears to support a finding that the Sheriff's
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Department discovered the failure to provide SLO County with appropriate Lnotification of the Unusual Event.
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ATTACHMENT EXIT INTERVIEW ATTENDEES
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W.'Fugimoto, Supervising Nuclear Engineer
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-J. Gisclon, Assistant Plant Manager-T. Grebel, Supervisor, Regulatory' Compliance
-W. Keyworth, Supervisor, Emergency Planning
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'J..-Sexton,-Assistant Plant Manager / Plant Superintendent D.'Sisk, Regulatory Compliance Engineer
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R. Thornberry; Plant Manager
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- L. Womack, Manager, Operations
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