ML020390499
ML020390499 | |
Person / Time | |
---|---|
Site: | Palo Verde ![]() |
Issue date: | 01/23/2002 |
From: | Bauer S Arizona Public Service Co |
To: | Document Control Desk, Office of Nuclear Reactor Regulation |
References | |
102-04648-SAB/TNW/RJR | |
Download: ML020390499 (109) | |
Text
REPLACEMENTS FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR Section XI As Required by the Provisions of the ASME Code et. al. Date 08/23/01
- 1. Owner A-izona Public Service Company. Name Sheet 1 of 2 P.O. Box 53999, Phoenix. Arizona 85072-2034 Address Station Unit 3
- 2. Plant Palo Verde Nuclear Generating Name 85354-7529. 2413887 5801 S. WhiterbrgR.TooaiAizn Address Work Order Number Type Code Symbol Stamp None
- 3. Work Performed by Westinghouse Authorization No. N/A Expiration Date N/A 911 W. Main St., Chattanooga, TN 37402 Address
- 4. Identification of System Reactor Coolant 19_71 Edition, W '73 Addenda, N/A Code Case 1
- 5. (a) Applicable Construction Code ASME M1[Class Replacements 19 92 Edition, 1992 Addenda (b) Applicable Edition of Section Xl Utilized for Repairs or and Replacement Components
- 6. identification of Components Repaired or Replaced Year Repaired ASME Code Manufacturer National Other Name of Name of Item Manufacturer Serial No. Board No. Identification Built Re lacement Yes or No 22860 3MRCEEO1A 1981 Repaired Yes Steam Generator CE 65273-1 N/A
- 2001 Replacement No Tube Plugs Westinghouse 2406659. See attached list.
- 7. Description of Work Plug SG 3-1 Hot leg tubes per DFWO Nominal Operating Pressure DJ Exempt RI N-416-1 j*
- 8. Test Conducted: Hydrostatic [ Pneumatic Q psi Test Temp, OF Other Q1 Pressure x 11 in.,
or drawings may be used, provided (1) size is B 1/2 NOTE: Supplemental sheets in form of lists, sketches, (3) each sheet is numbered and included on each sheet, and (2) information in items 1 through 6 on this report is form.
the number of sheets is recorded at the top of this 7*DP-gZZ i?
73DP-9ZZ17 PV-E0092 Vet. 6
FORM NIS-2 (Back)
PLUGGED (PLUGGING LIST ATTACHED).
- 9. Remarks SEE DFWO 2406659 FOR TUBES CERTIFICATE OF COMPLIANCE repair conforms to the rules in the report are correct and this We certify that the statements made repair or replacemen of the ASME Code, Section XL.
Type Code Symbol StampN/A .Expiration Date -i Certificate of Authorization No. N/A Si Date Signed......I.4.4.4 Signed owner or Owner's Designee, Title CERTIFICATE OF INSERVICE INSPECTION Board of Boiler and Pressure Vessel commission issued by the National I, the undersigned, holding a valid HSBI & I CO.
and the State or Province of Arizona and employed by Report during Inspectors the period -*--'. to,examinations described in this Owner's have .- ., andthe inspected components taken and state corrective that measuresto the described best of my this Owner'sand inknowledge belief,Hartford.
of Connecticut the Owner has performed Section Xl.
in accordance with the requirements of the ASME Code, warranty, expressed or implied, Report the Inspector nor his employer makes any neither By signing this certificate, Owners Report. Furthermore, and corrective measures described in this conceling the examinations injury or property Inspector nor his employer shall be liable in any manner for any personal neither the from or connected with this inspection.
damage or a loss of any kind arising
're- " kr- Az2,S
-National Board, State, Province, and Endorsements S,
lr4~crs &cCommissions Signature
(.c_ 5E-,o :24 .2D k_
Date 73DP-SZZ17 PV-E0092 Ver. 6 BACK
STEAM GENERATOR 3MRCEE01A "HOT LEG" WORK ORDER 2413887 ASME SECTION XI-REPAIR/REPLACEMENT MR No.
PART NO. SERIAL NO. HEAT NO.
COMP. ID 3MRCEE0IA J-9161-2 521386 0307-1601 7857 R79/C14 3MRCEEOIA J-9161-2 521386 0307-1601 7856 R45/C30 3MRCEE01A J-9161-2 521386 R66/C39 0307-1601 7877 3MRCEEOI1A J-91 61-2 521386 R1 081C39 0307-1601 .7852 3MRCEE01 A J-9161-2 521386 R127/C44 0307-1601 7851 3MRCEE01 A 7881 J-9161-2 521386 3MRCEE01A R133/C48 0307-1601 0307-1601 7882 J-9161-2 521386 R147/C82 3MRCEEOI1A 7858 J-9161-2 521386 R145fC68 0307-1601 3MRCEEOI1A 3MRCEE1 A 0307-1601 7883 J-9161-2 521386 R133/C82 78584 J-9161-2 521386 R135/C82 0307-1601 R12/C83 A 3MRCEE01 0307-1601 7881 J-9161-2 51 521386 7879 J-9161-2 521386 518 R145/C90 0307-t1601 0307-1601 7885 J-9161-2 R133/C82 R14/C86 A 3MRCEE01A 0307-1601 7863 J-9161-2 521386 518 3MRCEE01 J-9161-2 518 R145tC92 0307-1601 7879 R44/C87 A 3MRCEE01 3MRCEE01A 0307-1601 7886 J-9161-2 521386 0307-1601 7880 J-9161-2 521386 R143/C92 3MRCEEOItA R453C88 0307-1601 7862 J-9161-2 521386
-3MRCEE01A 7882 J-9161,2 521386 R141_/C93 R14/C89 A 0307-1601 0307-1601 788 J-9161-2 621386
-3MRCEE01 7A 3MRCEE0 3MRCEE01A 7858 J-9161-2 J-9161-2 521386 521386
- R1450C90 3,5 *-Ct'8o 0307-1601 0307-1601 7852 3MRCEE01A 3MRCEEO1A R47/C92 0307-1601 7872 J-9161-2 521386 3MRCEE08A Page 1 of 3
STEAM GENERATOR 3MRCEE01A "HOT LEG" WORK ORDER 2413887 3MRCEE01 A 521386 0307-1601 7869 J-9161-2 R44/C95 3MRCEEOIA 7877 J-9161-2 521386 R45/C96 0307-1601 3MRCEEOIA 7254 J-9161-1 521386 R1591C96 0307-1601 3MRCEE01A 521386 0307-1601 7875 J-9161-2 R44/C97 3MRCEEO1A 521386 0307-1601 7890 J-9161-2 R144/C97 3MRCEE01A 521386 0307-1601 7278 J-9161-1 R15/C097 3MRCEEOIA 521386 0307-1601 7874 J-9161-2 R45/C100 3MRCEE01A 7864 J-9161-2 521386 R44/C 103 0307-1601 3MRCEEOIA 7866 J-9161-2 521386 R36/C109 0307-1601 3MRCEE01A 521386 0307-1601 7891 J-9161-2 R1401C109 3MRCEEOIA 7860 J-91 61-2 521386 R54/C 111 0307-1601 3MRCEE01A 521386 0307-1601 7873 J-9161-2 R31/C 112 3MRCEEO1A 7867 J-9161-2 521386 R54/Cl 13 0307-1601 3MRCEE01A 521386 0307-1601 7898 J-9161-2 R48/C 115 3MRCEEIA 7251 J-9161-1 521386 R1451C116 0307-1601 3MRCEE01A 521386 0307-1601 7865 J-9161-2 R56/C117 3MRCEE01A 7892 J-9161-2 521386 RI08/C119 0307-1601 3MRCEE01A 7893 J-9161-2 521386 R40/C123 0307-1601 3MRCEEO1A 7870 J-9161-2 521386 R48/C123 0307-1601 3MRCEEOIA 7894 J-9161-2 521386 R57/C124 0307-1601 3MRCEE01A 7280 J-9161-1 521386 RI12/Cl 33 0307-1601 3MRCEEOIA 0307-1601 7895 J-9161-2 521386 R125/C134 3MRGEE01A J-9161-2 521386 R1 03fCl 38 0307-1601 7896 3MRCEE01A J-9161-2 521386 R121/C138 0307-1601 7897 3MRCEE01A J-9161-2 521386 RI118/C1 39 0307-1601 7898 Page 2 of 3
M GENERATOR 3MRCEEOIA "HOT LEG" Page 3 of 3
ASME SECTION XI - REPAIR/REPLACEMENT
- 2. Code Class ASME SECTION Ii, CLASS 1
- 1. Component ID 3MRCEE01A
- 3-1
- 3. Item Description STEAM GENERATOR
- 5. W.O. Number 2414006
- 4. N-5 Package Number 3RCOI-2
- 6. Original Construction Code Edition 1971 EDITION & 1973 WINTER ADDENDA EDITION & 1975 WINTER ADDENDA
- 7. Original Installation Code Edition .1974 TUBES PER ROLL PLUGS IN 3MRCEE01A COLD LEG
- 8. Work Description INSTALL WESTINGHOUSE AND DISPOSITION.
ENGINEERING DFWO 2406661 EVALUATION NDE Method of Flaw Detection EDDY CURRENT
- 9. [*j ISI Flaw Report Number 3R09 EDDY CURRENT EXAM. REPORT as per the requirements of IAW-4150.
- 10. Evaluation of the suitability of this work 2406661.
EVALUATION PER ENGINEERING DFWO WESTINGHOUSE
- 11. Repair/Replacement Work Organization ADDENDA Code/Edition f071 EI5ITION-& 1973 WINTER
- 12. Replacement Item Construction or reconciled 1974 EDITION: & 1975 WINTER ADDENDA
- 13. Repair/Replacement Activity Construction Code/Edition
- 14. ASME Section XI Code/Edition 1992 EDITION & 1992 ADDENDA.
.. " yES . I[NO
- 15. Preservice Inspection Required.
Inspection.
08/23/01 If required, include a step in'the W.O. to perform Preservice Initial Date YES, NO
- 16. ASME Section XI Pressure Test Required T08/23/01 If required, include a step in the W.O. for ISI & ANITTCEnspection.
Initial Date Date Initial applicable numbers for repaired or 08/23/01 18, Include a step in the W.O. to record below all Initial Date replacement items.
NO. HEAT NO. MRI-,HU NOu.
ITE P.I .D, PART NO. "SERIAL SEE ATTACHED LIS:
LIST SE SEE TAL*DIIq ATTACHED LIST TUBE PLUGS SEE ATTACHED P.
priorN reainDAhecop oet
- 20. E/ Eninee 17 ldease in th-W.O tcoprinte NaS2ome
-'* "-*b* Print Name MICHAEL ]B. NEWrELL
- 19. Plannero--"
Sign~ature-f Dat
- ,-4--- ROBERT G.Na1HOGSTROM Print Name Print 6,1 A,,I I PV-E0093 Vet. 6 73DP-gZ271
NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS FORM the ASME Code Section XI As Required by the Provisions of Date 08/23/01 et. al.
- 1. Owner Aan. Name of 2 Sheet 1 P.O. Box 5399 Arizona 85072-2034 oenix Address Generatin9 Station Unit 3
- 2. Plant Pauar Name2406 S........
85354-7529 O2414006 5801 S. Wintersbur Rd.. Tono ah Arizona Address Type Code Symbol Stamp None
- 3. Work performed by Westinghouse Authorization No. N/A Expiration Date N/A__
37402 911 W.Main St., Chattanooga, TN Reactor Coolant
- 4. identification of System W '73 Addenda, N/A Code Case ASME I]I Class 1 19 71 Edition,
- 5. (a) Applicable Construction Code 19 92 Edition, 1992 Addenda Xl Utilized for Repairs or Replacements (b) Applicable Edition of Section or Replaced and Replacement Components
- 6. Identification of Components Repaired StampeS d Other Year or Name of Manufacturer National es or N Name of Re lacement Item Manufacturer Serial No. Board No. Identification Built 65273-1 22860 3MRCEEOIA 1981 Repaired Steam Generator CE
-2001 Replacement INo N/A Tube Plugs Westinghouse list..__-
leg uespr DF-WO 2406661. See attached
- Exempt Ia N-416-1 [
P Pneumatic [*
- 8. Test Conducted: Hydrostatic Test Temp. - . .F Pressure_ _ psi Other ID provided (1) size is 8 112 x 11 in.,
sheeti in form of lists, sketches, or drawings may be used, sheet is numbered and NOTE: Supplemental 1 through 6 on this report is included on each sheet, and (3) each (2) information in items at the top of this form.
the number of sheets is recorded 73OP-9ZZ7 PV-EO092 Vet. 6
II FORM NIS-2 (Back)
LIST ATTACHED).
- 9. Remarks SEE DFWO 2406661 FOR TUBES PLUGGED (PLUGGING
- Jo *"t 'kOO*Lo CERTIFICATE OF COMPLIANCE report are correct and this repair conforms to the rules We certify that the statements made in the repair or replacement of the ASME Code, Section XL.
Type Code Symbol Stamp N/A Expiration Date Certificate of Authorization No. N/A
_51Z or ,fwners n.
fesignee, Date Sige owner or Owner's Designee, Title ~
Signed CERTIFICATE OF INSERVICE INSPECTION Pressure Vessel issued by the National Board of Boiler and 1,the undersigned, holding a valid commission HSBI & I CO.
inspectors and the State or Province of Arizona and employed by in this Owner's Report during of Hartford. Connecticut , have inspected the components described and to -,.-oi ,andstate that to the best of my knowledge the period *-2-o and taken**^4 corrective measures described in this Owner's belief, the Owner has performed examinations ~~~~~~ V... tt,inn Yl Report in accordance with the requirements 0tme AS,vI= U.o ,
expressed or implied, or nor his employer makes any warranty, By signing this certificate, neither the Inspect Furthermore, measures described in this.Owner's Report.
concerning the examinations and corrective injury or property be liable in any manner for any personal neither the Inspector nor his employer shall or connected with this inspection.
damage or a loss of any kind arising from Commissions r.> ',41 t.2(,S-k 4.z S/ rt National Board,. State, Province, and Endors- eints
- rs Signature Date C_ C7*o6FoP_.
73DP-9ZZ17 PV-E0092 Ver. 6 BACK
STEAM GENERATOR 3MRCEE01A "COLD LEG" WORK ORDER 2414006 ASME SECTION XI.REPAIRIREPLACEMENT MR NO.
PART NO. SERIAL NO. HEAT NO.
COMP. ID 3MRCEEO1 A 521386 9867 J-9162-2 R791C14 0307-1601 3MRCEEOIA J-9162-2 521386 3MRCEEO1 0307-1601 9892 R451C30 A
9893 J-9162-2 521386 R66tC39 0307-1601 3MRCEE01 A 521386 0307-1601 9861 J-9162-2 R108/C39 3MRCEE01A 521386 0307-1601 9854 J-9162-2 R127/C44 3MRCEE01A 521386 I 0307-1601 9857 J-9162-2 R133/C48 3MRCEEOIA J-9162-2 521386 0307-1601 9856 R134/C49 3MRCEEOIA J-9162-2 521386 0307-1601 9855 R1375C52 3MRCEE01A J-9162-2 521386 0307-1601 9876 R145/C68 3MRCEE01A J-9162-2 521386 0307-1601 9879 R141/C80 3MRCEEOIA J-9162-2 521386 0307-1601 9872 R35/C82 3MRCEEOIA J-9162-2 521386 0307-1601 9888 R133/C82 3MRCEE01 A 521386 0307-1601 9890 J-9162-2 R532/C83 3MRCEE01A J-9162-2 521386 0307-1601 9885 R149/C86 3MRCEEOIA 521386 0307-1601 9865 J-9162-2 R44/C87 3MRCEEOIA 521386 0307-1601 9873 J-9162-2 R53t/C8 3MRCEEO1A J-9162-2 521386 0307-1601 9880 R140/C89 3MRCEEOIA J-9162-2 521386 0307-1601 9874 R45/C90 9863 J-91 62-2 521386 3MRCEE08A R47/C90 0307-1601 3MRCEE01A 521386 0307-1601 9881 J-91 62-2 R1 45/C90 3MRCEE01A :0 521386 0307-1601 9865 J-9162-2 R4/C92 3MRCEE01Ai 521386 0307.1601 9882 J-9162-2 R143/C92 3MRCEE01A 521386 0307-1601 9895 J-9162-2 R142/C93 3MRCEE01A 9884 J-91 62-2 521386 R143~C94 0307-1601 Page 1 of 3
STEAM GENERATOR 3MRCEEOIA "COLD LEG" WORK ORDER 2414006 3MRCEEOIA 9 521386 9869 J-9162-2 521386 R44/C95 0307-1601 R45/C96 0307-1601 9864 J-9162-2 521386 3MRCEE01A 9886J-9162-2 521386 Rt 59/C96 0307-1601 9886 3MRC1 0307-1601 987 J-9162-2521386 R 521C97 R441C115 0307-1601 9868 J-9162-2 521386 R144/C117 0307-1601 9891 J-9162-2 521386 3MRCEEO1A 521386 R145IC100 0307-1601953 R61C5817 0307-1601 9860 J-91 62-2 521386 3MRCJ-9162 07A 9875 J-9162-2 521386 19
.RE0C 3MRCEE 3 J-962-2 521386 RR44/C 12 0307-1601 9859 R7*"C0A 9858 J-9162-2 521386 97 ._.__-.--
R54/C 117 0307-1601 R36/C109 0307-1601 9869 j-9162-2 J-9162-2 521386 521386 3RE01"--9875 R310/C19200-6199 3 9898 J-9162-2 521386 3R40C12 I 0307-1601 521386 3MRCE1A 3MRCEE0IA 99J9122521386 R125/C109 0307-1601 0307-16 9889 9W7 J-9162-2 R540/C123 3MRCEE01A 9887 989J-9162-2 J-9162-2 521386 521386._
-- RCE I0A ------
0307-1601 96 R48tC123 988J-9162--2 521386L_.
3MRCEE01A _.....__.----
R457/Cl 1602-61941 989J-9162-2 _____--. 521386..__
3MRCE"E01A 0307-1601 96 R561/C1133 J-9162-2 521386__
3MRE0E--"-988- ._._._---.
! R108/Cl 19 0307-1601985 983J-9162-2 521386_.
"3"M"*E01A 99 R4 01C1238 0307-1601 3MCEE01A 90J-122521386 0307-1601 95 R481/C123 J-9162-2 521386; 3MRCEE01A 3710 89J96-R118/C 3 Page 2 of 3
STEAM GENERATOR 3MRCEE01A "COLD LEG" Page 3 of 3
ASME SECTION XI - REPAIRPREPLACEMENT 1
- 2. Code Class ASME SECTION I1I. CLASS
- 1. Component ID 3MRCEE0IB
- 3-2
- 3. Item Description STEAM GENER.ATOR
- 5. W.O. Number 2414008
- 4. N-5 Package Number 3RCO1-2 ADDENDA 1971 EDITION & 1973 WINTER
- 6. Original Construction Code Edition
- 7. Original Installation Code Edition 1974 EDITION & 1975 WINTER ADDENDA TUBES PER ROLL PLUGS IN 3MRCEE01B HOT LEG
- 8. Work Description INSTALL WESTINGHOUSE ISPOSITION.
ENGINEEi.NGWrWk6TION CURRENT NDE Method of Flaw Detection EDDY
- 9. 1 ISI Flaw EXAM. REPORT Report Number 3R09 EDDY CURRENT work as per the requirements of IAW-4150.
- 10. Evaluation of the suitability of this 2406663.
EVALUATION PER ENGINEERING DFWO WESTINGHOUSE
- 11. Repair/Replacement Work Organization ADDENDA Item Construction or reconciled Code/Edition 1971 EDITION & 1973 WINTER
- 12. Replacement ADDENDA Code/Edition 1974 EDITION &1975 WINTER
- 13. Repair/Replacement Activity Construction
& 1992 ADDENDA.
- 14. ASME Section XI Code/Edition 1992 EDITION
- YES [j NO
- 15. Preservice Inspection Required.
perform Preservice Inspection.
In ý I Date 08/23/01 If required, include a step in the W.O. to
[ YES [j NO
- 16. ASME Section XI Pressure Test Required ISI & ANII Inspection.
S. iio _ 08/.23/01 Date If required, include a step in the W.O. for NIS-2 Form prior to releasing the component.
08/23/01 17. Include a step in the W.O. to complete Inta Date all applicable numbers for repaired or 08/23/01 18. Include a step in the W.O. to record below Initial Date replacement items.
HEAT NO. MR/ROS NO.
PART NO. SERIAL NO.
ITEM I.D. SEE ATTACHED LIST SEE ATTACHED LIS TUBE PLUGS SEE ATTACHED LIST EE ATTACHED LIST
- Print Name MICHAEL B. NEWELL
- 19. Planner--
.. . Si ire. Date Print Name RAMAKANT P. INDAP 2-_C%._ .)
- 20. IS, Engineer Date
/Siglaure Print Name ROBERT G. HOGSTR DM
- 21. ISIEnn24ee P-9Z Z7 I 7SD Signature J Date PFVEO093 Ver. 6
FOR REPAIRS OR REPLACEMENTS FORM NIS-2 OWNER'S REPORT of the ASME Code Section XI As Required by the Provisions Date 08/23/01
- 1. Owner zona.Public Servic COmafly. et. al.
P.O. Box 53999 Phoei" Arizona 85072-2034 Sheet_ _ _ of Address Unit 3
- Station
- 2. Plant Palo Verde Nuclear Gnen WI(OdrNme 2414008 5801 S. Wjntersbur Rd. Tonopah Arizona 85354-7529 Address None Type Code Symbol Stamp
- 3. Work Performed by Westinghouse Authorization No. N/A Name Expiration Date N/A 911 W. Main St., Chattanooga, TN 37402 Addrss System Reactor Coolant
- 4. Identification of Addenda, N/A Code Case ASME IInClass 1 19 71 Edition, W '73
- 5. (a) Applicable Construction Code 19 92 Edition, 1992 Addenda Xl Utilized for Repairs or Replacements (b) Applicable Edition of Section Components Repaired or Replaced and Replacement
- 6. Identification of Components Year or Stamped National Other Name of Manufacturer Name of Re lacement Yes or No Item Manufacturer Serial No. Board No. Identification Built 1981 Repaired Yes 65273-2 22861 3MRCEE01B Steam Generator CE 2001
-NAReplacement No Tube Plugs Westinghouse 466.Seatced list.
Ho emg_.L~rDW
- 7. Description of Work P_nMjSG j3-:2 Exempt [ N-416-1 [
Pneumatic E3 Nominal Operating Pressure [
- 8. Test Conducted: Hydrostatic [
. psi Test Temp. -F Other Q Pressure _
is 8 1/2 x 11 in.,
may be used, provided (1) size sheets in form of lists, sketches, or drawings sheet is numbered and NOTE: Supplemental each sheet, and (3) each in items 1 through 6 on this report is included on (2) information at the top of this form.
the number of sheets is recorded 73DP-9ZZ17 PV-E0092 Vet. 6
FORM NIS-2 (Back)
I9. Remarks SEE DFWO 2406663 FOR TUBES PLUGGED (PLUGGING LIST ATTACHED).
CERTIFICATE OF COMPLIANCE conforms to the rules the report are correct and this repair We certify that the statements made in repar or replacement of the ASME Code, Section Xl.
Type Code Symbol Stamp N/A Expiration Date .
Certificate of Authorization No. N/A Signed Po ;Zf
£2'I- Date .L10L S Owner or ownees Designee, Wel I
CERTIFICATE OF INSERVICE INSPECTION Pressure Vessel issued by the National Board of Boiler and 1,the undersigned, holding a valid .commission HSBI & I CO.
Ari-zona' and employed by Inspectors and the State or Province of
, have inspected the components described in this Owner's Report during of H*rtford. Connectcut knowledge and to ___-___-_ _ , and state that to the best of my the period -- 4-c' in this Owner's and taken corrective measures described belief, the Owner has performed examinations of the ASME Code,Section XI.
Report in accordance with the requirements warranty, expressed or implied, Inspector nor his employer makes any By signing this certificate, neither the Furthermore, measures described in this Owner's Report.
concerning the examinations and corrective injury or property shall be liable in any manner for any personal neither the Inspector nor his employer or connected with this inspecion.
damage or a loss of any kind arising from Commissions t,. 4tu,S &,
4t"z"2Az.
<; Snatiite SNatOnal Board, State, Proince, and En=ott, lnSpeS ArR.. . .2cc> k Date 6 BACK Ve*, 730P-9=17 Pv-E*
PV-E-009 Ver. 6 BACK
B STEAM GENERATOR 3MRCEE01 WORK ORDER "HOT LEG" SASE SEC ION )XMI-REAIRRE illl MMENT.
SERIAL NO. HEAT NO.
COMP. ID PART NO.
3MRCEED15B J-9162-2 - 521386 0307-1601 9723 R61C13 3MRCE01 b -9162-2 521386B 0307-1601 9722 R81C13 3MR E01B 521386 9711 --- 521386 R81/C2 0 0307-1601 3MRCE01 B J-9162-2 J._16.-- 521386 0307-1601 9724 R83/C22 521386 3MRCEE01 b 9702 J-9162-2-5 R95/C22 0307-1601 J-9162-2 521386 3MCE01 B 0307-1601 9458 R103/C26 521386 3-9RCEE2 9721 J-9162-2 R37/C28 0307-1601 B 2 J-9162-2 521386
,3MRcE R62/C29 0307-1601 9705 -.--- 521386 0307-1601 9712 J-9162-2 521386 R102/037 30-1601959---.- 979 J-9162-2 521386 R1 1307 R 12/C33 9-9162-2 521386 3MRCEE01 B RI6/C34 0307-1601 9750 j___._-
3MRCEEoB -9162-2 521386 R87IC36 0307-1601 9797 ._._6--. 521386
.3MRCEE0IB B-9162-2 R95/C36 0307-1601 9713 90 J-9162-2 -.-- 521386 RC R1 04/C37 6 0 0307-1601 9451 RCEE01 B 0971 J-9162-2 521386 3 0307-1601 945 .---
J-9162-2 521386 521386 R114/C5 3NRCE01 970 0307-1601 90 SR40/C55 521386 973 -9162-2 3ICE01 B ---
0307-t 601 99 R1 12/C57 9750 J-9162-2 521386 3NIR16C57137-B 977J-9162-2 521386 3M-RCE 0I B 99 R13/C58 RI 0307-1601 94519 J-9162-2 521386 3MRCEE01 B R110/C,61 0307-1601-----"-""
941 -9162-2 521386 3MREE01B 91 R81I /C62 0307-1601 971 -9162-2 521386 3MIRCEE015 90 8101C362 0307-1601 9423-9162-2 "521386R B
-NRCE01 95 R1 12=C3 ' 0307-1601 Page 1 of 4
STEAM GENERATOR 3MRCEE01 B WCPI( flPflFP 414.00S "HOT LEG" 3MRCEE01 B R109/C66 0307-1601 9708 J-9162-2 521386 3MRCEEOIB R1OO/C67 0307-1601 9748 J-9162-2 521386 3MRCEEOI B R77/C74 0307-1601 9709 J-9162-2 521386 3MRCEEOIB RI11/C74 0307-1601 9791 J-9162-2 521386 3MRCEE01B R99/C76 0307-1601 9747 J-9162-2 521386 3MRCEE01 B R68/C77 0307-1601 9453 J-9162-2 521386 3MRCEEOI B R65/C80 0307-1601 9731 J-9162-2 521386 3MRCEE01B R69/C80 0307-1601 9736 J-9162-2 521386 3MRCEE01B R60/C81 0307-1601 9732 J-9162-2 521386 3MRCEE01 B R621C81 0307-1601 9733 J-9162-2 521386 3MRCEE01B R96/C81 0307-1601 9745 J-9162-2 521386 3MRCEE01B R102/C81 0307-1601 9749 J-9162-2 521386 3MRCEE01 B R35/C82 0307-1601 9468 J-9162-2 521386 3MRCEE0I B R97/C82 0307-1601 9746 J-9162-2 521386 3MRCEEOI B R62/C83 0307-1601 9729 J-9162-2 521386 3MRCEE01 B R64/C83 0307-1601 9730 J-9162-2 521386 3MRCEEOIB R39/C84 0307-1601 9469 J-9162-2 521386 3MRCEEOIB R69/C84 0307-1601 9737 J-9162-2 521386 3MRCEEO1 B R71/C84 0307-1601 9742 J-9162-2 521386 3MRCEE01 B R102/C85 0307-1601 9790 J-9162-2 521386 3MRCEEO1B R70/C87 0307-1601 9740 J-9162-2 521386 3MRCEE01 B R76/C87 0307-1601 9743 J-9162-2 521386 3MRCEEO1 B R57/C88 0307-1601 9727 J-9162-2 521386 3MRCEE01B R59/C88 0307-1601 9728 J-9162-2 521386 3MRCEEI1B R1181C89 0307-1"601 9792 J-9162-2 521386 Page 2 of 4
STEAM GENERATOR 3MRCEE01 B "HOT LEG" .
2414008 WORK ORDER 3MRCEE01 B 521386 0307-1601 9738 J-9162-2 R691C92 3MRCEEOIB 521386 0307-1601 9701 J-91 62-2 R44/C93 3MRCEEOI 5 J.9162-2 521386 R69/C98 0307-1601 9739 3MRCEE01 B J-9162-2 521386 R44/C099 0307-1601 9717 9734 J-9162-2 521386 R65/C100 0307-1601 3MRCEE01 B J-9162-2 521386 R1 2/C1 01B 3MRCEEOI 0307-1601 9793 9735 J-9162-2 521386 R65/1C 02 0307-1601 3MRCEE 01 9724 J-9162-2 521386 R7OIC103 B 3MRCEEOI- 0307-1601 B
3MRCEEO1 521386 0307-1601 9791 J-9162-2 R30/C1 06 3MRCEEOIB 9715 J-9162-2 521386 R36/C107 0307-1601 3MRCEE01B 521386 0307-1601 9720 J-9162-2 R40tC109 B 3MRCEE01 521386 0307-1601 9454 J-9162-2 R134/C111B 3MRCEE01 521386 0307-1601 9472 J-9162-2 R152/0115 3MRCEEOI B 9714 J-9162-2 521386 R43/C116 0307-1601 3MRCEEOI B 3MRCEE01 B 9457 J-9162-2 521386 R31C15 11 0307-1601 9467 J-9162-2 521386 RICER/C 150 0307-1601 3MRCEEOI B 3MRCEE01 521386 0307-1601 9470 9471 J-9162-2 J-9162-2 CER125/Cl130 3RI143/Cl 26 0307-1601 94567 J-9162-2 521386 R110/C120 0307-1601 3MRCEEOI B 521386 0307-1601 9471 J-9162-2 R143/C128B 3MRCEE01 Page 3 of 4
B STEAM GENERATOR 3MRCEE01 _____O "HOT LEG" Page 4 of 4
REPAIR/REPLACEMENT ASME SECTION X1l III CLASS I p2.Code Class ASM-E SECTION
- 1. component~ ID 3MRCEE01B
- 3. Item Description STEAM GENERATOR #3-2.
2 5. W.O. Number 2414011
- 4. N-5 package Number 3RC01- WINTER ADDENDA Code Edition 1971 EDITION & 1973
- 6. Original Construction WINTER ADDENDA Code Edition 1974 EDITION & 1975 COLD LEG TUBES PER
- 7. Original installation PLUGS IN 3MRCEE01B WESTINGHOUSE ROLL ION AND DISPOSITION.
- 8. Work Description INSTALL ENGINEERING DWO 2406664 EV Detection EDDY CURRENT NDE Method of Flaw REPORT
- 9. E! ISI Flaw EDDY CURRENT EXAM.
Report Number 3R09 50..
requirements of JAW-41 per the2406664.
of the suitability PER of this work asDFPWO ENGINEERING
- 10. Evaluation EVALUATION WESTINGHOUSE.
- 11. Repair/Replacement Work Organization & 1973 WINTER ADDENDA or reconciled Code/Edition 1971 EDITION
- 12. Replacement Item Construction 1974 EDITION & 1975 WINTER ADDENDA Activity Construction CodeIEddition
- 13. Repair/Replacement ADDENDA.
Xl CodefEdition 1992 EDITION & 1992
- 14. ASME Section f NO YES-Required., Inspection.
- 15. Preservice inspection to perform Preservice[.-DN O If required, include a step in the W.O.
08/23/01 D a teia D NO ID YES Test Required
- 16. ASME Section Xl Pressure include a step in the W.O.
for ISI & ANII Inspection.
08/23/01 If required, NIS-2l Form prior to forthe releasing component.
repaired or numbers 08/23/01 17. Include a step in the W.O. to complete ppial
- Date all applicable .
in the W.O. to record below
- 18. Include a stepitems. O 08/23/01
ýitij'aereplacement ET Os O SEILNO ITMID.ATNO.
Print Name MICHAEL B. NEWELL 19.
Date
- 19. Plannerre P. INDAP Print Name RAMAj(ANT
- 20. IS!Engineer_ Eierae.sD Print Name ROBERT G. HOGSTROM
- 21. ANlI KC* V Da.Z te e _73EP.9ZZ7 PV.EDO93Vflr. e
FOR REPAIRS OR REPLACEMENTS FORM NIS-2 OWNER'S REPORT of the ASME Code Section XI As Required by the Provisions Date 08/23/01 CompanY et. al.
- 1. Owner Arizona Public Service Name of 2 Sheet_ _
P.. Box 539 Arizona 85072-2034 Phoenix Address Station. Unit rk O d r N m e
- 2. Plant Palo Verde Nuclear Generatirl Name 85354-7529 2414011 W7414rd0r1N1 __er 5801 S. Wintersbur Rd. Tono Add ressWah Arizona Type Code Symbol Stamp None
- 3. Work Perforrned by Westin house Authorization No. N/A Expiration Date N/A 37402 911 W. Main St., Chattanooga, TN Reactor Coolant
- 4. Identification of System N/A Code Case Code ASME II1Class 1 19. 71 _Edition, W '73 Addenda,
- 5. (a) Applicable Construction 1992 _Addenda of Section Xl Utilized for Repairs or Replacements 19 92 Edition, (b) Applicable Edition or Replaced and Replacement Components
- 6. Identification of Components Repaired Other Year Repaird ASMECode Manufacturer National acement e Name of Name of eManufacturer Serial No. Board No. Identification ent Yes Item cture CE 65273-2 22861 3MRCEE0IB red Steam Generator No N/A Replacement Westinghouse
- Tube Plugs attached list SG 3-2 Cold le tubesr DFWO 2406664. See
- 7. Description of Work P Nominal Operating Pressure [ Exempt II N-416-1 [
Hydrostatic [ Pneumatic j*
- 8. Test Conducted:
Test Temp. . F Pressure --- psi Other Q 8 1/2 x 11 in.,
of lists, sketches, or drawings may be used, provided (1) size is and NOTE: Supplemental sheets in form report is included on each sheet, and (3) each sheet is numbered 6 on this (2) information in items 1 through the top of this form.
of sheets is recorded at the number 73DP-9ZZ17 PV-EO092 Vet. 6
FORM NIS-2 (Back)
LIST ATTACHED).
- 9. Remarks SEE DFWO 2406664 FOR TUBES PLUGGED (PLUGGING CERTIFICATE OF COMPLIANCE repair conforms to the rules that the statements made in the report are correct and this We certify rpair or replacement of the ASME Code,Section XI.
N/A Type Code Symbol Stamp Signe Certificate of Authorization No. N/A J Ct/ K- Expiration Date 0ate to-2, 0-0 '-*
Signed Owner or Owner's Designe, Title INSPECTION CERTIFICATE OF INSERVICE Board of Boiler and Pressure Vessel undersigned, holding a valid commission issued by the National 1, the HSBI & I CO.
and the State or Province of Arizona and employed by Report during Inspectors
, have inspected the components described in this Owner's of Hartford. Co-nncticut and state that to the best of my knowledge and.
to - -o*
the period - in this Owner's measures described examinations and taken corrective belief, the Owner has performed of the ASME Code,Section XI.
Report in accordance with the requirements any warranty, expressed or implied, the Inspector nor his employer makes By signing this certificate, neither this Owner's Report. Furthermore, the examinations and corrective measures described in concerning any personal injury or property shall be liable in any manner for neither the Inspector nor his employer from or connected with this inspection.
damage or a loss of any kind arising
.. "AS.LA.
24.4 Commissions Endorsements National Board, State. Province, and
- ."-P.ASignat-re Date c)o'e*- .2.._.-
73DP-9ZZ17 PV-E0092 Ver. 6 BACK
B STEAM GENERATOR 3MRCEE01 "COLD LEG" ~MR N""---O.
WORK ORDER 2414011 -- ** --
ASME ECTION X1-REPAIR/REPLCMN HEAT NO. --.
ARNO. ERIALNO.
COMP. ID 3MRCEE1B -9162-2 521386B J-9162-2 521386 0307-1601 9477 R6/C13 521386B 3MRCEE019 J-9162-2 9439 R8/C13 0307-1601 3MRCEE01 B 521386 9480 J-9162-2 R81/C20 0307-1601 3MRCEE01 B 521386 9489 J-9162-2 R831C22 0307-1601 3MRCEE01B 521386 9485 J-9162-2 R95/C22 0307-1601 3RC9-9162-2 5213860011 R13/C26 0307-1601 9488 3MRCEE01B J-9162-2 521386 0307-1601 9424 R2I/C29 RC0E01 B 9437 J-9162-2 521386 0307-1601 943 .--.- 521386 RI02/C33 3R2C0E01B 9436 J-9162-2
-- '-521386 521386 R12/C33 0307-1601 3MRCE01B 521386 R71/C33 0307-1601 9466 J-9162-2 521386 R8EE0C34 0307-1601 9425 J-9162-2 521386 R87/C36 0307-1601941-.---
3MRCEE01 B 3-9162-2 521386 R9504C37 0307-1601 3 "R8EE012B 9478 J-9162-2 521386 3MRCEE01 B J-9162-2 521386 R1041C53 0307-1601 9465 3MRCEE 93J9122521386 521386 3MRCEE01 B ---- '
R140IC53 0307-1601 0307-1601 9424 98 RI41/C57 J-9162-2 521386
"-3M-RCEE01 1393 0307-1601934-.----------'-""-'"
R1126/C57 J-9162-2 521386 9437
[ R13C58E007160 96 -122518 R77.6 0307-1601 9425 J-9162-2 521386 3*MRCEE01 13 RI C6 0307-1601 96 -122518 3-MRCEE01 B 97 -122518 R8/6 0307-1601 942J9 22521386 3MRCEE01 B R801/C6203760948312 94J9122521386 3MRCEE01 B R1 12/C603-60940-922 Page 1 of 4
STEAM GENERATOR 3MRCEE01B --------- ---
"COLD LEG" "ODLG WORK ORDER 2414011 3MRCEEO1 B J-9162-2 521386 0307-1601 9485 RI091C66 521386 3MRCEE01B 9476 .. ____-
R7701C67 0307-1601 3MRCEEOIB J-9162-2 521386B 521386 0307-1601 9444 R771C74
"-'-MRCEE01BJ-122538 9484 R681C74 0307-1601 9499 J-9162-2 521386 0307-1601 9463 J-9-162-2 R359C76 R65/C80 0307-1601 J-9162-2 521386 3MRCEEO1B 9464 9412 ..-. 2-.,521386 R62/C80 R68/C77 0307-1601 J9162-2 521386B 3MRCEE01B 9495 R64/C81 0307-1601 3MRCEEO1BB 3MRCEEOI 9410 J-9162-2 521386 R62/C81 0307-1601 521386 3MRCEEOIB 9411 J-9162-2 -----
R3"M EEC 0307-1601 49 R96/C81 3710 0307-1601 949 J-9162-2 521386 R71JC84 J-9162-2 521386 0307-1601 9401 R102/C81 3MRCEE01B B21386 J-9162-2 0307-1601 9500 . ---- 52138 R351C82 3MRCEEOIB J-9162-2 521386 0307-1601 9431 R97/C82 3MRCEE01 B J-9162-2 521386 0307-1601 9412 R571C88 3MRCEEOI 3MRCEEO1 B J-9162-2 521386 0307-1601 9492 518 R59/C88 J-9162-2 518
- '3MRCEE01B3 9410 S R39!C84 0307-1601 J-9162-2 521386---.---
0307-1601 9411 R69/C84 3MRCEEO B J-9162-2 521386 0307-1601 9494 521386 R71/8C4 B 947J-9 162-2 S3MRCEE01 R1 02/C85 0307-1601947.---
9500 J_-916-2-----
R70/C87 0307-1601 518 3MRCEE01 B1 521386-3MRCEEOIB 0307-1601 9448 R76/CB7 J-122521386 3MRE01B J-16 R57/C88 00-619413 518 3MRCEE01BJ-622 9490J9122538 R59/C88 0307-1601 J-9162-9446 3MRCEE01B5238 0307-1601 R 1818C89 Page 2 of 4
STEAM GENERATOR 3MRCEEOIB "COLD LEG" W ,R)"K* O.,RDELR:. 2'r4u14 1 3MRCEE0 3B 0307-1601 9408 J-9162-2 521386 R69/C92 3MRCEE01B 0307-1601 9403 J-9162-2 521386 R44/C93 3MRCEE01 B 0307-1601 9491 J-9162-2 521386 R69/C98 3MRCEEOIB 0307-1601 9498 J-9162-2 521386 R44/C99 3MRCEE01 B 0307-1601 9405 J-9162-2 521386 R65/C100 3MRCEEOI B 0307-1601 9445 J-9162-2 521386 R128/C101 3MRCEE01 B 0307-1601 9407 J-9162-2 521386 R65/C102 3MRCEEOI B 0307-1601 9497 J-9162-2 521386 R44/C103 3MRCEE01B 0307-1601 9443 J-9162-2 521386 R152/C103 3MRCEEO1B 0307-1601 9430 J-9162-2 521386 R95/C 104 3MRCEE01B 0307-1601 9493 J-9162-2 521386 R706C105 3MRCEE01 B 0307-1601 9496 J-9162-2 521386 R39/CI06 3MRCEE01B 0307-1601 9402 J-9162-2 521386 R36/C 107 3MRCEE01 B 0307-1601 9495 J-9162-2 521386 R40tCl 09 3MRCEEO1 B 0307-1601 9435 J-9162-2 521386 R134/C111 3MRCEE01 B 0307-1601 9429 J-9162-2 521386 R152/Cl 15 3MRCEE01 B 0307-1601 9404 J-9162-2 521386 R43/Cl16 3MRCEEO1 B 0307-1601 9406 J-9162-2 521386 R23/C 118 3MRCEE01 B 0307-1601 9449 J-91 62-2 521386 RI 15/C1 20 3MRCEE01 B R111/C122 0307-1601 9426 J-9162-2 521386 3MRCEEOI B 0307-1601 9442 J-9162-2 521386 R110/C127 3MRCEE01 B R143/C128 0307-1601 9421 J-9162-2 521386 3MRCEE01 B 0307-1601 9427 J-9162-2 521386 R125/C130 3MRCEE01 B R11I0/C3133 0307-1601 9421 J-91 62-2 521386 3MRCEE01 B_10 R92/C1 35 0307'10 9422 J-91 62-2 521386 Page 3 of 4
STEAM GENERATOR 3MRCEE01B "COLD LEG" Page 4 of 4
ASME SECTION XI - REPAIRIREPLACEMENT CLASS 1
- 2. Code Class AS3E SECTION III,
- 1. Component ID 3PRCEL032 TO STEAM GENERATOR #1 PIPING
- 3. Item Description REACTOR VESSEL
- 5. W.O. Number 2428231
- 4. N-5 Package Number 3RC01-2 1974 ADDENDA Construction Code Edition ASME SECTION III, CLASS 1, 1974, SUMMIER
- 6. Original WINTER 1975 ADDENDA ASME SECTION m, CLASS 1, 1974,
- 7. Original Installation Code Edition Seal Assembly (MNSA) on the RCS2427755. piping to stop the RCS leakage Description Install a Mechanical Nozzle
- 8. Work nozzle location 1121D. Reference DFWO at-RTD-jrCDT NDE Method of Flaw Detection
- 9. U ISI Flaw Report Number work as per the requirements of IAW-4150.
- 10. Evaluation of the suitability of this described in engineeriDWO 2427755 Evaluation of the installation of the MNSA is Arizona Public Service
- 11. Repair/Replacement Work Organization Code/Edition ASME Sec. IlI, 1, 1989 Edition
- 12. Replacement Item Construction or reconciled Ed., Winter 1975 Addenda Activity Construction Code/Edition ASME Sec. III,Cl 1, 1974
- 13. Repair/Replacement Docket number STN 50-5 XI Code/Edition 1992 Edition, 1992 Addenda, NRC Relief Request, NRC
- 14. ASME Section
@j YES I1J NO
- 15. Preservice Inspection Required. Preservice Inspection.
date S/0/1A/6, If required, include a step in the W.O. to perform tAl Ej YES Q NO
14./0 a i_ If required, include a step in the prior to releasing the component.
-y *#pitlj¢ Date
/ 17. Include a step in the W.O. to complete NIS-2 Form
/04?(v:' or below all applicable numbers for repaired
- 18. Include a step in the W.O. to record tal De replacement items. MR/ROS NO.
SERIAL NO. HEAT NO.
ITEM I.D. PART NO.
56
~~~ ('ýN/
ly~ R ~ A.
S*7 Compression Collar APN/A Green
/a. 47i'~ Print Name, Herbert L.
Print Name IS, Engineer
- 20. Planner 19.
"*- Signature/
Print Name ° 6.
- 21. LAA. 1,,,-
NNI Date I
k Ssignature 73DP-9ZZ17 PV-EO093 Ver. 6
FOR REPAIRS OR REPLACEMENTS FORM NIS-2 OWNER'S REPORT of the ASME Code Section XI As Required by the Provisions ,<,\J-Date JI1
- 1. Owner Arizona Public Service Company, et. al. Datee__*_ _ o Name Sheet 1 -of 2 P.O. Box 53999, oenix. Arizona-85072-2034 Unit 3 Generating Nuclear........... Name2423 Station
- 2. Plant Palo Verde 1- alV 2428231 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 Address Type Code Symbol Stamp None
- 3. Work Performed by Arizona Public Service Authorization No. N/A Name Expiration Date N/A P.O. Box 53999, Phoenix, Address Arizona 85072-7529 001
- 4. Identification of System Reactor Coolant System, line number 3PRCEL032, Spool Code Case ASME Sec. III 19 74 Edition, S'75 Addenda, -
- 5. (a) Applicable Construction Code Addenda for Repairs or Replacements 19 92 Edition, 1992 (b) Applicable Edition of Section Xl Utilized or Replaced and Replacement Components
- 6. Identification of Components Repaired Seal Assembly (MNSA) iaw DFWO 2427755.N-
- 7. Description of Work Install a Mechanical Nozzle N-416-1 Q*
Nominal Operating Pressure [@1 Exempt IQ
- 8. Test Conducted: Hydrostatic U Pneumatic []
I Pressure psi Test Temp. °F Other QJ provided (1) size is 8 1/2 x 11 in., I in form of lists, sketches, or drawings may be used, NOTE: Supplemental sheets and (3) each sheet is numbered and in items 1 through 6 on this report is included on each sheet, (2) information at the top of this form.
the number of sheets is recorded 73DP.9ZZi7 PV-E0092 Ver. 6
FORM NIS-2 (Back) seby(NA nteRSppn oso h C ekg ozeSa a Mechan~~~~~~~~~~~~~~~ica Install
- 9. Remarks Install a Mechanical Nozzle Seal Assembly' (MNSA) on the RCS piping to stop the RCS leakage at RTD nozzle location 3JRCDTWO1 12HD. Reference DFWO 2427755.
- 4-t. A.#_*,-*5\
CERTIFICATE OF COMPLIANCE and this repair conforms to the rules We certify that the statements made in the report are correct replacement repair or of the ASME Code, Section Xl.
Type Code Symbol Stamp ______
N.a p Expiration Date Certificate of Authorization No.
41 /-,
Signe/ .. /,_I/ rDate ,./, 2 Owner or Owner's Designee, Title CERTIFICATE OF INSERVICE INSPECTION Board of Boiler and Pressure Vessel I, the undersigned, holding a valid commission issued by the National Inspectors and the State or Province of Arizona and employed by HSBI & I CO.
, have inspected the components described in this Owner's Report during of Hartford, Connecticut the period -- to ____________- _-__ , and state that to the best of my knowledge and measures described in this Owner's belief, the Owner has performed examinations and taken corrective Xl.
Report in accordance with the requirements of the ASME Code, Section any warranty, expressed or implied, By signing this certificate, neither the Inspectornor his employer makes this Owner's Report. Furthermore, concerning the examinations and corrective measures described in for any personal injury or property neither the Inspector nor his employer shall be liable in any manner inspection.
damage or a loss of any kind arising from or connected with this Commissions )S - "'-h ." A-z. - .- k inspt rs Signature National Board, State, Province, and Endorsements Date .. _ 2Qt 73ur-YZ-,
PV-E0092 Ver. 6 BACK
ASME SECTION XI - REPAIR/REPLACEMENT
- 1. Component ID 3PCHBV337 2. Code Class ASME SECT. III, CLASS 2
- 3. Item Description UNIT 3 CHARGING PUMP "B" DISCHARGE ISOLATION VALVE
- 4. N-5 Package Number 3CH04-1 5. W.O. Number 2429127 7Lt ,rl.,
- 6. Original Construction Code Edition 1974 EDITION THRU S,'ADDENDA
- 7. Original Installation Code Edition 1974 EDITION THRU W'75 ADDENDA
- 8. Work Description REMOVE EXISTING SOCKET WELDED GLOBE VALVE AND INSTALL NEW BUTT WELDED GATE VALVE
- 10. Evaluation of the suitability of this work as per the requirements of IAW-41 50.
REPLACED BY AUTHORIZATION OF DFWO 2423453
- 11. Repair/Replacement Work Organization ARIZONA PUBLIC SERVICE COMPANY
- 12. Replacement Item Construction or reconciled Code/Edition ASME SECT III CL 1 '74 EDITION W'75 ADD
- 13. Repair/Replacement Activity Construction Code/Edition ASME SECT CL 2 '74 EDITION W'75 ADD
- 14. ASME Section XI Code/Edition 1992 EDITION W'92 ADD
- 15. P service Inspection Required. QJ YES [@J NO 101 u-)[ ok If required, include a step in the W.O. to perform Preservice Inspection.
/ initial Date
- 16. AE Section XI Pressure Test Required (aj YES Ll NO wi t,-d*oi If required, include a step in the W.O. for ISI & ANII Inspection.
Date nala Da4te. -* 17. Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
7Fbha Date j*.u ri 1 18. Include a step in the W.O. to record below all applicable numbers for repaired or Initial Date replacement items.
ITEM I.D. PART NO. SERIAL NO. HEAT NO. MR/ROS NO.
- 19. Planner 1 o-71ol Print Name C(e'-,',J r eo
<,Signar Datr j21. ANII "'
S Inature Date Print Name (2.. (1 PV-E0093 Vet. 6 73DP-97-Z1 7
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
- 1. Owner Arizona Public Service Company, et. al. Date 10/07/01 Name P.O. Box 53999, Phoenix. Arizona 85072-2034 Sheet 1 of 2 Address
- 2. Plant Palo Verde Nuclear Generating Station Unit 3 Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 2429127 Work Order Number Address Arizona Public Service Co. Type Code Symbol Stamp None
- 3. Work Performed by Name Authorization No. N/A 5801 S. Wintersburg Rd., Tonopah, Az. 85354 Expiration Date N/A Address
- 4. Identification of System Chemical Volume Control System
- 5. (a) Applicable Construction Code ASME III Class 2 19 74 Edition, W ' 75 Addenda, Code Case (b)Applicable Edition of Section Xl Utilized for Repairs or Replacements 19 92 Edition, 1992 Addenda
- 6. Identification of Components Repaired or Replaced and Replacement Components Name of Manufacturer National Other Year Repaired ASME Code Name of or Stamped Item Manufacturer Serial No. Board No. Identification Built Replacement (Yes or No) 2" Gate Valve Borg Warner 901-L-0137 N/A 3PCHBV337 1982 Replacement Yes
- 7. Description of Work Remove existing globe valye and install new gate valve.
Pneumatic [J Nominal Operating Pressure C Exempt r1 N -416-1 Ij
- 8. Test Conducted: Hydrostatic [J psi Te st Temp. OF Other Q Pressure NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8 1/2 x 11 in.,
(2) information in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.
730P-9ZZ1 7 er.I PV-E092 730P-9ZZ17 PV-E0092 Ver. 6
FORM NIS-2 (Back)
- 9. Remarks Valve 3PCHBV337 is difficult to operate and will be replaced with a new butt welded gate valve.
Work Order 2429127 CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this replacement conforms to the rules repair or replacement of the ASME Code,Section XI.
Type Code Symbol Stamp N/A Certificate of Authorization No. N/A Expiration Date ,,IA/
Signed * * .. j_7 , Date ///Z/e'(
Owner or Owner's Designee, Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Arizona and employed by HSBI & I CO.
of Hartford, Connecticut , have inspected the components described in this Owner's Report during the period ___.-_- ___to _ _-_-__ , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code,Section XI.
By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
Commissions sNB 9685 "N" "I" Az 264 National Board, State, Province, and Endorsements (Ipector's Signature Date o2_ -200k 730P-BZZI 7 PV-E0092 Vet. 73DP-9ZZ17 Pv.E0092 ver. 66 BACK BACK
I ASME SECTION XI - REPAIR/REPLACEMENT I
- 1. Component ID 3MEWAE01 2. Code Class ASIVIE Section HI, C1 3
- 3. Item Description Essential Cooling Water Heat Exchanger "A"
- 4. N-5 Package Number 3EW01-1 5. W.O. Number 2430049
- 6. Original Construction Code Edition 1974 Edition thra W'75 Addenda
- 7. Original Installation Code Edition 1974 Edition thru W'75 Addenda
- 8. Work Description Weld material repair of the East end channel head and east and west end channel covers..
- 9. Q IS] Flaw NDE Method of Flaw Detection Report Number
- 10. Evaluation of the suitability of this work as per the requirements of IAW-4150.
Weld repair required after inspection of metal surfaces prior to periodic coating. Minor corrosion due to coating damage.
- 11. Repair/Replacement Work Organization APS
- 12. Replacement Item Construction or reconciled Code/Edition Sec. 1IH C1.3/'74 Eddition, W'75 Addenda g 13. Repair/Replacement Activity Construction Code/Edition Sec. Im CI.3/'74 Eddition, W'75 Addenda
- 14. ASME Section XI Code/Edition 1992 Edition and '92 Addenda
- 15. Pr ervice Inspection Required. [J YES . [ NO If required, include a step in the W.O. to perform Preservice Inspection.
f'*itaI Date
- 16. ASME Section XI Pressure Test Required [j YES [I NO (4,lyl If required, include a step in the W.O. for ISI &ANII Inspection.
n-aal Date a,/ . 17. Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
""O*,,/ 18. Include a step in the W.O. to record below all applicable numbers for repaired or 77Xhnltal D"*ate replaced items.
COMP I.D. PART NO. SERIAL NO. HEAT NO. MR/ROS NO.
3MEWAEO1 N/A N/A N/A N/A
- 19. Planner , _,//Print Name 44. r6-i t - - "Signature Date
- . ISI Engineer :, /C/016/10 Print Name /4 '4&.¶,. f-O'/O*c, gature Date
- 21. AN II . ,.8.. ,e ,* 4I"/ Print Name re.F -,--/,. A-Wre.,'-
"Signature /'Date PM-E0093 Vet. 5 73DP-9ZZ17
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
- 1. Owner Arizona Public Service Company, et. al. Date 10/06/01 Name P.O. Box 53999, Phoenix, Arizona 85072-2034 Sheet 1 of 2 Address
- 2. Plant Palo Verde Nuclear Generating Station Unit 3 Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 2430049 Address Work Order Number
- 3. Work Performed by Arizona Public Service Co. Type Code Symbol Stamp None Name Authorization No. N/A 5801 S. Wintersburg Rd. Tonopah, Arizona 85354-752S Expiration Date N/A Address
- 4. Identification of System (EW) Essential Cooling Water
- 5. (a) Applicable Construction Code Section III, Cl. 3 19 74 Edition, W'75 Addenda, Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 92 Edition, 1992 Addenda
- 6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Other Year Repaired, ASME Code Component Manufacturer Serial No. Board No. Identification Built Replaced or Stamped AE tEch StuhrWl 14Replacement Yes or No)
A EW Ht. Exch. Struther Wells 1760632913 14441 MEWAE01 '78 Repaired Yes
- 7. Description of Work Weld Material Repair
- 8. Test Conducted: Hydrostatic Ll Pneun natic *j Nominal Operating Pressure [] Exempt N-416-1 I*1 Other fj PressuJre psi Test Temp. OF NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8 1/2 x 11 in.,
(2) information in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.
PV-E092Ver.5 7DP-9Z1i PV-EO092 Ver. 5 73DP-97__Z17
FORM NIS-2 (Back)
- 9. Remarks Pressure test per N-416-1, Performed weld repair/build-up or erroded area designated by enginering in the Spray Pond side of the Heat Exchanger.
CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this repair conforms to the rules of the ASME Code, Section Xl. repair or replacement Type Code Symbol Stamp N /A Certificate of Authorization No. 4 /A- Expiration Date 1-/_'A Signed / b.. "'-'.,K n C'&- Date f lV _- 0 Owner or Owner's Designee, Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Arizona and employed by HSBI & I CO.
of Hartford, Connecticut , have inspected the components described in this Owner's Report during the period k- G- 0 k to ,o- ,* -o , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section Xl.
By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
______"____-_Commissions NB 9685 "N. "ItI"AZ264 lnbectors Signature National Board, State, Province, and Endorsements Date ,a P--o .- z'-i.
73DP*9ZZ1 7 PV-E0092 5 BACK Ver. 5 PV-Eoog2 Ver. BACK 73DP-gZZ17
ASME SECTION Xl - REPAIR/REPLACEMENT
- 1. Component ID 3PRCEL018, 3PRCEV244 2. Code Class ASMt Section Ji, C1I
- 3. Item Description Pzr spray line and installed check valve
- 4. N-5 Package Number 3RC03-2 5. W.O. Number 2431286
- 6. Original Construction Code Edition 1974 Edition, thru W'75 Addenda
- 7. Original Installation Code Edition 1974 Edition, thru W'75 Addenda of
- 8. Work Description Replace the installed check valve body (3PRCEV244) with new pipe per Appendix "A" ENG-DMWO #219184 and EDC #1998-00653.
- 10. Evaluation of the suitability of this work as per the requirements of IAW-4150.
Check Valve is being replaced to eliminate a RCS leak path from the pressure seal body to bonnet joint. No leak or flaw has been detected in the pressure boundary.
- 11. Repair/Replacement Work Organization Arizona Public Service
- 12. Replacement Item Construction or reconciled Code/Edition 1974 Edition, thru W'75 Addenda
- 13. Repair/Replacement Activity Construction Code/Edition 1974 Edition, thru W'75 Addenda
- 14. ASME Section XI Code/Edition 1992 Edition, '92 Addenda
- 15. Preservice Inspection Required. [a1 YES Ll NO DWS 10/14/01 If required, include a step in the W.O. to perform Preservice Inspection.
Initial Date
- 16. ASME Section XI Pressure Test Required ID YES [ NO DWS 10/14/01 If required, include a step in the W.O. for ISI & ANII Inspection.
Initial Date DWS 10/14/01 17. Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
Initial Date DWS 10/14/01 18. Include a step in the W.O. to record below all applicable numbers for repaired or Initial Date replacement items.
ITEM I.D. PART NO. SERIAL NO. HEAT NO. MRIROS NO.
4.0" PIPE N/A N/A OX/ 0 & 7
- 19. Planner /ae Print Name David Shaffer
/Signature ate
- 20. ISI Engineer _/ Print Name i~9Ati) /:7--T 7 Date/
/- inature
- 21. ANII -'- Print Name C.o,,gcE .
Si ,ature Date 7"* nlO0771*7 I
PV-E0093 Ver. 6 730P-9ZZ17
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
- 1. Owner Arizona Public Service Company, et. al. Date 10,/14/01 Narize P.O. Box 53999, Phoenix. Arizona 85072-2034 Sheet 1 of 2 Address
- 2. Plant Palo Verde Nuclear Generating Station Unit 3 Name 5801 S. Wintersbur2 Rd.. Tonopah, Arizona 85354-7529 2431286 Address Work Order Number APS Type Code Symbol Stamp None
- 3. Work Performed by Name Authorization No. N/A 5801 S. Wintersburg Rd. Tonopah, AZ. 85354-7529 Expiration Date N/A Address
- 4. Identification of System Reactor Coolant (RC)
- 5. (a) Applicable Construction Code Section II, Cl 1 19 74 Edition, W'75 Addenda, Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 92 Edition, 1992 Addenda
- 6. Identification of Components Repaired or Replaced and Replacement Components Other Year Repaired ASME Code Name of Name of Manufacturer National or Stamped (Yes or No)
Serial No. Board No. Identification Built Replacement Item Manufacturer 4.0" Pipe N/A N/A N/A 3PRCEL018 c. Replacement No
- 7. Description of Work Replace existing Pzr spray line check valve (3PRCEV244) with 4.0" pipe.
- 8. Test Conducted: Hydrostatic QJ Pneumatic QJ Nominal Operating Pressure [J Exempt [J N-416-1 I*
Other [J Pressure psi Test Temp. OF NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8 1/2 x 11 in.,
(2) information in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.
730P-9ZZ1 7 PV-E00g2 Ver.
Ver. 66 73DP-9ZZ17 PV-E0092
FORM NIS-2 (Back)
- 9. Remarks -DI-WO # 2431286.
CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this replacement conforms to the rules repair or replacement of the ASME Code, Section Xl.
Type Code Symbol Stamp N/A Certificate of Authorization No. N/A Expiration Date ,
Signed ,e L.*'ze.,A ?Ak- ,/ L/- --, ISI Engineer Date ,,/,z/*
Owner or Owners Designee, Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Arizona and employed by HSBI & I CO.
of Hartford, Connecticut , have inspected the components described in this Owner's Report during the period t-t--o to ,,-a-ok , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code,Section XI.
By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
Commissions NB 9685 "N" "I" AZ264
- spectoes Signature National Board, State, Province, and Endorsements Date ._ ., 20ook Zo,,.
7SDP-9ZZ17 BACK ver. 66 BACK PV-E0092 Ver.
PV-EO092 73DP-9ZZt7
ASME SECTION XI - REPAIR/REPLACEMENT
- 1. Component ID 3PSIAL241 2. Code Class 2
- 3. Item Description "A" TRAIN LPSI SUCTION PIPING FROM SHUT DOWN COOLING
- 4. N-5 Package Number 3SI07-3 5. W.O. Number 2431785
- 6. Original Construction Code Edition ASME SECT. III, CL2, 1974 EDITION '75 ADD
- 8. Work Description WELD REPAIR THE PIPING THAT WAS DAMAGED BY WELDING
- 10. Evaluation of the suitability of this work as per the requirements of IAW-4150.
A6C~I 4 ~r ~5/4yik -, &tng-) Z Z*I ('
Ic- /2-j',
- 11. Repair/Replacement Work Organization ARIZONA PUBLIC SERVICE 2 1974 EDITION W'75 ADD
- 12. Replacement Item Construction or reconciled Code/Edition ASME SECT. III, CL W'75 ADD
- 13. Repair/Replacement Activity Construction Code/Edition ASME SECT. III; CL 2 1974 EDITION
- 14. ASME Section XI Code/Edition ASME SECT. XI, 1992 EDITION 92 ADD
- 15. Preservice Inspection Required. n YES [* NO N/A 10/12/01 If required, include a step in the W.O. to perform Preservice Inspection.
Initial Date
- 16. ASME Section Xl Pressure Test Required [i YES [ NO JD 10/12/01 If required, include a step in the W.O. for ISI & ANII Inspection.
Initial Date JD 10/12/01 17. Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
Initial Dale JD 10/12/01 18. Include a step in the W.O. to record below all applicable numbers for repaired or Initial Date replacement items.
ITEM I.D. PART NO. SERIAL NO. HEAT NO. MR/RUS NO.
- 19. Planner 10/12/01 Print Name JAMES I.DAVIS Signature Date
/t/12/1e Print Name A-* ^,,rev k,*oV-*
- 20. ISI Engineer 5 '
Si ljture10,d-e 7r(,.$/_ cco9ate t.J/
I 21. ANII PV-E00g3 PV-EO093 Ver. 6
- /P z Signature Date Name ROBERT H TROM O 4eoa
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI 1.Owner Arizona Public Service Company, et. al. Date io - Q, - 0" Name P.O. Box 53999, Phoenix, Arizona 85072-2034 Sheet 1 of 2 Address
- 2. Plant Palo Verde Nuclear Generating Station Unit 3 Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 2431785 Address Work Order Number
- 3. Work Performed by Arizona Public Service Type Code Symbol Stamp None Name Authorization No. N/A 5801 S. Wintersburg Rd., Tonopah, Arizona 85 3 54-7 52S Expiration Date N/A Address
- 4. Identification of System Safety Injection
- 5. (a) Applicable Construction Code ASME Sec III, C1 2 19 74 Edition, S'75 Addenda, Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 92 Edition, 1992 Addenda
- 6. Identification of Components Repaired or Replaced and Replacement Components-
- Name of Name of " Manufacturer National Other Year Repaired ASME Code or Stamped Item Manufacturer Serial No. Board No. Identification Built lReplacement (Yes or No)
PIPE SPOOL PULLMAN POWER 9469 N/A 3PSIAL241 1978 Repaired Yes
- 7. Description of Work REPAIR THE WELDING ARC DAMAGE.
- 8. Test Conducted: Hydrostatic U " Pneumatic,'I Nominal Operatir ng Pressure [J Exempt [j N-416-1 Ej Other [J Pressure psi Test Temp. OF NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8 1/2 x 11 in.,
(2) information in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.
PV-E0092 Ver. 6 73DP-9ZZ17
FORM NIS-2 (Back)
- 9. Remarks Work Order 2431785 repaired the piping that was accidentally damaged by a welding arc strike.
The work order excavated the area, weld repaired and blended to the original contour.
CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this repair conforms to the rules of the ASME Code, Section Xl. repair or replacement Type Code Symbol Stamp A//A Certificate of Authorization No. I/M " Exjpiration Date /_//_4 Signed 4:::.;e $ '1"2 "5.r "Q'! '
f .
Date 1c1/.1of Owner or Owner's Designee, Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Arizona and employed by HSBI & I CO.
of Hartford. Connecticut , have inspected the components described in this Owner's Report during the period - to tO*--O* , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code,Section XI.
By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspecton.
Commissions - r-N3 , ',>2!,S
- -Y' -It"Az. 62" (3 Inspector's Signature National Board, State, Province, and Endorsements Date OcTor.FP-. 3. 2C6 73DP-gzzl 7 PV-E0092 Ver.
PV-E0092 BACK Ver. 66 BACK 73DP-9ZZ17
ASME SECTION Xi - REPAIR/REPLACEMENT
- 1. Component ID 3MEWBE01 2. Code Class ASME Section I-I, Cl 3
- 3. Item Description Essential Cooling Water Heat Exchanger "B"
- 4. N-5 Package Number 3EW02-2 5. W.O. Number 2433026
- 6. Original Construction Code Edition 1974 Edition thru W'75 Addenda
- 7. Original Installation Code Edition 1974 Edition w W'75 Addenda
- 8. Work Description Perform weld repairs to the West End Channel Head on the floor area.
- 9. [ISI Flaw NDE Method of Flaw Detection Report Number
- 10. Evaluation of the suitability of this work as per the requirements of IAW-4150.
Weld repair required after inspection of metal surfaces prior to periodic coating. Minor corrosion due to coating damage.
- 11. Repair/Replacement Work Organization APS
- 12. Replacement Item Construction or reconciled Code/Edition Sec.III Cl. 3 /74 Edition, W'75 Addenda
- 13. Repair/Replacement Activity Construction Code/Edition Sec.Ifl Cl. 3 /'74 Edition, W'75 Addenda
- 14. ASME Section XI Code/Edition 1992 Edition and '92 Addenda
- 15. Preservice Inspection Required. i1 YES 1 NO Ai,
- 10/17/01 If required, include a step in the W.O. to perform Preservice Inspection.
Initial Date
- 16. API0E Section XI Pressure Test Required [Ej YES Li NO
ýý 10/17/01 If required, include a step in the W.O. for ISI &ANII Inspection.
i tal I Date
,AZl~~10/17/01 17. Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
1 at Date 10/17/01 18. Include a step in the W.O. to record below all applicable numbers for repaired or "rInitial Date replacement items.
ITEM I.D. PART NO. SERIAL NO. HEAT NO. MR/ROS NO.
3MEWBE01 N/A N/A N/A N/A
- 19. Planner _C) I (7 o Print Name Glenn E. Moore
- ' tu e Date
- 20. ISI Engine ' Print Name Wiley J.Ahlstrom
'.-/,-"
Signature
- 21. ANII ,-C Print Name Robert G. Hogstrom Signature Date PV-EGO93 Vet. 6 73DP-DZZ17
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Date 10/17/01
- 1. Owner Arizona Public Service Company, et. al.
Nan02e P.O. Box 53999. Phoenix. Arizona 85072-2034 Sheet 1 of 2
_ L Address Unit 3
- 2. Plant Palo Verde Nuclear Generating Station Name 2433026 5801 S. Wintersburg Rd., Tonopah,_Arizona 85354-7529 Address Work Order Number Type Code Symbol Stamp None
- 3. Work Performed by Arizona Public Service Co.
Name Authorization No. N/A Expiration Date N/A 5801 S. Wintersburg Rd. Tonopah, Arizona 85354-7529 Address
- 4. Identification of System (EW) Essential Coolifig Water 19 74 Edition, W'75 Addenda, Code Case
- 5. (a) Applicable Construction Code Section III, C1.3 (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 92 Edition, 1992 Addenda
- 6. Identification of Components Repaired or Replaced and Replacement Components I,'
Name of Name of Manufacturer National Other Year Repaired or Stamped Item Serial No. Board No. Identification Built Reolacement (Yes or No)
Manufacturer B EW Ht. Exch. Struthers Wells 17606329152 N/A MEWBE01 80 Repaired Yes
- 7. Description of Work Hydrostatic Ij Pneumatic [*j Nominal Operating Pressure [j Exempt fJ N-416-1
- 8. Test Conducted:
Other QJ Pressure psi Test Temp. _OF NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8 1/2 x 11 in.,
(2) information in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.
73DP-9ZZ17 PV-E0092 Ver. 6
FORM NIS-2 (Back)
- 9. Remarks Pressure test N-416-1, Performed weld repair/build-up of erroded area designated by engineering in the Spray Pond side of the Heat Exchanger. ( wv,. o- ? 3?*0 2 9)
CERTIFICATE OF COMPLIANCE conforms to the rules We certify that the statements made in the report are correct and this repair repair or replacement of the ASME Code,Section XI.
Type Code Symbol Stamp ,VfA Certificate of Authorization No. Expiration Date A//
Signed z ý O1OsDe "r11e Date Lo/Z Y1201 owner or Owner's Designee, Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Arizona and employed by HSBI & I CO.
of Hartford, Connecticut , have inspected the components described in this Owner's Report during the period 0-0i-ok to to .Zs-OC, , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section X1.
By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
Commissions NB 9685 "N` AZ264 ots-*Signature r's National Board, State, Province, and Endorsements Date caLz £ 73DP.gzzl 7 73DP-gZZ17 PV-E0092 Ver. 6 BACK
ASME SECTION XI- REPAIR/REPLACEMENT
- 1. Component ID 3JRCBHV0108 2. Code Class ASME SECTION ml CLASS 1
- 3. Item Description 1 INCH SOENOID OPERATED VALVE MODEL 98F-001 (TARGET ROCK)
- 4. N-5 Package Number 3-RC03-3 5. W.O. Number SWMS#00-00219434
- 6. Original Construction Code Edition 1977 EDITION, ADDENDA WINTER 1978
- 7. Original Installation Code Edition 1974 EDITION, ADDENDA WINTER 1974
- 8. Work Description REMOVE AND REPLACE VALVE PER PLANT CHANGE TO NEW STYLE VALVE 1 INCH MODEL# 98F-001
- 9. LISI Flaw NDE Method of Flaw Detection Report Number
- 10. Evaluation of the suitability of this work as per the requirements of IAW-41.50.
BEING REPLACED PER PLANT CHANGE. NO FAILURE OF ASME SECTION Ml BOUNDRY.
5 eeg S W mS ýZlIttWS!.) 6 (Q,
- 11. Repair/Replacement Work Organization APS
- 12. Replacement Item Construction or reconciled Code/Edition 1977 EDITION, ADDENDA WINTER 1978
- 13. Repair/Replacement Activity Construction Code/Edition 1974 EDITION, ADDENDA WINTER 1974
- 14. ASME Section XI Code/Edition 1992 EDITION, ADDENDA 1992
- 15. Preservice Inspection Required. [i YES [j NO n
Initial 9/c/il/b&
Date Ifrequired, include a step in the W.O. to perform Preservice Inspection.
- 16. ASME Section XI Pressure Test Required ij YES Ei NO
, C*.91Zy1"* n If required, include a step in the W.O. for ISI &ANII Inspection.
Initial Dale Vo S9/*Z rj17. Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
Initial ~Date 9 p//jZ 7n 18. Include a step in the W.O. to record below all applicable numbers for repaired or Initial Date replacement items.
ITEM I.D. PART NO. SERIAL NO. HEAT NO. MR/ROS NO.
3JRCBHV0108 98F-001 -0 -cc>otO 1,%3____-,
9//Q/,4
"[ate
" - Print Name GERALD OSMUNDSON a
_____ Print Name 4-N-DA Date
'-1-2%-O0 Print Name *. (.
73OP-9ZZ17 PV-EO0O3 Vet. 6 Vet.6 PV-E0093 73DP-gZZ17
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS Code Secti on X1 As Required by the Provisions of the ASMVE
-Date 09120/00
- 1. Owner Arizona Public Service Company, et. al.
Name Sheet 1 of 2 P.O. Box 53999, Phoenix, Address Arizona 85072-2034 Unit 3 Plant Palo Verde Nuclear Generating Station Name000293 2.
_ 00-00219434 5801 S. Wintersburg Rd., Address Tonopah, Arizona 85354-7529
- 3. Work Performed by APS Type Code Symbol Stamp None Authorization No. N/A Expiration Date N/A 5801 S Wintersburg Rd, Tonopah, Address Arizona 85354-7529 CLASS 1
- 4. Identification of System RC, ASME SECTION III, Case Section III, CLASS 1 19 74 Edition, 75W Addenda, _Code
- 5. (a) Applicable Construction Code 19 92 Edition, 1992 Addenda for Repairs or Replacements (b) Applicable Edition of Section Xl Utilized or Replaced and Replacement Components
- 6. Identification of Components Repaired Stm e Other Year Repae Name of Manufacturer National Name of Item Manufacturer Serial No. Board No. Identification Built Re lacement Yes or No 3jrcbhv108 Replacement -s VALVE Target Rock .N/A INCH 1 valve model# 98F-001 valveand install new style
- 7. Description of Work Remove Exempt [a N-416-1 U Pneumatic {J Nominal Operating Pressure [j
- 8. Test Conducted: Hydrostatic [*
psi Test Temp. __OF Other UIJ Pressure size is 8 1/2 x 11 in.,
ih form of lists, sketches, or drawings may be used, provided (1)
NOTE: Supplemental sheets (3) each sheet is numbered and in items 1 through 6 on this report is included on each sheet, and (2) information top of this form.
the number of sheets is recorded at the 73DP.9ZZ17 PV-E0092 Ver. 6
FORM NIS-2 (Back)
- 9. Remarks Jq.c. -
CERTIFICATE OF COMPLIANCE to the rules made in the report are correct and this replacement conforms We certify that the statements repair or replacement of the ASME Code, Section X1.
Type Code Symbol Stamp
_ Expiration Date _
Certificate of Authorization No. ___
52?- r. , " Date Signed 1 *%$ý"
Owner or Owners Designee. Title INSPECTION CERTIFICATE OF INSERVICE and Pressure Vessel holding a valid commission issued by the National Board of Boiler I, the undersigned, - HSBI & CO. I _
the State or Province of Arizona and employed by during Inspectors and described in this Owner's Report have inspected the nvecomponents Sut and of Hrtford Connecicut.r ,
ispectd thoconenent and
, state that to the best of my knowledge the period C-- nec o t to in this Owner's has performed examinations and taken corrective measures described belief, the Owner of the ASME Code, Section Xl.
Report in accordance with the requirements expressed or implied, certificate, neither the Inspector nor his employer makes any warranty, By signing this this Owner's Report. Furthermore, corrective measures described in concerning the examinations and injury or property Inspector nor his employer shall be liable in any manner for any personal neither the from or connected with this inspection.
damage or a loss of any kind arising
'- k 2LA Commissions and National Board, State, Province, Inspector's Signature Date 3o-o C,.
730P.9ZZ17 PV-E0092 Ver. 6 BACK
I I
I ASME SECTION XI - REPAIR/REPLACEMENT
- 1. Component ID 3JRCBHV0 109 2. Code Class ASME SECTION III CLASS 1 MODEL 98F-001 (TARGET ROCK) 3, Item Description 1 INCH SOENOID OPERATED VALVE 35 Number 3-RC03-3 5. W.O. Number SWMS#00-002194
- 4. N-5 Package WINTER 1978
- 6. Original Construction Code Edition 1977 EDITION, ADDENDAWINTER4974 ADDENDA Edition 1974 EDITION,
- 7. Original Installation Code PLANT CHANGE TO NEW STYLE VALVE
- 8. Work Description REMOVE AND REPLACE VALVE PER 1 INCH MODEL# 98F-001
- 10. Evaluation of the suitability of this work as per the requirements OF ASME SECTION III BOUNDRY.
BEING REPLACED PER PLANT CHANGE. NO FAILURE
- 11. Repair/Replacement Work Organization APS
-97 TA, H'Ot
- 12. Replacement Item Construction or reconciled Code/Edition ADDENDA WINTER497+ t97-
'3 Renair/Replacement Activity Construction Code/Edition 1974 EDITION, I 14. ASME Section Xl Code/Edition 1992 EDITION, ADDENDA 1992 U YES @ NO
- 15. Preservice Inspection Required.
Inspection.
I-_/ 9/f Vtuei Ifrequired, include a step in the W.O. to perform Preservice
[* YES [D NO
- 16. ASME Section XI Pressure Test Required If required, include a step in the W.O. for IS[Nam;!ia- & ANII Inspection.
IE IlD.P eat4e to complete NIS-2 Form prior to releasing the component.
20/.Tý00_ /VoSelC/]
17.
18.
Include include a
a step step in in the the W.O.
W.O. to record below all applicable numbers for repaired Or Iiv<aY -- Date Iiil / bat4 replacement items, HEAT NO. MRIHOS NOu.
ITEM I.D. PART NO. SERIAL NO.
""dA 66 7 .od 3JRCBH-V0109 98F-00
- 19. Planner..,' Date Prn Name GERLDStooS
- " - --- " Signature-P rint Name."** " '-
- Lafl
?J!tz
- 20. ISI Engineer.
DateJ**
-Z-o Print Name .,* e.-
211 ANII ". , -. ,
7ZS naur I -730P-gZZ17 PV-EO093 Ver. 6
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
- 1. Owner Arizona Public Service Company, et. al. Date 09/20/00 Name Sheet 1 of 2 P.O. Box 53999, Phoenix, Arizona 85072-2034 Address
- 2. Plant Palo Verde Nuclear Generating Station Unit 3 Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 00-00219435 Address Work Order Number Type Code Symbol Stamp None
- 3. Work Performed by APS Name Authorization No. N/A Expiration Date N/A 5801 S Wintersburg Rd, Tonopah, Arizona 85354-7529 Address
- 4. Identification of System RC, ASME SECTION III, CLASS 1 Section III, CLASS 1 19 74 Edition, 75W Addenda, Code Case
- 5. (a) Applicable Construction Code (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 92 Edition, 1992 Addenda
- 6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Other Year Repaired ASME CodE Item Manufacturer Serial No. Board No. Identification Built Replacement (Yes or No Target Rock -7 N/A 3jrcbhv0109 zec Replacement '&v, VALVE
- 7. Description of Work Remove valve and install new style 1 INCH valve model# 98F-001 Hydrostatic [J Pneumatic tJ Nominal Operating Pressure [ Exempt [* N-416-1 [
- 8. Test Conducted:
Pressure psi Test Temp. OF Other
- size is 8 1/2 x 11 in.,
NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) and (2) information in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered the number of sheets is recorded at the top of this form.
73DP-9ZZ17 PV-E0092 Ver. 6
FORM NIS-2 (Back) 0 Pommrte ,Ie- rf'-Y- in a CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this replacement conforms to the rules repair or replacement of the ASME Code,Section XI.
Type Code Symbol Stamp__/__
Certificate of tAuorization No. A/.//,. Expiration Date N/A Signed ,,S" z---- /- '-
V Date /O-,,q8--C/
-7 r/ Owner or Owner's Designee. Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Arizona and employed by HSBI & I CO.
of Hartford, Connecticut , have inspected the components described in this Owner's Report during the period R-a.-oo to to- a-o , and state that to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section Xl.
By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
Commissions "P ,.cS --" -I" A,-*- Zc" National Board, State, Province, and Endorsements
-o s Signature Datector.
Date Oc-rorwr,E? M, t200 73DP-gZZ17 PV-EO092 Ver. 6 BACK
ASME SECTION X - REPAIRIREPLACEMENT
- 2. Code Class ASME III, NF / CLASS 2 Component ID 3S1067H003
- 3. Item Description SNUBBER 5.., W.O. Number #684229
- 4. N-5 Package Number 3S107-3
- 6. Original Construction Code Edition 1974 Edition,Winter 1975 Addenda
- 7. Original Installation Code Edition 1974 Edition, Winter 1975 Addenda Work Description Replacement of snubber with Rigid Strut.
8.
- 10. Evaluation of the suitability of this T'eplaced with Rigid Strut.
Design Mod. I.A.W. EDC# 94-00467. Snubber-being
. APS:
- 11. Repair/Replacement Work Organization 2 /74 Edition.'75 Winter Addenda Code/Edition SubsectionNF, Class
- 12. Replacement Item Construction Code/Edition Same as (Item#12)
- 13. Repair/Replacement Activity Construction 2 1992 Edition_,_.99 Addenda
- 14. ASME Section XI Code/Edition
.Preservice Inspection
- V c-- - & 15. Include step in the W.O. to perform Initial Date copy of this form to ISI Group.
Zx,: C ) g- 'x 16. Include a step in the *W.O. to send'completed Date Form prior to releasing the component.
Initial 2
,* c- 17. Include a step in the W.O. to completeWNlS-Initial Date all applicable numbers.
__Q 0 -b 9 18. Include step in the W.O. to record below Initial Date HEAT NO. ROSIEROS NO.
PART NO. SERIAl NO.
COMP I.D. PLO182621 29 N/A N/A Strut#3961 13687 3S1067H003 N/AROS#904 Rear Bracket #356959 N/A .
4 63 N/A PL0182621 Pipe Clamp#36 1 N/A .
- f I P) .Print Name J. Cruse
- 19. Planner Print Name
'9. Pla Engineer__________________________
Signature Date ANI ,21. Print Name__________________
Signature Date7DPgZ7 t'V-E0093Vet. I
I FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section X1 Owner Arizona Public Service Company, et. al. .Date 08/06/98 Name P. 0. Box 53999, Phoenix, Arizona 85072-2034 Sheet 1 of 2 Address
- 2. Plant Palo Verde Nuclear Generating Station Unit 3 Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 W.O.#684229 Address Repair Organization P.O. No., Job No., etc.
- 3. Work Performed by APS Type Code Symbol Stamp None Name Authorization No. N/A Same as (Item#2) Expiration Date N/A Address
- 4. Identification of System SI
- 5. (a) Applicable Construction Code ASME III,,NF / CL 2 1974 Edition, '75W Addenda, N/A Code Case (b) Applicable Edition of Section Xl Utilized for Repairs or Replacements 1992 Edition, 1992 Addenda
- 6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Other Year Repaired, ASME Code Replaced or Stamped Component Manufacturer Serial No. Board No. Identification Built Replacement (Yes or No) igid Strut Lisega N/A N/A 3SI067H003 l2L7 01 Replacement No Rear Bracket Lisega N/A N/A 3SI067H003 U0*?13- Replacement No Pipe Clamp Lisega N/A N/A 3S1067H003 2 I.001 Replacement No
- 7. Description of Work Replacement of snubber with Rigid Strut.
- 8. Test Conducted: Hydrostatic [,J Pneumatic 1 Nominal Operating Pressure N-416-1 Exempt [A Other 1- Pressure psi Test Temp. oF INOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8 1/2 x 11 in.,
(2) information in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.
PV-ED092 Ver, 1 73DP-97Z-I7
FORM NIS-2 (Back)
.. Remarks W.O>#6 84229 3-S1-06.
3-SI-067-HOO3 Rear End Bracket welding was done on 06-20-97 under ASME Section XI /'80 W '81 CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this replacement conforms to the rules repair or replacement of the ASME Code, Section Xl.
Type Code Symbol Stamp N/A Certificate of Authorization No. N/A Expiration Date N/A Date -*30 /
(Zi ZIned I- . P--
/ Owner or Owner's Designee, Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Arizona and employed by HSBI & I CO.
of Hartford, Connecticut , have inspected the components described in this Owner's Report during the period e_*.
- to ,o- - , and state that to the best of my knowledge and and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code,Section XI.
By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
Commissions " ,z 2(- q*g
- <KZ~
- 6 Dectors Siqnature / ,,,., National Board, State, Province, and Endorsements I
PV-E0092 Ver. I BACK 11-9-17
ASME SECTION XI - REPAIR/REPLACEMENT Component ID 3CH142H003 2. Code Class ASME III ,NF/CLASS 2
- 3. Item Description SNUBBER
- 4. N-5 Package Number 3CH02-5 5. W.O. Number #684229
- 6. Original Construction Code Edition 1974 Edition,Winter 1975 Addenda
- 7. Original Installation Code Edition 1974 Edition, Winter 1975 Addenda
- 8. Work Description Replacement of snubber with Rigid Strut.
- Report Number
- 10. Evaluation of the suitability of this work as per the requirements of IWA-4150.
Design Mod. I.A.W. EDC #94-00467. Snubber being replaced with Rigid Strut.
- 11. Repair/Replacement Work Organization . APS
- 12. Replacement Item Construction Code/Edition Subsection NF, Class 2 / 74 Edition.'75 Winter Addenda
- 13. Repair/Replacement Activity Construction Code/Edition Same as (Item#12)
- 14. ASME Section XI Code/Edition 1992 Edition 1992 Addenda
- 3* , c. Q.t 15. Include step in the W.O. to perform Preservice Inspection Initial Date
- "* ' 9-/* 16. Include a step in the W.O. to send completed copy of this form to ISl Group.
Initial Date
- T, c.. 9 -/-?-q-e 17. Include a step in the W.O. to complete.NIS-2 Form prior to releasing the component.
Initial Date
- "
- q ..--
7 -'18 18. Include step in the W.O. to record below all applicable numbers.
Initial Date COMP I.D. PART NO. SERIAL NO. HEAT NO. ROS/EROS NO.
3CH142H003 Strut #3962RR1 N/A N/A ROS#L4R-"8-26-2i
- 19. PlanneN ., .. 1 t.,.-_P- Print Name J. Cruse Signature Date ISI Engineer "T I c--' g Print Name _______--_-___
Signature ýJ Date
- 21. ANII i 4$7A, - Print Name Z"6. l{*'*sDrzoe LLsignature Date PV-EOOF)3Vr., I 73DP-SZZ17
REPAIRS OR REPLACEMENTS FORM NIS-2 OWNER'S REPORT FOR Code Section X1 As Required by the Provisions of the ASME Date 08/06/98 Name et. al.
Owner Arizona Public Service Company, Sheet 1 of 2 P. O. Box 53999, Phoenix, Arizona Address 850 7 2 -2 03 4 U i Unit 3
- 2. Plant Palo Verde Nuclear GeneratingNameStation Arizona 85354-7529 W.O.#684229 5801 S. Wintersburg Rd., Tonopah, Address Repair Organization P.O. No., Job No., etc.
APS Type Code Symbol Stamp None
- 3. Work Performed by Name Authorization No. N/A Expiration Date N/A Same as (ItemgQ SI
- 4. Identification of System Case Code ASME III, NF / CL 2 1974 Edition, '75W Addenda, N/A Code
- 5. (a) Applicable Construction 1992 Addenda for Repairs or Replacements 1992 Edition, (b) Applicable Edition of Section XI Utilized or Replaced and Replacement Components
- 6. Identification of Components Repaired Other Yea RepaIed ASME Code Name of Name of Manufacturer National Built Replacement (Yes or No)
Manufacturer Serial No. Board No. Identification Component Replacement No N/A N/A 3CH142H003
":,id Strut Lisega 4 67 Replacement of snubber with Rigid Strut I.A.W. EDC#94-00
- 7. Description of Work J Pneumatic j Nominal Operating Pressure j N-416-1
- 8. Test Conducted: Hydrostatic psi Test Temp. ._'17 Exempt jl Other , Pressure _
provided (1) size is 8 1/2 x 11 in.,
in form of lists, sketches, or drawings may be used, NOTE: Supplemental sheets is numbered and the 6 on this report is included on each sheet, and (3) each sheet (2) information in items 1 through of this form.
number of sheets is recorded at the top 730P.9ZZ17 PV-E0092 Ver. I
FORM NIS-2 (Back)
- 9. Remarks W.O.#684229 3CH1 42H003 CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this replacement conforms to the rules of the ASME Code,Section XI. repair or replacement Type Code Symbol Stamp N/A Certificate of Authorization N9. N/A Expiratior 3 Date N/A Signed _ /5/' &(- t: Date-/,-? .- C' Owner or Owner's Designee, Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Arizona and employed by HSBI & I CO.
of Hartford, Connecticut , have inspected the components described in this Owner's Report during the period __-__-, __to ,o-,-o* , and state that to the best of my knowledge and and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section Xl.
By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
-:7 1i Z- Commissions ,.) 6 " Az A"
%i.nspectors Signature National Board, State. Province. and Endorsements 0/ .t3Ct V
Date T0-ro .- '3 730P-eZZlT PV-E0092 Vet- iI PV-EO092 Vr eACK BACK 730P-OZ717
ASME SECTION XI - REPAIRIREPLACEMENT
- 2. Code Class ASME III, NF / CLASS 2 Component ID 3CH424H002
- 3. Item Description Snubber
- 5. W.O. Number #684229
- 4. N-5 Package Number 3SI01-1
- 6. Original Construction Code Edition 1974 Edition,Winter 1975 Addenda
- 7. Original Installation Code Edition 197, AdtoinVwinter 1975 Addenda Rigid Strut.
- 8. Work Description Replacement of snubber with
- 10. Evaluation of the suitability of this work as per Design Mod. I.A.W. EDC#94-00467. Snubber being replaced with Rigid Strut.
- 11. Repair/Replacement Work Organization Addenda Subsection NF, Class 2 / 74 Edition '75 Winter
- 12. Replacement Item Construction Code/Edition Same as (Item#12)
- 13. Repair/Replacement Activity Construction Code/Edition Addenda
- 14. ASME Section XI Code/Edition 1992 Edition,1992
. ._15. Include step in the W.O. to performýPreservice Inspection Initial Date Group.
, c D-) t"7-7.°tj 16. Include a step in the W.O. to send completed copy of this form to lSI Initial Date prior to releasing the component.
)YDInitial< "I Date
- 17. Include a step in the W.O. to complete NIS-2 Form
-' . -i9 1k18. Include step in the W.O. to record below all applicable numbers.
Initial Date HEAT NO. ROSIEROS NO.
PART NO. SERIAL NO.
COMP I.D. 90S04136;1; N/A N/A 3CH424H002 Strut #395049 Rear Bracket #35 5959 N/A N/A Rear Bracket#3559 59 N/A N/A C -,-.% Print Name J. Cruse
- 19. Planne,- . _.
Signature Date Print Name i;'C- t11P4
-0. ISI Engineer
!I- -Print ,N-, Name . - o& .ot,
- 21. Date Signature 730P-gZZ17 PV-E0093 Vet. 1
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Owner Arizona Public Service Company, et. al. Date 08/06/98 Name Sheet 1 of 2 P. 0. Box 53999, Phoenix, Arizona 85072-2034 Address Unit 3
- 2. Plant Palo Verde Nuclear Generating Station Address Name Arizona 85354-7529 W.O.#684229 5801 S. Wintersburg Rd., Tonopah,aoress Repair Organization P.O. No., Job No., eta APS' Type Code Symbol Stamp None
- 3. Work Performed by N/A Name Authorization No.
Expiration Date N/A Samne as (Ltem#2)
Address
- 5. (a) Applicable Construction Code ASME III, NF / CL 2 1974 Edition, '75W Addenda, N/A Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1992 Edition, 1992 Addenda
- 6. Identification of Components Repaired or Replaced and Replacement Components Other Year Repaired,or ASME StampedCode Name of Name of Manufacturer National Replaced Component Manufacturer Serial No. Board No. Identification Built Replacement (YesorNo)
Lisega N/A N/A 3CH424H002 ,01 Replacement No
",,gid Strut Lisega N/A N/A 3CH424H002 1(1 Replacement No Rear Brackets
- 7. Description of Work Replacement of snubber with Rigid Strut I.A.W. EDC#94-00467 Nominal Operating Pressure N-416-1 j
- 8. Test Conducted: Hydrostatic J Pneumatic OF Exempt F Other 1 Pressure psi Test Temp.
INOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8 1/2 x 11 in.,
(2) information in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form. i3P9Z PV.5 V73DP-e7Z. 7 PV.EOg02 Vet. I
FORM NIS-2 (Back)
- 9. Remarks W.O.#684229 3CH424H002 CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this replacement conforms to the rules repair or replacement of the ASME Code,Section XI.
Type Code Symbol Stamp N/A Expiration Date N/A Certificate of Authorization No. N/A Signed _5/ 2t-'4-,---i Date ,-,---'
6 Owner or Owner's Designee, Title CERTIFICATE OF INSERVICE INSPECTION Vessel I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Arizona and employed by HSBI & I CO.
Inspectors and the State or Province of of Hartford, Connecticut , have inspected the components described in this Owner's Report during the period ,_-(--,__
_____ to ,o-,.-o* and state that to the best of my knowledge and this Owner's and belief, the Owner has performed examinations and taken corrective measures described in Report in accordance with the requirements of the ASME Code,Section XI.
or implied, By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed concerning the examinations and corrective measures described in this Owner's Report. Furthermore, property neither the Inspector nor his employer shall be liable in any manner for any personal injury or damage or a loss of any kind arising from or connected with this inspection.
- '* " Inspectors Signature Commissions ,P ,* - - ." -1" ,A7 26c(
National Board, State, Province, and Endorsements Date D[
!PV-E0092 Ver. 1 BACK 73OP-OW117
ASME SECTION XI - REPAIR/REPLACEMENT Component ID 3CH424H003 2. Code Class ASME III, NF / CLASS 2
- 3. Item Description Snubber
- 4. N-5 Package Number 3SI01-1 5. W.O. Number #684229
- 6. Original Construction Code Edition 1974 Edition,Winter 1975 Addenda
- 7. Original Installation Code Edition 1974 Edition, Winter 1975 Addenda
- 8. Work Description Replacement of snubber with Rigid Strut
- 10. Evaluation of the suitability of this work as per the requirements of IWA-4150.
Design Mod. I.A.W. EDC#94-00467. Snubber being replaced with Rigid Strut.
- 11. Repair/Replacement Work Organization APS
- 12. Replacement Item Construction Code/Edition Subsection NF, Class 2 / 74 Edition.'75 Winter Addenda
- 13. Repair/Replacement Activity Construction Code/Edition Same as (Item#12)
- 14. ASME Section Xl Code/Edition 1992 Edition, 1992 Addenda
) -- 7- 15. Include step in the W.O. to perform Preservice Inspection Initial Date
_-'_ _ ot - 16. Include a step in the W.O. to send completed copy of this form to ISI Group.
Initial Date
- - - "7.- c,, 17. Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
Initial Date
-'5 _- 'I - C-O 18. Include step in the W.O. to record below all applicable numbers.
Initial Date COMP I.D. PART NO. SERIAL NO. HEAT NO. ROSIEROS NO.
3RCH424H03 Strut #396079 N/A N/A ROS#90413682 Rear Bracket #356959 N/A N/A PL0039445 Pipe Clamp #375161 N/A N/A PL0182621 I 4. I t I. I t i I. I I I. I - I I F F I
- 4. 1 1 I
--L/L--t .
- 19. Planner 19.A,'..7.w,-_----Y nr- ' .
- q -K./? Print Name J. Cruse Signature Date
- 1. IS. Engineer - 6..9 Print Name R ,-il-7 )AP-Date Signature Print Name Q?. 6 o. -rf*.,.4 I21. ANII I i gn r Data Dnln 73DP-9ZZ1 7 PV-EOag3 Ver. I 7
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section Xl Owner Arizona Public Service Company, et. al. Date 08/06/98 Name P. 0. Box 53999, Phoenix, Arizona 85072-2034 Sheet 1 of 2 Address Unit 3
- 2. Plant Palo Verde Nuclear Generating Station Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 W.O.#684229 Address Repair Organization P.O. No., Job No., etc.
- 3. Work Performed by APS Type Code Symbol Stamp None Name Authorization No. N/A Same as (Itemn#2) Expiration Date N/A Address
- 4. Identification of System ISI
- 5. (a) Applicable Construction Code ASME III,NF / CL 2 1974 Edition, '75W Addenda, N/A Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1992 Edition, 1992 Addenda
- 6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Other Year Repaired, Replaced or ASME Code Stamped Component Manufacturer Serial No. Board No. Identification Built Replacement (Yes or No) orid Strut Lisega N/A N/A 3CH424H003 2al Replacement No Rear Bracket Lisega N/A N/A 3CH424H003 ,J(l Replacement No Pipe Clamp Lisega N/A N/A 3CH424H003 2JL Replacement No
_____ _____ 1.____ ___ ____ __ ____ ___
4 t t
________________ I ________________ L____________ .i _________ S
- 7. Description of Work Replacement of Snubber with Rigid Strut I.A.W.EDC#94-00467 HydrostaticFj N-416-1
- 8. Test Conducted: Pneumatic IF Nominal Operating Pressure J
.F Exempt FA Other j Pressure psi Test Temp.
NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8 1/2 x I1 in.,
! (2) information in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.
I.PV-E0092 Ver. 1 73DP]-SZZ17
FORM NIS-2 (Back)
J,. Remarks W.O.#684229 3CH424H003 CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this replacement conforms to the rules repair or replacement of the ASME Code,Section XI.
Type Code Symbol Stamp N/A Certificate of Authoriza tion No. N/A Expiration Date N/A hyi/-.fj ,S"* d-sx'i1 *-/*i *A0-/.4*,Date le',--5-"
Signed Owner or Owner's Designee, Tille CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Arizona and employed by HSBI & I CO.
of Hartford, Connecticut , have inspected the components described in this Owner's Report during the period tz.- - to ,.- 1-t -o0 , and state that to the best of my knowledge and and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code,Section XI.
By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
Commissions . -'Z",
- i. .. ," 2i, i,'-4Le c hz / National Board. State, Province, and Endorsements IPV-E0092 Ver. I BACK 73DP-OZZ17/
II ASME SECTION XI - REPAIR/REPLACEMENT
- 2. Code Class ASME III, NF / CLASS 2 Component ID 3S1002H002
- 4. N-5 Package Number Addenda
- 6. Original Construction Code Edition 1974 Edition, Winter 1975
- 7. Original Installation Code Edition 1974 Edition, Winter 1975 Addenda
- 8. Work Description Replacement of Snubber with Rigid Strut.
- 10. Evaluation of the suitability of this work as per the with Rigid Strut.
replaced Design Mod. I.A.W. EDC#94-00467.Snubber being APS
- 11. Repair/Replacement Work Organization NF, Class 2 / 74 Edition.'75 Winter Addenda
- 12. Replacement Item Construction Code/Edition Subsectiion Same as (Item#12)
- 13. Repair/Replacement Activity Construction Code/Edition Addenda 114. ASME Section X1 Code/Edition 1992 Edition, 1992
"- . -- -- 15. Include step in the W.O. to perform Preservice Inspection Initial Date T-p.c. -- (q 16. Include a step in the W.O. to send completed copy of this form to IS Group.
Initial Date the component.
C *-t 17. Include a step in the W.O. to complete NIS-2 Form prior to releasing Initial Date numbers.
ai-DQ. Y-" -t9 18. Include step in the W.O. to record below all applicable Initial Date SERIAL NO. HEAT NO. ROSIEROS NO.
COMP I.D. PART NO.
N/A TL 64 % 0 3S1002H002 Strut # 396049RR1 N/A
__ . 9--19 Date
, Print Name J. Cruse
'*" qf*TL* *"Print Name o*" *" "4- 2AP Date Dae Print Name 2&
- 21. ANII Date I Signature 730P.gZZ177 PV-EO093Ver.1
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS XI by the Provisions of the ASME Code Section As Required Owner Arizona Public Service Company, et. al. Date 08/07/98 Name P. 0. Box 53999, Phoenix, Arizona 85072-2034 Sheet 1 of 2 Address
- 2. Plant Palo Verde Nuclear Generating Station Unit 3 Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 W.O.#684229 Address Repair Organization P.O. No., Job No., etc.
- 3. Work Performed by APS Type Code Symbol Stamp None Name Authorization No. N/A Same as (Item# 2) Expiration Date N/A Address
- 4. Identification of System SI Code Case
- 5. (a) Applicable Construction Code ASME III, NF / CL 2 1974 Edition, '75W Addenda, N/A (b) Applicable Edition of Section Xl Utilized for Repairs or Replacements 1992 Edition, 1992 Addenda
- 6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Other Year Repaired, ASME Code Replaced or Stamped Component Manufacturer Serial No. Board No. Identification Built Replacement (Yes or No)
"gid Strut Lisega N/A N/A 3SI002H002 7j,01 Replacement No
- 7. Description of Work Replacement of Snubber with Rigid Strut.
- 8. Test Conducted: Hydrostatic I-I Pneumatic j Nominal Operating Pressure AJ N-416-1 FA Exempt 21 Other J Pressure psi Test Temp. __OF 8 1/2 x 11 in.,
"NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is sheet, and (3) each sheet is numbered and the (2) information in items 1 through 6 on this report is included on each number of sheets is recorded at the top of this form.
73DP-9ZZ17 PV-EO092 Vet. 1
I FORM NIS-2 (Back)
I
- 9. Remarks W.O.#684229 3SI002H002 CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this replacement conforms to the rules repair or replacement of the ASME Code,Section XI.
Type Code Symbol Stamp N/A Certifircate of Authorization No. N/A Expiration Date N/A sJ~i r isr Date lo-/'3 ,
ýJ Owner or Owners tjesignee, title owner or owner's Designee, I ille CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Arizona and employed by HSBI & I CO.
of Hartford, Connecticut , have inspected the components described in this Owner's Report during the period - to c-,-cA , and state that to the best of my knowledge and Owner's and belief, the Owner has performed examinations and taken corrective measures described in this Report in accordance with the requirements of the ASME Code,Section XI.
or implied, By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
t ?:pector's Signature .1 ,
Commissions -, 6ýs 1 IiY, k" 26.3, National Board, State, Province, and Endorsements Date A-
)c~-to, I. .2C0(
I 73DP.SZZ17 7
PVoE0092 Ver. 1 BACK
ASME SECTION XI - REPAIR/REPLACEMENT
- 2. Code Class ASME IIl, NF / CLASS 2
- 1. Component ID 3SI002H004
- 3. Item Description SNUBBER
- 4. N-5 Package Number 3SI07-3 5. W.O. Number 684229
- 6. Original Construction Code Edition 1974 Edition, Winter 1975 Addenda
- 7. Original Installation Code Edition 1974 Edition, Winter 1975 Addenda
- 8. Work Description Replacement of Snubber with Rigid Strut.
- 10. Evaluation of the suitability of this work as per the requirements of IAW-4150.
Design Mod. I.A.W. EDC# 94-00467, Snubber being replaced with Rigid Strut.
- 11. Repair/Replacement Work Organization CLASS 2 /74 Edition, '75Winter Adde
- 12. Replacement Item Construction or reconciled Code/Edition Subsection NF,
- 13. Repair/Replacement Activity Construction Code/Edition SAME AS (ITEM #12)
- 14. ASME Section XI Code/Edition 1992 Edition, 1992 Addenda
, ,*-,t YES
- 15. Preservice Inspection Required.
-,z, ýýlrlet If required, include a step in the W.O. to perform Preservice Inspection.
Initial/
[lj YES @j NO
- 16. ASME Section XI Pressure Test Required "92-~9//t2/ If required, include a step in the W.O. for ISI & ANII Inspection.
)jitial Date
- ___,____ 17. Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
- itial Dat6 for repaired or V* 6f Xi5//6 18. Include a step in the W.O. to record below all applicable numbers Initial D Datd replacement items. -7 ITEM I.D. PART NO. SERIAL NO. I HEAT NO.
STRUT#395049S N/A N/A 3S1002H004 Rear bracket#355959 N/A N/A N/A N/A Pipe clamp #362261 i1 It I. I- 1
_________________ ~I._ _ _ _ _ _ _ _
- 19. Planner */.,* t /ii. ,*. .*- OStY/,/Print Name Robert M Burtsell Date
- 20. ISI Engineer (S/.C_ Print Name R.P. Indap Date
- ignature
- 21. ANII la-,4 -0 Print Name R. G. Hogstrom
- . *inn*ttlr*
uae uata 73DP-gZZ17 PVME0093Ver. 6
L FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI et. al. Date 08/05/98 I
Owner Arizona Public Service Company, Name Sheet 1 of 2 P. 0. Box 53999, Phoenix, Arizona 85072-2034 Address Unit 3
- 2. Plant Palo Verde Nuclear GeneratingNameStation 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 W.O.#684229 Repair Organization P.O. No., Job No., etc.
Address Type Code Symbol Stamp None
- 3. Work Performed by APS N/A Name Authorization No.
Expiration Date N/A Same as (Item#2) Address
- 4. Identification of System SI Edition, '75W Addenda, N/A Code Case
- 5. (a) Applicable Construction Code ASME III, NF / CL 2 1974 1992_ Edition, 1992 Addenda (b) Applicable Edition of Section XI Utilized for Repairs or Replacements Components
- 6. Identification of Components Repaired or Replaced and Replacement Stamped Repaired,or ASME Code Manufacturer National Other Year Replaced Name of Name of Serial No. Board No. Identification Built Replacement (Yes or No)
Component Manufacturer N/A 3SI002H004 2ff 1 Replacement No igid Strut Lisega N/A N/A 3SI002H004 al Replacement No Rear Bracket Lisega N/A Pipe Clamp Lisega N/A N/A 3 SI002H004 7J* J Replacement No I.A.W.EDC#94-00467
- 7. Description of Work Replacement of Snubber with Rigid Strut
- 8. Test Conducted: Hydrostatic I Pneumatic Ij Nominal Operating Pressure J N-416-1 Ll psi Test Temp. 0F Exempt
- Other Li Pressure l NOTE: Supplemental sheets in form of lists, sketches, or drawings may (2) number of sheets is recorded at the top of this form.
be used, provided (1) size is 8 1/2 x 11 in.,
information in items I through 6 on this report is included on each sheet, and (3) each sheet is numbered and the 73oP-gzz1 7
7 Ver. 1 PVMEN0U2
i i
I I
FORM NIS-2 (Back)
- 4. Remarks t*(*nA 111n 445Z19 "I qVTC ")
.. JJ TtnJi 1JU CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this replacement conforms to the rules repair or replacement of the ASME Code,Section XI.
Type Code Symbol Stamp N/A Certificate of Authoriti N/A Expiration Date N/A Signed_ Z'lý. I Date &'-3--o(
Owner or Owners Designee, Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Arizona and employed by HSBI & I CO.
of Hartford, Connecticut , have inspected the components described in this Owner's Report during the period _ -_-ot_ to ,o-,A-o. , and state that to the best of my knowledge and described in this Owner's and belief, the Owner has performed examinations and taken corrective measures Report in accordance with the requirements of the ASME Code, Section XA.
or implied, By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
Commissions 3,1 4 National Board, State, Province, and Endorsements tipector ,s Signature Date lo X_-20T0 I PV.IO002 Vet. I BACK J 73DP-OZ7.17
ASME SECTION Xl - REPAIR/REPLACEMENT
- 2. Code Class ASME III, NF / CLASS 2
- 1. Component ID 3SI009H001
- 3. Item Description SNUBBER
- 5. W.O. Number 684229 / #216570
- 4. N-5 Package Number 3SI01-2
- 6. Original Construction Code Edition 1974 Edition, Winter 1975 Addenda 1975 Addenda
- 7. Original Installation Code Edition 1974 Edition,Winter Rigid Strut.
- 8. Work Description Replacement of Snubber with
- 10. Evaluation of the suitability of this work as per the requirements replaced with Rigid Strut.
Design Mod I.A.W. EDC# 94-00467, SNUBBER Being APS
- 11. Repair/Replacement Work Organization Subsection NF, Class-2 / 74 Edition '75 Winter Addenc
- 12. Replacement Item Construction or reconciled Code/Edition Code/Edition (Same as Item #12)
- 13. Repair/Replacement Activity Construction
- 14. ASME Section Xi Code/Edition 1992 Edition, 1992 Addenda
- j YES L NO
- 15. Preservice Inspection Required.
Iniia D*te / If required, include a step in the W.O. to perform Preservice Inspection.
Initial Date
- 16. ASME Section XI Pressure Test Required Li YES [J NO Y(*IX& g~4 b// If required, include a step in the W.O. for ISI & ANII Inspection.
Form prior to releasing the component.
. e ý*S 17. Include a stop in the W.O. to complete NaS-2 Date or in the W.0 to record below all applicable numbers for repaired igtnala
./47/ 18 . Include a stepitems.
Initial Date replacement "
SERIAL NO. HEAT NO. NH/I-OU NOl.
ITEM I.D. PART NO.
N/A N/A ROS#90398233 3SI009H001 STRUT # 396079 N/A NIA '_,.,,J-5 Z-:,t.
Rear Bracket #356959 N/A N/A RO#0378 ROS#90397384 Pipe Clamp #363263 z¢'*,,,ýý--, ****./: ;*- .. .. rn Name Robert M. BurtseI1 r19. Plannner _X- Date ignaiure
.5*
- 20. k*~l nginer **', * ,;*/l*/g t.Print Name R.P.Indap 5ate
'Signature ANI t4-04,-.
Date Print Name R.G. Hogstrom 21.,
I1 21 A ¢ 'Signature
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section Xl Owner Arizona Public Service Company, et. al. Date 08/05/98 Name P. 0. Box 53999, Phoenix, Arizona 85072-2034 Sheet 1 of 2 Address
- 2. Plant Palo Verde Nuclear Generating Station Unit 3 Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 W.O.#684229 Address Repair Organization P.O. No., Job No., etc.
- 3. Work Performed by APS Type Code Symbol Stamp None Name Authorization No. N/A Same as (Item# 2) Expiration Date N/A Address
- 4. Identification of System Si
- 5. (aý Applicable Construction Code ASME III, NF / CL 2 1974 Edition, '75W Addenda, N/A Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1992 Edition, 1992 Addenda
- 6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Other Year Repaired, Replaced or ASME Code Stamped Component Manufacturer Serial No. Board No. Identification Built Replacement (Yes or No)
-idStrut Lisega N/A N/A 3SI009H001 f'fij Replacement No R-Bracket Lisega N/A N/A 3SIO09HOO1 U 1 Replacement No Pipe Clamp Lisega N/A N/A 3SI009H001 tJl Replacement No
- 7. Description of Work Replacement of Snubber with Rigid Strut I.A.W. EDC#94-00467 N-416-1
- 8. Test Conducted: Hydrostatic j Pneumatic j Nominal Operating Pressure psi Test Temp. oF Exempt [A Other [ Pressure NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8 1/2 x 11 in.,
(2) information in items 1 throfgh 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.
,,ur.aa,,
PV-EO092 Ver. 11 PV.500a2Ver. 730P-OZZ17
FORM NIS-2 (Back)
I F- .
- 9. Remarks W.O. #684229 3 SIO09HOO I CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this replacement conforms to the rules of the ASME Code, Section Xl. repair or replacement Type Code Symbol Stamp N/A Certificate of Authorization No. N/A Expiration Date N/A Signed ,] /i ,./*d.-'.... Date /57-,*3 -c/
.1 - Owner or Owner's Designee, Title Date CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Arizona and employed by HSBI & I CO.
of Hartford, Connecticut , have inspected the components described in this Owner's Report during the period Id- ok to ,i- [,-ok , and state that to the best of my knowledge and and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section Xl.
By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
Commissions . qi'&s " " "f: t ,-z&.k Inspector's Signature National Board, State, Province, and Endorsements Date O*-o *- I'S
,v-eee ver.1 BACK 73DP.aZZl7 P'V-EO02z Ver. I BACK 73DP-9ZZ17
I IIF I
ASME SECTION XI - REPAIRIREPLACEMENT Component ID 3SI067H001 2. Code Class ASME III, NF / Class 2
- 3. Item Description Snubber
- 4. N-5 Package Number 3SI07-3 5. W.O. Number #684229
- 6. Original Construction Code Edition 1974 Edition,Winter 1975 Addenda
- 7. Original Installation Code Edition 1974 Edition, Winter 1975 Addenda
- 8. Work Description Replacement of Snubber With Rigid Strut.
- 10. Evaluation of the suitability of this work as per the requirements of IWA-4150.
Design Mod. I.A.W. EDC# 94-00467. Snubber being replaced with Rigid Strut.
- 11. Repair/Replacement Work Organization APS
- 12. Replacement Item Construction Code/Edition Subsection NF, Class 2 / 74 Edition.'75 Winter Addenda
- 13. Repair/Replacement Activity Construction Code/Edition Same as (Item#12)
- 14. ASME Section XI Code/Edition 1992 Edition, 1992 Addenda
"-T:o ( ci -C-7-9 15. Include step inthe W.O. to perform Preservice Inspection Initial Date j--DC. 3 -- - 16. Include a step in the W.O. to send completed copy of this form to lSl Group.
Initial Date
_.W*_2%x:.q-7-°i-, 17. Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
Initial Date Q'PC_ 01-77 -? 18. Include step in the W.O. to record below all applicable numbers.
Initial Date COMP I.D. PART NO. SERIAL NO. HEAT NO. ROS/EROS NO.
3SI067H001 Strut #395079RR1 N/A N/A PL0182621
- 19. Planner- * . Print Name J. Cruse 1
. Ie Eng Signature Date
""0.ISDEngineer -(--1 a 9' Print Name T jM Signature Date S21. ANI, /' 74*t* *.intur 4'-11-DT6 Print Name * "d -e" PV-EO093 Ve. I 73DP-gZZ17
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI 11-Owner Arizona Public Service Company, et. al. Date 08/06/98 Name P. 0. Box 53999, Phoenix, Arizona 85072-2034 Sheet 1 of 2 Address
- 2. Plant Palo Verde Nuclear Generating Station Unit 3 Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 #684229 Address Repair Organization P.O. No., Job No., etc.
- 3. Work Performed by A.PS Type Code Symbol Stamp None Name Authorization No. N/A Same as (Item#2) Expiration Date N/A Address
- 4. Identification of System SI
- 5. (a) Applicable Construction Code ASME IIINF / Cl 2 1974 Edition, '75W Addenda, N/A Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1992 Edition, 1992 Addenda
- 6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Other Year Repaired, ASME Code Replaced or Stamped Component Manufacturer Serial No. Board No. Identification Built Replacement (Yes or No)
"igid Strut Lisega N/A N/A 3SI067H1001 nL\j Replacement No
- 7. Description of Work Replacement of Snubber with Rigid Strut I.A.W. EDC#94-00467
- 8. Test Conducted: Hydrostatic j Pneumaticj Nominal Operating Pressure N-416-1 Exempt J Other [- Pressure psi Test Temp.
,F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8 1/2 x 11 in.,
(2) information in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.
e.73Pe1 ivso FV*E0092. Ver. I* 73DP-9Z717
I FORM NIS-2 (Back)
I d. Remarks 3S1067H0(
W.O.4684229 CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this replacement conforms to the rules repair or replacement of the ASME Code, Section Xl.
.Type Code Symbol Stamp N/A Certificate of Authorization No. N/A Exl *iration Date N/A Date/O -/55
- V Owner or Owner's Designee, Ttie CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Arizona and employed by HSBI & I CO.
of Hat-ford, Connecticut , have inspected the components described in this Owner's Report during the period - to to .o-.$- and state that to the best of my knowledge and and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code,Section XI.
By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
/;ý17 Commissions ezt "Z--""" . 2L.(
/ý t rz-,
I/ I National Board. State, Province, and Endorsements IliAspector's Sionature Date __c--, R_-. __
! PV-EO092 Ver. I BACK l 3DP J-SZZ17-I I
ASME SECTION XI- REPAIR/REPLACEMENT
- 1. Component ID 3SI241H007 2. Code Class ASME IL,NF / CLASS 2
- 3. Item Description SNUBBER
- 4. N-5 Package Number 3SI07-3 5. W.O. Number LEGACY #00684229 / 216570
- 6. Original Construction Code Edition 1974 EDITION, WINTER 1975 ADDENDA
- 7. Original Installation Code Edition 1974 EDITION, WINTER 1975 ADDENDA
- 8. Work Description REPLACEMENT OF SNUBBER WITH RIGID STRUT.
- 10. Evaluation of the suitability of this work as per the requirements of IAW-41 50.
DESIGN MOD I.A.W. EDC# 94-00467. SNUBBERS BEING REPLACED WITH RIGID STRUTS.
- 11. Repair/Replacement Work Organization APS
- 12. Replacement Item Construction or reconciled Code/Edition Subsection, NF, Class 2/74 Edition.'75 Winter Addend
- 13. Repair/Replacement Activity Construction Code/Edition SAME AS (ITEM #12)
- 14. ASME Section XI Code/Edition 1992 EDITION, 1992 ADDENDA
- 15. Preservice Inspection Required. !* YES 1i NO
) p,?-/ -2ao,/ If required, include a step in the W.O. to perform Preservice Inspection.
Initial Date
- 16. ASME Section XI Pressure Test Required Li YES [ NO
' Q~P-z/Z-,2aa/ If required, include a step in the W.O. for ISI & ANII Inspection.
ntia Date 0,P-7,,# .. ,*{ 17. Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
Initial Date
,,,t/. 18. Include a step in the W.O. to record below all applicable numbers for repaired or Initial Date replacement items.
ITEM I.D. PART NO. SERIAL NO. HEAT NO. (MRROS NO.
3SI241H007 STRUT #395049S N/A N/A §r O*!' ,*
R-BRACKET #355959 N/A N/A ____________
PIPE CLAMP #364661 N/A N/A PL0182621
- 19. Planner , # A- O9-1,z-.zoo Print Name ROBERT M. BURTSELL Signature Date 1-0. ISI Engnee q >a, Print Name R.P. INDAP Signature J Date
- 21. AN II I ! q- *-o, Print Name ROBERT G. HOGSTROM Signature Date PV-EO093 Ver. 6 1 r
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Owner Arizona Public Service Company, et. al. Date 08/07/98 Name P. 0. Box 53999, Phoenix, Arizona 85072-2034 Sheet 1 of 2 Address
- 2. Plant Palo Verde Nuclear Generating Station Unit 3 Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 W.O.#684229 Address Repair Organization P.O. No., Job No., etc.
- 3. Work Performed by APS Type Code Symbol Stamp None Name Authorization No. N/A Same as (Item#2) Expiration Date N/A Address
- 4. Identification of System SI
- 5. (a) Applicable Construction Code ASME III, NF / CL 2 1974 Edition, '75W Addenda, N/A Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1992 Edition, 1992 Addenda
- 6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Other Year Repaired, ASME Code Replaced or Stamped Component Manufacturer Serial No. Board No. Identification Built Replacement (Yes or No)
",idStrut Lisega N/A N/A 3SI241H007 -" Replacement No Rear Bracket Lisega N/A N/A 3SI241H007 Zc] Replacement No Pipe Clamp Lisega N/A N/A 3Si241H007 -f [ Replacement No
______ ______ I _____ I I
____ _____ I I J. 4 4 4 '4 .4
- 7. Description of Work Replacement of Snubber with Rigid Strut I.A.W. EDC # 94-00467
- 8. Test Conducted: Pneumatic Nominal Operating Pressure N-416-1 j Hydrostatic ,i Exempt - Other [A Pressure psi Test Temp. °F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8 1/2 x 11 in.,
(2) information in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.
PV-ED092 VeW.I 73DP-9ZZ17
FORM NIS-2 (Back)
- d. Remarks W.O.#684229 3SI241H0(
CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this replacement conforms to the rules repair or replacement of the ASME Code,Section XI, Type Code Symbol Stamp N/A Certificate of Authorization No. N/A Expiration Date N/A Signed -*. 6'J 4 Date 0p-/,.-Oi Owner or Owner's Designee, Title CERTIFICATE OF INSERVICE INSPECTION 1, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Arizona and employed by HSBI & I CO.
of Hartford, Connecticut , have inspected the components described in this Owner's Report during the period _ -,_-_, _to _,_-_s-o _ , and state that to the best of my knowledge and and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code,Section XI.
By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
,* /j* Commissions -S`.'" 4-' . 26-`
/ --t.-.I."vt National Board, State. Province, and Endorsements XJ Inspector's Signature "
Date is I
I I
73DP.ezzll PV-EO092 VerII PV-ee592Ver. eACK BACK 73DP-gZ7Z17
1 oASME SECTION XI - REPAIR/REPLACEMENT
- 1. Component ID 3SI241H008 2. Code Class ASME ULI, NF / CLASS 2
- 3. Item Description SNUBBER
- 4. N-5 Package Number 3SI07-3 5. W.O. Number 684229/#216570
- 6. Original Construction Code Edition 1974 Edition, Winter 1975 Addenda
- 7. Original Installation Code Edition 1974 Edition,Winter 1975 Addenda
- 8. Work Description Replacement of Snubber with Rigid Strut.
- 10. Evaluation of the suitability of this work as per the requirements of IAW-41 50.
Design Mod I.A.W. EDC# 94-00467, SNUBBER Being replaced with Rigid Strut.
- 11. Repair/Replacement Work Organization APS
- 12. Replacement Item Construction or reconciled Code/Edition Subsection NF, Class-2 / 74 Edition '75 Winter Addenc
- 13. Repair/Replacement Activity Construction Code/Edition (Same as Item #12)
- 14. ASME Section Xl Code/Edition 1992 Edition, 1992 Addenda
- 15. Preservice Inspection Required. [J YES [I NO
,y ~A*/.j
-.. 2,'/ If required, include a step in the W.O. to perform Preservice Inspection.
Initial Date
- 16. ASME Section XI Pressure Test Required [j YES [J NO A4 .4/,. t;4'E",-./If required, include a step in the W.O. for ISI & ANII Inspection.
'1i1ial Date
_.___,___ d{ - 17. Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
J*itial Date
, C. ;,,. 1 8. Include a step in the W.O. to record below all applicable numbers for repaired or Initial Date replacement items.
-1 ITEM I.D. PART NO. SERIAL NO. HEAT NO. MR/ROS NO.
3SI241H008 STRUT # 395059 N/A N/A PL0182621 Rear Bracket #355959 N/A N/A PLO62_Z- 3*qs2.
Pipe Clamp #364661 N/A N/A PL0182621
- 19. Planner . - -. ,-z/ /,'.-Print Name Robert M. Burtsell Signatu)re Date
- 20. ISI Engineer I, A.-i"/- -- Print Name R.P.Indap Signature Date 2 1.ANII '1"'. - Print Name R.G. Hogstrom "Signature Date PV-EO093 Vet. 6 7- -17
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section Xl Owner Arizona Public Service Company, et. al. Date 08/07/98 Name P. 0. Box 53999, Phoenix, Arizona 85072-2034 Sheet 1 of 2 Address
- 2. Plant Palo Verde Nuclear Generating Station Unit 3 Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 W.O.#684229 Address Repair Organization P.O. No., Job No., etc.
- 3. Work Performed by APS Type Code Symbol Stamp None Name Authorization No. N/A Same as (Item# 2) Expiration Date N/A Address
- 4. Identification of System SI
- 5. (a) Applicable Construction Code ASME III,NF / CL 2 1974 Edition, '75W Addenda, N/A Code Case (b) Applicable Edition of Section Xl Utilized for Repairs or Replacements 1992 Edition, 1992 Addenda
- 6. Identification of Components Repaired or Replaced and Replacement Components /
Name of Name of Manufacturer National Other Year Repaired,or Replaced ASME Stamped Code Component Manufacturer Serial No. Board No. Identification Built Replacement (Yes or No)
"igid Strut Lisega N/A N/A 3SI241H008 2[- Replacement No Rear Bracket Lisega N/A N/A 3SI241H008 *,L* Replacement No Pipe Clamp Lisega N/A N/A 3SI241H008 .?tH/ Replacement No
- 7. Description of Work Replacement of Snubber with Rigid Strut 1.A.W. EDC# 94-00467
- 8. Test Conducted: Hydrostatic I Pneu m atic J Nominal Operating Pressure J N-416-1 Exempt ; Other F Pressure psi Test Temp. 0F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8 1/2 x 11 in.,
I (2) information in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.
PV-E0092 Vet. i 73DP.gZ717
I I
I FORM NIS-2 (Back)
, Remarks W.O.#684229 3SI241H008 CERTIFICATE OF COMPLIANCE replacement conforms to the rules We certify that the statements made in the report are correct and this repair or replacement of the ASME Code,Section XI.
Type Code Symbol Stamp N/A Expiration Date N/A Certificate of Autho .zation No. N/A Signedror One.s Designee, Tte or Owner's Designee, Title Date /C)//5' c~
- " *Owner CERTIFICATE OF INSERVICE INSPECTION of Boiler and Pressure Vessel I, the undersigned, holding a valid commission issued by the National Board Arizona and employed by HSBI & I CO.
Inspectors and the State or Province of of Hartford, Connecticut , have inspected the components described in this Owner's Report during the period &- to , .1,1- , and state that to the best of my knowledge and described in this Owner's and belief, the Owner has performed examinations and taken corrective measures Xl.
Report in accordance with the requirements of the ASME Code, Section any warranty, expressed or implied, By signing this certificate, neither the Inspector nor his employer makes Furthermore, concerning the examinations and corrective measures described in this Owner's Report.
manner for any personal injury or property neither the Inspector nor his employer shall be liable in any inspection.
damage or a loss of any kind arising from or connected with this C om m issions ..... _
National Board, State. Province. and Endorsements lrnipectoes Signature ./
- J/
DateDate __ __
I 73DP-9ZZ17 7
PV-EO092 Ver. I BACK
ASME SECTION Xl - REPAIR/REPLACEMENT
- 2. Code Class ASME IIINF, / CLASS 2 Component ID 3SI241H009
- 3. Item Description SNUBBER
- 4. N-5 Package Number 3SI07-3 5. W.O. Number #684229
- 6. Original Construction Code Edition 1974 Edition, Winter 1975 Addenda Addenda
- 7. Original Installation Code Edition 1974 Edition, Winter 1975
- 8. Work Description Replacement of Snubber with Rigid Strut.
- 9. j IS] Flaw NDE Method of Flaw Detection Report Number of IWA-4150.
- 10. Evaluation of the suitability of this work as per the requirements with rigid strut.
Design Mod. I.A.W. EDC 00467 snubber being replaced
- 11. Repair/Replacement Work Organization APS NF,CLASS 2 / 74 Edition,'75 Winter Addenda
- 12. Replacement Item Construction Code/Edition Subsection as (Item#12)
- 13. Repair/Replacement Activity Construction Code/Edition Same
- 14. ASME Section XI Code/Edition 1992 Edition 1992 Addenda
-- O'-,-7 ..-Vq 15. Include step in the W.O. to perform Preservice Inspection Initial Date
._-____ " 9i *16. Include a'step in the W.O. to send completed copy of this form to ISI Group.
Initial Date the component.
______ 0 *.
-- -q;, 17. Include a step in the W.O. to complete NIS-2 Form prior to releasing Initial Date
ýýD e-- ci -.7 -' 1 Z, 18. Include step in the W.O. to record below all applicable numbers.
Initial Date SERIAL NO. HEAT NO. ROSIEROS NO.
COMP I.D. PART NO.
N/A PL0182621
'3S1241H009 Strut #39610 9 N/A N/A ROS#90413712 zeal- R-Bracket #356959 N/A qj kAL._ , CV7 -C Print Name J. Cruse
- 19. Planner .
Signature Date Print Name P.' ~ N' P
'0. 151 Engineer Signature t1I Date
- 21. ANII -,-q--t? Print Name 9.6. L 0rrIZ*,.
Signature Date 73DP-9ZZ17 PV-E0093Ver. I
I FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI 08/06/98 Owner Arizona Public Service Company, et. al. Date Name P. 0. Box 53999, Phoenix, Arizona 85072-2034 Sheet 1 of 2 Address Unit 3
- 2. Plant Palo Verde Nuclear Generating Station Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 W.0.#684229 Address Repair Organization P.O. No., Job No., etc.
APS Type Code Symbol Stamp None
- 3. Work Performed by Name Authorization No. N/A Expiration Date N/A Same as (Item #2)
Address
- 4. Identification of System SI
- 5. (a) Applicable Construction Code ASME IIINF/CL 2 1974 Edition, 75W Addenda, N/A Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1992 Edition, 1992 Addenda
- 6. Identification of Components Repaired or Replaced and Replacement Components National Other Year Repaired, ASME Code Name of Name of Manufacturer Replaced or Stamped Component Manufacturer Serial No. Board No. Identification Built Replacement (Yes or No)
"igidstrut Lisega N/A N/A 3SI241H009 2D-J0 Replacement No Rear Bracket Lisega N/A N/A 3S1241H009 '.Ej Replacement No
____________ L ____________ L _________ . _______ _________ - ____ -
- 7. Description of Work Replacement of Snubber with Rigid Strut I.A.W.EDC-94-00467 Pneumatic Nominal Operating Pressure N-416-1F]
- 8. Test Conducted: Hydrostatic 1J Exempt Other 1 Pressure psi Test Temp.
NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) sizeis 8 1/2 x 11 in.,
I (2) information in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.
PV-E0092 Ver. 1 7
I I
FORM NIS-2 (Back)
I Remarks W .0. #684229 3S1941 1-f1009 3SI241HOO9 CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this replacement conforms to the rules repair orreplacement of the ASME Code,Section XI.
Type Code Symbol Stamp N/A Certificate of Authorization/No. N/A Expiratior iDate N/A Signed 5/ *X&/A-'*, Date 16 -(3---(
/ Owner or Owner's Designee, Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Arizona and employed by HSBI & I CO.
of Hartford, Connecticut , have inspected the components described in this Owner's Report during the period q-k to ,--o , and state that to the best of my knowledge and and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code,Section XI.
By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
A Commissions " , . . " 7 A National Board, State, Province, and Endorsements
\j Inspectors sSignature * .
Date a-* 06-e-I PV-E0092 Ver. I SACK I3WSL1 73DP-SZ.Z17
ASME SECTION XI - REPAIRIREPLACEMENT Component ID 3S1241H011 2. Code Class ASME II][,NF/CLASS2
- 3. Item Description Snubber
- 4. N-5 Package Number 3SI07-3 5. W.O. Number #684229
- 6. Original Construction Code Edition 1974 Edition, Winter 1975 Addenda
- 7. Original Installation Code Edition 1974 Edition, Winter 1975 Addenda
- 8. Work Description Replacement of Snubber with Rigid Strut.
15 IS[ Flaw NDE Method of Flaw Detection Report Number_
- 10. Evaluation of the suitability of this work as per the requirements of IWA-4150.
Design Mod. I.A.W.EDC # 94-00467. Snubber being replaced with Rigid Strut.
- 11. Repair/Replacement Work Organization APS
- 12. Replacement Item Construction Code/Edition SubsectionNF, Class 2 / 74 Edition.'75 Winter Addenda
- 13. Repair/Replacement Activity Construction Code/Edition .-Same as(Item#12)
- 14. ASME Section Xl Code/Edition 1992 Edition, 1992 Addenda Dc. C- -77ý- - 15. Include step in the W.O. to perform Preservice Inspection Initial Date S - .* 16. Include a step in the W.O. to send completed copy of this form to ISI Group.
Initial Date Cq 96-7 17. Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
Initial Date "7 ' 18. Include step in the W.O. to record below all applicable numbers.
Initial Date COMP i.D. PART NO. SERIAL NO. HEAT NO. ROSIEROS NO.1 3SI241H011 Strut #395109 N/A N/A ROS#90397390 Rear Bracket #355959 N/A N/A PL0039445 Pipe Clamp #364661 N/A N/A ROS#90M97390,
- 19. Planner\-' - - Print Name J. Cruse Signature Date
__ __ __-----__--___ __ __ _ PrintNam e _ _ _*___
SSignature Date j21. ANII ýg- Print Name ~
Signature Dt PV-E0093 Vet. I 73DP-9ZZ17
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section Xl Owner Arizona Public Service Company, et al. Date 08/07/98 Name P. 0.Box 53999, Phoenix, Arizona 85072-2034 Sheet 1 of 2 Address
- 2. Plant Palo Verde Nuclear Generating Station Unit 3 Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 W.O.#684229 Address Repair Organization P.O. No., Job No., etc
- 3. Work Performed by APS Type Code Symbol Stamp None Name Authorization No. N/A Same as (Item#2) Expiration Date N/A Address
- 4. Identification of System SI
- 5. (a) Applicable Construction Code ASME III, NF/ CL 2 1974 Edition, '75W Addenda, N/A Code Case (b) Applicable Edition of Section Xl Utilized for Repairs or Replacements 1992 Edition, 1992 Addenda
- 6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Other Year Repaired, ASME Code Replaced or Stamped Component Manufacturer Serial No. Board No. Identification Built Replacement (Yes or No)
'gid Strut Lisega N/A N/A 3S1241H01 1 7...-0(3 Replacement No Rear Bracket Lisega N/A N/A 3SI241H011I 20 I Replacement No Pipe Clamp Lisega N/A N/A 3SI241H01l1 2.10 I Replacement No
- 7. Description of Work Replacement of Snubber with Rigid Strut I.A.W. EDC # 94-00467
- 8. Test Conducted: Hydrostatic j Pneumatic Nominal Operating Pressure N-416-1 ý,*
Exempt A. Other l Pressure psi Test Temp. OF NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8 1/2 x 11 in.,
(2) information in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.
PV-E0092 Ver. I 73DP-gZZ1 7
FORM NIS-2 (Back)
- z. Remarks W.O.#684229 3SI2410HO CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this replacement conforms to the rules repair or replacement of the ASME Code, Section Xl.
Type Code Symbol Stamp N/A Certificate of Authorization No. N/A Expiratior"1Date N/A Signedow ineTitle Date /0 -/'3-6V Owner or Owner's Designee, Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Arizona and employed by HSBI & I CO.
of Hartford, Connecticut , have inspected the components described in this Owner's Report during the period q- It-,t to ,o-,3-o. , and state that to the best of my knowledge and and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code,Section XI.
By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
Commissions _ý ' -" " A`
National Board, State, Province, and Endorsements
- 'Z,5 t.- pector's Signature Date Oco-sew tZ CA 7DP-9ZZi7 ver.II PV-Ese92Vet.
PV-E0092 eACK BACK 73DP-9ZZ17
ASME SECTION Xl- REPAIR/REPLACEMENT
- 1. Component ID 3SI241H014 2. Code Class ASME M, NF / CLASS 2
- 3. Item Description SNUBBER
- 4. N-5 Package Number 3SI07-3 5. W.O. Number 684229/#216570
- 6. Original Construction Code Edition 1974 _dition, Winter 1975 Addenda
- 7. Original Installation Code Edition 1974 Edition,Winter 1975 Addenda
- 8. Work Description Replacement of Snubber with Rigid Strut.
- 9. [j ISl Flaw NDE Method of Flaw Detection Report Number
- 10. Evaluation of the suitability of this work as per the requirements of IAW-4150.
Design Mod I.A.W. EDC# 94-00467, SNUBBER Being replaced with Rigid Strut.
- 11. Repair/Replacement Work Organization APS
- 12. Replacement Item Construction or reconciled Code/Edition Subsection NF, Class-2 / 74 Edition '75 Winter Addend
- 13. Repair/Replacement Activity Construction Code/Edition (Same as Item #12)
- 14. ASME Section Xl Code/Edition 1992 Edition, 1992 Addenda
- 15. Preservice Inspection Required. [a YES [i NO 4v*, 4 .iV,/"/-c:V/ If required, include a step in the W.O. to perform Preservice Inspection.
Initial Date
- 16. ASME Section Xl Pressure Test Required L YES Ej NO
/' 60 'e Ce// If required, include a step in the W.O. for ISI & ANII Inspection.
itiall 'Date
_______-/ ~ 17. Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
Initial Ddte
,:-,, !/ý 18. Include a step in the W.O. to record below all applicable numbers for repaired or Initial Dt replacement items.
ITEM I.D. PART NO. SERIAL NO. HEAT NO. MR/ROS NO. "
3SI241H014 STRUT # 396129RR1 N/A N/A ?401_______
- 19. Planner /** £*-/- *-?/ Print Name Robert M. Burtsell Signatyge .. Date
'0. IS] Engineer - ri--/cr Print Name R.P.Indap asignature PDate
- 21. ANII '- "-,-c. Print Name R.G. Hogstrom
,(ignature Date 73DP)I--9Z.Z17 PV-EO093 Ver. 6
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section Xl Owner Arizona Public Service Company, et. al. Date 08/05/98 Name P. 0. Box 53999, Phoenix, Arizona 85072-2034 Sheet 1 of 2 Address
- 2. Plant Palo Verde Nuclear Generating Station Unit 3 Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 W.O.#684229 Address Repair Organization P.O. No., Job No., et.
- 3. Work Performed by APS Type Code Symbol Stamp None Name Authorization No. N/A Same as (Item #2) Expiration Date N/A Address
- 4. Identification of System SI
- 5. (a) Applicable Construction Code ASME III, NF / CL 2 1974 Edition, '75W Addenda, N/A Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1992 Edition, 1992 Addenda
- 6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Other Year Repaired, ASME Code Replaced or Stamped Component Manufacturer Serial No. Board No. Identification Built Replacement (Yes or No)
",id Strut Lisega N/A N/A 3 S1241 HO14 ZtI9f I Replacement No
- 7. Description of Work Replacement of snubber with Rigid strut I.A.W. EDC #94-00467
- 8. Test Conducted: Hydrostatic f Pneumatic ,j Nominal Operating Pressure N-416-1 J Exempt jP Other Pressure psi Test Temp. OF I,4OTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8 1/2 x 11 in.,
(2) information in items I through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.
7DP.9ZZ11 PV.E0092 pV-EO092 Var.II Vet. 73DP-SZZ17
I FORM NIS-2 (Back)
- 9. Remarks W.O. #684229 3SI241 H0O14 CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this replacement conforms to the rules of the ASME Code, Section Xl. repair or replacement Type Code Symbol Stamp N/A Certificate of Authorization.No. N/A Expiration Date N/A Signed 9A - Datehj>--/*-oi/
Owner or Owner's Designee, Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Arizona and employed by HSBI & I CO.
of Hartford, Connecticut , have inspected the components described in this Owner's Report during the period _ -d,_-o_ to ___-,_- __ , and state that to the best of my knowledge and and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code,Section XI.
By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
K SlJispector's Signature Commissions National Board. State, Province. and Endorsements Date Dc-mser-- De-Z 12oc; Pv-euea2 Ver.I BACK 730P.aZZ17 PV-EO092 Ver, I BACK 73DP-9ZZ17
ASME SECTION XI - REPAIRIREPLACEMENT I. Component ID 3SI307H006 2. Code Class A SME IIINF / CLASS 2
- 3. Jtem Description SNUBBER
- 4. N-5 Package Number 3SI01-2 5. W.O. Number # 684229
- 6. Original Construction Code Edition 1974 Edition,Winterl975 Addend a
- 7. Original Installation Code Edition 1974 Edition, Winter 1975 Addenda
- 8. Work Description Replacement of snubber with rigid strut.
- 9. F IS] Flaw NDE Method of Flaw Detection Report Number
- 10. Evaluation of the suitability of this work as per the requirements of IWA-4150.
Design Mod. I.A.W. EDC#94-00467. Snubber being replaced with Rigid Strut.
- 11. Repair/Replacement Work Organization APS
- 12. Replacement Item Construction Code/Edition Subsection NF, Class 2 / 74 Edition.'75 Winter Addenda
- 13. Repair/Replacement-Activity Construction Code/Edition Same as (Item#12)
- 14. ASME Section Xl Code/Edition 1992 Edition, 1992 Addenda
- .. *-9--'! 15. Include step in the W.O. to perform Preservice Inspection Initial Date
_-_____ q*-i -'1
- 16. Include a step in the W.O. to send completed copy of this form to ISI Group.
Initial Date
.5T1C_. 9 - 17. Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
Initial Date
- -C C - 0 ! 18. Include step in the W.O. to record below all applicable numbers.
Initial Date COMP I.D. PART NO. SERIAL NO. HEAT NO. ROSIEROS NO.
3SI307H006 Strut#396079 N/A N/A PL0011430 R-Bracket#356959 N/A N/A PL0182621 Pipe Clamp#376161 N/A N/A PL182621
- 19. Planner . ' - , Q R Print Name J. Cruse
( Sigatt7 ~Date
.0. ISI Engineer Print Name 'R P. F sgnature \J Date
- 21. ANII ,; /7au-4L Print Name 1. 6*. -( -r1.o,4 I,* Signature Date 73DP-9ZZ17 PV-EO093 Ver. 1
I FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section Xl
- j. Owner Arizona Public Service Company, et. al. Date 08/05/98 Name P. 0. Box 53999, Phoenix, Arizona 85072-2034 Sheet 1 of 2 Address
- 2. Plant Palo Verde Nuclear Generating Station Unit 3 Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 W.O.#684229 Address Repair Organization P.O. No., Job No., etc.
- 3. Work Performed by APS Type Code Symbol Stamp None Name Authorization No. N/A Same as.(Item#2) Expiration Date N/A Address
- 4. Identification of System SI
- 5. (a) Applicable Construction Code ASME III, NF / CL 2 1974 Edition, '75W Addenda, N/A Code Case (b) Applicable Edition of Section Xl Utilized for Repairs or Replacements 1992 Edition, 1992 Addenda
- 6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Other Year Repaired, ASME Code Replaced or Stamped Component Manufacturer Serial No. Board No. Identification Built Replacement (Yes or No)
,gid Strut Lisega N/A N/A 3 SI307H006 Z Replacement No R-Bracket Lisega N/A N/A 3SI307H006 ',.PDI Replacement No Pipe Clamp Lisega N/A N/A 3SI307H006 7-ajJ Replacement No
- 7. Description of Work Replacement of snubber with Rigid strut I.A.W. EDC#94-00467
- 8. Test Conducted: Hydrostatic Dj Pneumatic Nominal Operating Pressure N-416-1 I Exempt ,1 Other Pressure psi Test Temp.
NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8 1/2 x 11 in.,
I (2) information in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.
PV-E0092 PV-C0052 Ver.
Ver.II 730P.SZZI7 73DP-9ZZt7
Remarks FORM NIS-2 (Back) 9.
- 9. Remarks W.0.4684229 3SI307H006 3S1307H006 CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this replacement conforms to the rules of the ASME Code,Section XI. repair or replacement Type Code Symbol Stamp N/A Certificate of Authorization No. N/A Expiration Date N/A Signed iJ'/, ,'/-57*eO*"T /- '.&'-, -- Date /c>-/?- /
Owner or Ownr,'s Designee, Title CERTIFICATE OF INSERVICE INSPECTION 1, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Arizona and employed by HSBI & I CO.
of Hartford, Connecticut , have inspected the components described in this Owner's Report during the period -t -, - mt to -k -, , , and state that to the best of my knowledge and and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section X1.
By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
Commissions 3.- "S
- 1Z-"
-I"A,. 2 L~k National Board, State, Province, and Endorsements k' Inspector's Signature Date Oc-roTep- 1-4 1 i I
P-V-E0092 Vet. I
'-02 r.I BACK ec(7D.Z1 730P-gZZ17
REPAIRIREPLACEMENT ASME SECTION XI -
- 2. Code Class ASMIE III, NF / CLASS 2 Component ID 3SI307H007
- 3. Item Description SNUBBER
. W.O. Number #684229
- 4. N-5 Package Number 3SI01-2
- 6. Original Construction Code Edition 1974 Edition, Winter 1975 Addenda 1975 Addenda --
- 7. original Installation Code Edition 1974 Edition, Winter Rigid Strut.
of snubber with
- 8. Work Description Replacement NDE M ethod of Report Flaw Detection Number _____________________
- 9. IS1 Flaw of IWA-4150.
io. Evaluation of the suitability of this work as per the requirements Being replaced with Rigid Strut.
Design Mod. LiA.W. EDC# 94-00467. Snubber
- 11. Repair/Replacement Work Organization 5 Addenda Class 2 / 74 Edition.'7 Winter
- 12. Replacement Item Construction Code/Edition SubsectionN, Code/Edition Sae a----
- 13. Repair/Replacement Activity Construction
'4. ASME Section Xl Code/Edition 1992 Edition, 1992iAddenda--
.=,7r) -15. include step in the W.O. to perform PreserVIce Inspection S.nit o e t coft prior to releasing the com a eat
ý)9 nl d a step
- 17. Icuease nteWO
"-Z:initial () - 7 Date below all applicable numbers.
i -, -Pe6 0DQ 18. Include step in the W.O. to record ROSIEROS NO.
Initial SERIAL NO.
HEAT NO. 82 261_____
R/ 90/A4,01 3 690 S PART NO. ------ N/A ROS#9041 COMP I.D. Stut #397O59S N/A
393707Strut N/A__----OS9457 59
- 357 9 N/A P-0182 62 N/A N/A Pipe Clamp #376162 Print Name J. Cruse.
(1 -- 7 C
- 9. Planner\ .--
-c- - ,cr Print N am e - ";ý P-" o CT. D -- - -- -
/Signature Printae1 .IiJA
'r). IS] Engineer________________________ Name o
- 21. ANi 4et6Print P-ga 7
t7re-'
S ign atu -a-eS7gD pV-E0 93 Vet. 1
OR REPLACEMENTS FORM NIS-2 OWNER'S REPORT FOR REPAIRS Section X1 As Required by the Provisions of the ASME Code et. al. Date 08/05/98 Owner Arizona Public Service Company, Name 7 2 2 03 4 Sheet 1 Of 2 P. 0. Box 53999, Phoenix, Arzona 850 -
Unit 3
- 2. Plant Palo Verde Nuclear GeneratingNameStation
, Arizona 85354-7529 W.0.4684229 5801 S. Wintersburg Rd., Tonopah Address Repair Organization P.O. NO., Job No., etC APS Type Code Symbol Stamp None
- 3. Work Performed by Name Authorization No. N/A Expiration Date N/A Same as (Item#2)
Address Identification of System SI 4.
N/A Code Case NF / CL 2 1974 Edition, '75W Addenda,
- 5. (a) Applicable Construction Code ASME III, Addenda Repairs or Replacements 1992 Edition, 1992 (b) Applicable Edition of Section X1 Utilized for S de tmpeC and Replacement Components laired , or
- 6. Identification of Components Repaired or Replaced ---- '-
- Rep ASME Code
-- ---- Other Year Repaired, of Manufacturer National Name of Name (Yes or No)
Serial No. Board No. Identification Buil Replacement Relaemn (Ysoro Component Manufacturer Component~~ 7.*)f3) Replacement No N/A N/A 3SI307H1007 igid Strut Lisega N/A N/A 3S1307H007 200 l Replacement No R-Bracket Lisega 2f*l Replacement No N/A N/A 3SI307H007 Pipe Clamp Lisega 4 7 of Work Replacement of snubber with Rigid Strut I.A.W. EDC#94-00 6
- 7. Description Hydrostatic j Pneumatic j Nominal Operating Pressure J1 N-416-1 FA
- 8. Test Conducted:
psi Test Temp. F Exempt I Other [ Pressure (1) size is 8 1/2 x 11 in.,
sheets in form of lists, sketches, or drawings may be used, provided NOTE: Supplemental is numbered and the in items I through 6 on this report is included on each sheet, and (3) each sheet (2) information form.
number of sheets is recorded at the top of this 73OP-SZZ17 PV-E0092 Ver.I
FORM NIS-2 (Back)
- j. Remarks W.O.#684229 3SJ307H007 CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this replacement conforms to the rules repair or replacement of the ASME Code, Section Xl.
Type Code Symbol Stamp N/A Certificate of Authorization No. N/A Expiration Date N/A Date ,'6-/'2-of(
Signed v'
- f Owner or Owner's Designee, Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Ari*zOna and employed by HSBI & I CO.
of Hartford, Connecticut , have inspected the components described in this Owner's Report during the period - to to- - , and state that to the best of my knowledge and and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code,Section XI.
By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
Commissions _1 "AZS 26 Inspector's Signature National Board, State, Province, and Endorsements Date 0c-r-*
7SDP-9Z217 PV-E0092 7"3DP-9ZZ17 Pv-Ema2Ver.
ver. 11 BACK BACK
I Component ID ASME SECTION XI - REPAIR/REPLACEMENT 3SI008H004 2. Code Class ASME III ,NF/CLASS2
- 3. Item Description Snubber
- 4. N-5 Package Number 3SI01-2 5. W.O. Number #684229
- 6. Original Construction Code Edition 1974 Edition, Winter 1975 Addenda
- 7. Original Installation Code Edition 1974 Edition, Winter 1975 Addenda
- 8. Work Description Replacement of Snubber with Rigid Strut.
- 10. Evaluation of the suitability of this work as per the requirements of IWA-4150.
Design Mod. I.A.W.EDC#94-00467. Snubber being replaced with Rigid Strut.
- 11. Repair/Replacement Work Organization APS
- 12. Replacement Item Construction Code/Edition Subsection NF, Class 2 / 74 Edition. '75 Winter Addenda
- 13. Repair/Replacement Activity Construction Code/Edition Same as (Item#12)
- 14. ASME Section XI Code/Edition 1992 Edition,1992 Addenda SD.*_ 9 15. Include step in the W.O. to perform Preservice Inspection Initial Date
-3C_>-. -- 9 8_ 16. Include a step in the W.O. to send completed copy of this form to ISl Group.
Initial Date
- , C7- -- ct
- 17. Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
Initial Date
.- __-'-__-___ 18. Include step in the W.O. to record below all applicable numbers.
Initial Date COMP I.D. PART NO. SERIAL NO. HEAT NO. ROS/EROS NO.
3SI008H004 Strut #395049 N/A N/A ROS#90397383 Rear Bracket #355959 N/A N/A ROS#90413684 Pipe Clamp #362761 N/A N/A ROS#90413684
- 19. Planner( CI-A- 4 .L1-1*P.J Print Name J. Cruse
( Signature Date ISl Engineer 9- - Print Name rt* , .. 1,.7_A*) P Signature "Date
- 21. ANII 4 ,ý 4-1q Print Name 26. 4
&7Z¶ Q
ksignature Date PV-EOO9'. Ver. I 73DP-9ZZ17
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section X1 Owner Arizona Public Service Company, et. al. Date 08/06/98 Name P. 0. Box 53999, Phoenix, Arizona 85072-2034 Sheet 1 of 2 Address
- 2. Plant Palo Verde Nuclear Generating Station Unit 3 Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 W.O.#684229 Address Repair Organization P.O. No., Job No.. etc.
- 3. Work Performed by APS Type Code Symbol Stamp None Name Authorization No. N/A Same as (Item#2) Expiration Date N/A Address
- 4. Identification of System SI
- 5. (a) Applicable Construction Code ASME III, NF / CL 2 1974 Edition, '75W Addenda, N/A Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1992 Edition, 1992 Addenda
- 6. Identification of Components Repaired or Replaced and Replacement Components Other Year Repaired, ASME Code Name of Name of Manufacturer National Replaced or Stamped Component Manufacturer Serial No. Board No. Identification Built Replacement (Yes or No)
'-id Strut Lisega N/A N/A 3S1008H004 210J Replacement No Lisega N/A N/A 3SI008H004
- Replacement No Rear Bracket N/A N/A 3SI008H004 U Replacement No Pipe Clamp Lisega
- 7. Description of Work Replacement of Snubber with Rigid Strut I.A.W. EDC#94-00467 N-416-1
- 8. Test Conducted: Hydrostatic L] Pneumatic J Nominal Operating Pressure [1 Exempt Other L Pressure psi Test Temp.
8 1/2 x 11 in.,
NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is I (2) information in items 1 through 6 on this report is included on each sheet, and (3) each number of sheets is recorded at the top of this form.
I PV-ED022 Ver. 1 sheet is numbered and the
,3op.a ,,7 730P.9=17
I FORM NIS-2 (Back)
- 9. Remarks W.O.#684229 3SIO08HOC REAR END BRACKET WELDING WAS DONE ON 05/30/97 UNDER ASME SECTION XI '80 W '81.
CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this replacement conforms to the rules of the ASME Code, Section Xl. repair or replacement Type Code Symbol Stamp N/A Certificate of Authorization No. N/A Expiration Date N/A Signed ,49-*: Date/ f -- "
S.... .
- v Owner or Owner's Designee, Title CERTIFICATE OF INSERVICE INSPECTION
[, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Arizona and employed by HSBI & I CO.
of Hartford, Connecticut , have inspected the components described in this Owner's Report during the period ____-_4k-__k% __ to to-,Z-ok , and state that to the best of my knowledge and and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code,Section XI.
By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
-S '," AZ 26"-
Commissions
'ýJ Inspector's Signature National Board, State, Province, and Endorsements Date 01 f 'C' 1,9 _
I PV-E0092Ver.1 eACt( 73Dp-eZZi7 PV-E002 Ver. 1 BACK 73DP-gZZ17
I I
I I
ASME SECTION XI - REPAIR/REPLACEMENT Code Class ASME III ,NFF/CLASS2 Component ID 3SI241H005 2.
- 3. Item Description Snubber
- 4. N-5 Package Number 3SI07-3 5. W.O. Number #684229
- 6. Original Construction Code Edition 1974 Edition, Winter 1975 Addenda
- 7. Original Installation Code Edition 1974 Edition, Winter 1975 Addenda
- 8. Work Description Replacement of Snubber with Rigid Strut.
- 9. ] IS1 Flaw NDE Method of Flaw Detection Report Nuumber
- 10. Evaluation of the suitability of this work as per the requirements of IWA-4150.
Design Mod. I.A.W. EDC# 94-00467. Snubber being replaced with Rigid Strut.
- 11. Repair/Replacement Work Organization APS
- 12. Replacement Item Construction Code/Edition Subsectiion NF, Class 2 /74 Edition '75 Winter Addenda
- 13. Repair/Replacement Activity Construction Code/Edition, - Same as (Item#12)
- 14. ASME Section Xl Code/Edition 1992 Edition,1992 Addenda
- V*QcL 9-'7 -o 15. Include step in the W.O. to perform Preservice Inspection Initial Date
--- cL -.7-s , 16. Include a step in the W.O. to send completed copy of this form to Isr Group.
Initial Date
____. __-7__-__ 17. Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
Initial Date C..*
- 18. Include step in the W.O. to record below all applicable numbers.
Initial Date COMP I.D. PART NO. SERIAL NO. HEAT NO. ROS/EROS NO.
3S1241H005 Strut #392R-' N/A N/A 9 99 377.,' 02 IF5. f -- 2.?.
- 19. Plannek7ýV)..._.., ;*-- C*_.-..
ý,. Xe.
-- *-7 0 , Print Name J. Cruse Signature Date
- 20. ISI Engineer__ ______-_--f___a_____ Print Name_____________
- 21. ANII _-_-_
Date Print Name Q.6. -o&*-co*
(-ignature PV-E*0093 Ver. I 73DP-9-7
I I FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section X1 Owner Arizona Public Service Company, et. al. Date 08/07/98 Name I
P. 0. Box 53999, Phoenix, Arizona 85072-2034 Sheet 1 of 2 Address
- 2. Plant Palo Verde Nuclear Generating Station Unit 3 Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 W.O.#684229 Repair Organization P.O. No., Job No., etc.
Address
- 3. Work Performed by APS Type Code Symbol Stamp None Name Authorization No. N/A Same as (Item# 2) Expiration Date N/A Address
- 4. Identification of System SI
- 5. (a) Applicable Construction Code ASME III, NF / CL 2 1974 Edition, '75W Addenda, N/A Code Case (b) Applicable Edition of Section Xl Utilized for Repairs or Replacements 1992 Edition, 1992 Addenda
- 6. Identification of Components Repaired or Replaced and Replacement Components I Name of Name of Manufacturer National Other Year Repaired, Replaced or ASME Code Stamped I Component igid Strut Manufacturer Lisega Serial No.
N/A Board No. Identification N/A 3S1241H005 Built
'0f A Replacement Replacement (Yes or No)
No
+ 4 4 1 1 I. _______________________________________
_______________________________________ i _______________________________ I .I
- 7. Description of Work Replacement of Snubber with Rigid Strut I.A.W. EDC# 94-00467
- 8. Test Conducted: Hydrostatic Pneumatic ! Nominal Operating Pressure N-416-1 FA Exempt 0 Other j Pressure psi Test Temp. oF NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8 1/2 x 11 in.,
I (2) information in items I through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.
! PVoED092 Ver. 1 PE02 e.I 7fPZ1 73DP-0ZZ17
FORM NIS-2 (Back)I
- j. Remarks W.O.#684229 3SI241H0(
REAR END BRACKET WELDING WAS DONE ON 01/31/97 UNDER ASME SECTION W.O.#684229 XI '80 W'81.
CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this replacement conforms to the rules of the ASME Code,Section XI. repair or replacement Type Code Symbol Stamp N/A Certificate of Authq N/A Expiratior FIDate N/A Signed .7 - , -. Date/a-,3.-&rf 11 Owner or Owner's Designee, Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Arizona and employed by HSBI & I CO..
of Hartford, Connecticut , have inspected the components described in this Owner's Report during the period -q.
,*-_o to .. - , and state that to the best of my knowledge and and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code,Section XI.
By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
Commissions ,4F * " .. " iz 2(
irnas~ector's Signature - t National Board, State, Province, and Endorsements Date o eL. J'20 1 I Veri PV-eflee2Ver..1 PV-ED92 SACK BACK 730P-9Z217 73DP-9ZZ17
V ASME SECTION X! - REPAIR/REPLACEMENT Component ID 3SI241H012 2. Code Class ASME UI, NE/CLASS 2
,,NF/CLASS 2
- 3. Item Description Snubber
- 4. N-5 Package Number 3SI07-3 5. W.O. Number 684229
- 6. Original Construction Code Edition 1974 Edition, Wimter 1975 Addenda
- 7. Original Installation Code Edition 1974 Edition, Winter 1975 Addenda
- 8. Work Description Replacement of snubber W/rigid strut
- 10. Evaluation of the suitability of this work as per the requirements of IWA-4150.
Design mod LAW EDC #94-00467 Snubber replaced with a rigid strut.
- 11. Repair/Replacement Work Organization APS
'75 Winter
- 12. Replacement Item Construction or reconciled Code/Edition Subsection NF, Class 2/74 Edition, Winter
- 13. Repair/Replacement Activity Construction Code/Edition Subsection NF, Class 2/74 Edition, '75
- 14. ASME Section XI Code/Edition 1992 Edition, 1992 Addenda
- 3. Preservice Inspection Required. FA YES j NO
/'*i~lDate
___09/21/98 If required, include a step in the W.O. to perform Preservice Inspection.
- 16. ASME Section XI Pressure Test Required FJ YES 21 NO 09/21/98 If required, include a step in the W.O. for ISI & ANII Inspection.
JZ 09/21/98 17. Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
0 Daap 8In9 8nal
- .*.*., 09/21/98r - 18B. Include a step in the W.O. to record below all applicable numbers.
COMP I.D. PART NO. SERIAL NO. HEAT NO. ROS/EROS NO.
Strut #3962RR1 N/A N/A PL0007422 3SI241H012 Planne _\XSignatu e 09/21/98 Date Print Name L.D. Pagan
.. //
- 20. ISI Engineer__ __ __ _ __ __ _ Print Name I-' iP NL*lrt4
- 21. ANII .- 2S-1* Print Name 2.
L.
Sag Date 73OP-9Z17 PV.E- Ver. 2
I FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
- 1. Owner Arizona Public Service Company, et. al. Date 08/06/98 Name P. 0. Box 53999, Phoenix, Arizona 85072-2034 Sheet 1 of 2 Address
- 2. Plant Palo Verde Nuclear Generating Station Unit 3 Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 W.0.#684229 Address Repair Organization P.O. No., Job No., etr
- 3. Work Performed by APS Type Code Symbol Stamp None Name Authorization No. N/A Same as (Item#2 Expiration Date N/A Address
- 4. Identification of System SI
- 5. (a) Applicable Construction Code ASME III, NE / CL 2 1974_Edition, '75W Addenda, N/A Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1992 Edition, 1992 Addenda
- 6. Identification of Components Repaired or Replaced and Replacement Components I Name of Name of IReplaced Manufacturer National Other Year Repaired, or ASME Code Stamped Component Manufacturer Serial No. Board No. Identification Built Replacement (Yes or No)
Rigid StUt Lisega N/A N/A 3SI241H012 Replacement No
- 7. Description of Work Replacement of Snubber with Rigid Strut I.A.W.EDC # 94-00467
- 8. Test Conducted: Hydrostatic J Pneumatic Nominal Operating Pressure J N-416-1 Exempt Other Pressure psi Test Temp. 0F I
NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8 1/2 x II in.,
(2) information in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.
JUP.LL1I PV-EO092 Ver. 1 73DP-OZ-Z1I
I FORM NIS-2 (Back)
- 9. Remarks W.0.4684229 3SI241H012 CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this replacement conforms to the rules of the ASME Code,Section XI. repair or replacement Type Code Symbol Stamp N/A Certificate of Authorization No. N/A Expiratior Date N/A Signed /. " - r , Date /,_ -
Owner or Owner's Designee, Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Arizona and employed by HSBI & I CO.
of Hartford, Connecticut , have inspected the components described in this Owner's Report during the period -zz-m to ,o-,S-o , and state that to the best of my knowledge and and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code,Section XI.
By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owners Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
-ý : *i ! .- " Az. 2'-'
Commissions Inspector's Signature National Board, State, Province, and Endorsements Date -
7OP-eZZ17 Pv.Esee2 PV-E0092 Ver.
Ver. 1I sAcK BACK 73Dp-9ZZ1 7
I ASME SECTION Xl - REPAIR/REPLACEMENT
- 1. Component ID 3SI307H002 2. Code Class ASME III, NF / CLASS 2
- 3. Item Description SNUBBER
- 4. N-5 Package Number 3SI01-2 5. W.O. Number LEGACY #00684229 / 216570
- 6. Original Construction Code Edition 1974 EDITION, WINTER 1975 ADDENDA
- 7. Original Installation Code Edition 1974 EDITION, WINTER 1975 ADDENDA
- 8. Work Description REPLACEMENT OF SNUBBER WITH RIGID STRUT.
- 10. Evaluation of the suitability of this work as per the requirements of IAW-4150.
DESIGN MOD I.A.W. EDC# 94-00467. SNUBBERS BEING REPLACED WITH RIGID STRUTS.
- 11. Repair/Replacement Work Organization APS
- 12. Replacement Item Construction or reconciled Code/Edition Subsection, NF, Class 2/74 Edition.'75 Winter Addend
- 14. ASME Section Xl Code/Edition 1992 EDITION, 1992 ADDENDA
- 15. Preservice Inspection Required. [a YES C) NO x?'#)& of- - If required, include a step in the W.O. to perform Preservice Inspection.
initial Date
- 16. ASME Section XI Pressure Test Required Li YES @J NO SA -/*2-2#o/ If required, include a step in the W.O. for ISI & ANII Inspection.
naDate 6*-/,e--a 17, Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
Initial Date
" .z-2zco/
1*'-*' 18. Include a step in the W.O. to record below all applicable numbers for repaired or Initial Date " replacement items.
ITEM I.D. PART NO. SERIAL NO. HEAT NO. MR/ROS NO.
3SI307H002(E) STRUT #396159 N/A N/A PLO182621 3SI307H002(W) STRUT #396159 N/A + N/A PLO182621 (NE) R-BRACKET #356959 NIA N/A PLO182621 (NW) R-BRACKET #356959 N/A N/A i PLO182621 (SE) R-BRACKET#356959 NIA N/A PLO182621 (SW) R-BRACKET #356959 NIA N/A PLO182621
- 19. Planner t3..4' -.
P ,/*0-0a/ Print Name ROBERT M. BURTSELL Signature . Date
'0. ISl Engineer 1ý & ,//-' f Print Name R.P. INDAP Signature Date
- 21. ANII - ,-,z-o* Print Name ROBERT G. HOGSTROM
( Signature Date PV-EO093 Vet. 6 73DP-9ZZ17
IFORM NIS-2As OWNER'S Required by the REPORT FOR Provisions REPAIRS of the ASME Code ORSection REPLACEMENTSXl Owner Arizona Public Service Company, et. al. Date 08/06/98 Name P. 0.Box 53999, Phoenix, Arizona 85072-2034 Sheet 1 of 2 Address
- 2. Plant Palo Verde Nuclear Generating Station Unit 3 Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 W.O.#684229 Address Repair Organization P.O. No., Job No., etc.
- 3. Work Performed by APS Type Code Symbol Stamp None Name Authorization No. N/A Same as (Item#2) Expiration Date N/A Address
- 4. Identification of System SI
- 5. (a) Applicable Construction Code ASME III, NF / CL 2 1974 Edition, '75W Addenda, N/A Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 1992 Edition, 1992 Addenda
- 6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Other Year Repaired, ASME Code Component Manufacturer Serial No. Board No. Identification Built Replaced or Stamped
_______________________it_ Replacement (Yes or No)
'-id Strut &. -) Lisega N/A N/A 3SI30711002 20111 Replacement No RN Rear Bracket (4-ea.) Lisega N/A N/A 3SI307H002 20* Replacement No
- 7. Description of Work Replacement of snubber with Rigid Strut I.A.W. EDC#94-00467
- 8. Test Conducted: Hydrostatic A Pneumatic Nominal Operating Pressure Ij N-416-1 Exempt , Other 1- Pressure psi Test Temp.
ItOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8 1/2 x 11 in.,
(2) information in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.
PV-E0092 Ver' I 73DP-gZZ17
I FORM NIS-2 (Back)
- 9. Remarks W.O.#684229 3SI307H002 CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this . replacement conforms to the rules repair or replacement of the ASME Code,Section XI.
Type Code Symbol Stamp N/A Certificate of Authorization No. N/A Expiration Date N/A _
Sianed 95/
1-51, Date/0 -,-ý--)(
Owner or Owner's Designee, Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of Arizona and employed by HSBI & I CO.
of Hartford, Connecticut , have inspected the components described in this Owner's Report during the period -t- L-_-0% to ,o- k-ok , and state that to the best of my knowledge and and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code, Section Xl.
By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
/1 Commissions *-. ct- t 2.G(
Inspectors Signature National Board, State, Province, and Endorsements
"/ -' '
Date cr o-:, t-a-PVEO2Ve.I BCK70 Zi7 PV-E0092 Ver, 1 BACK 73DP-OZZ17
I ASME SECTION XI- REPAIR/REPLACEMENT
- 1. Component ID 3SI307H005 2. Code Class ASME III, NF / CLASS 2
- 3. Item Description Snubber
- 4. N-5 Package Number 3S101-2 5. W.O. Number W.O.#684229
- 6. Original Construction Code Edition 1974 Edition, Winter 1975 Addenda
- 7. Original Installation Code Edition 1974 Edition, Winter 1975 Addenda
- 8. Work Description Replacement of snubber with Rigid Strut.
- 9. [A ISl Flaw NDE Method of Flaw Detection Report Number
- 10. Evaluation of the suitability of this work as per the requirements of IWA-4150.
Design Mod. I.A.W. EDC#94-00467, Snubber being replaced with Rigid Strut.
- 11. Repair/Replacement Work Organization APS
- 12. Replacement Item Construction Code/Edition Subsection NF, CLASS 2 / 74 Edition.'75 Winter Addenda
- 13. Repair/Replacement Activity Construction Code/Edition Same as (Item#12) j4. ASME Section XI Code/Edition 1992 Edition,1992 Addenda
-TP2 c 9 e 15. Include step in the W.O. to perform Preservice Inspection Initial Date
_- 9 7 - 16. Include a step in the W.O. to send completed copy of this form to ISl Group.
Initial Date "D <:- 9 7- -- 17. Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
Initial Date
-- *"C- IntialDate 18. Include step in the W.O. to record below all applicable numbers.
COMP I.D. PART NO. SERIAL NO. HEAT NO. ROS/EROS NO.
3SI307H005 Stut#397109 N/A N/A PL0182621 R-Bracket#357959 N/A N/A PL0007423 Pipe Clanp#363264 N/A N/A PLO182621 19 . lne & A--4.v, - - "" Print Name J. Cruse (r7 Signature Date "20. ISI Engineer q--c7 cA Print Name " .T*'Nr4D Signature', Date
- 21. ANII i4Laa Print NameDat LSignature Date 7"3DP-9Z.717 PV-EO093 Vet. 1
I FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI I
- 1. Owner Arizona Public Service Company, et. al. Date 08/06/98 Name P. 0. Box 53999, Phoenix, Arizona 85072-2034 Sheet 1 of 2 Address
- 2. Plant Palo Verde Nuclear Generating Station Unit 3 Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 W.O.#684229 Address Repair Organization P.O. No., Job No., etc.
- 3. Work Performed by APS Type Code Symbol Stamp None Name Authorization No. N/A Same as (Item#2) Expiration Date N/A Address
- 4. Identification of System SI
- 5. (a) Applicable Construction Code ASME III, NF / CL 2 1974 Edition, '75W Addenda, N/A Code Case (b) Applicable Edition of Section Xl Utilized for Repairs or Replacements 1992 Edition, 1992 Addenda
- 6. Identification of Components Repaired or Replaced and Replacement Components Name of Name of Manufacturer National Other Year Repaired, ASME Code Component Manufacturer Serial No. Board No. Identification Built Replacement (Yes or No)
Rigid Strut Lisega N/A N/A 3SI307H005 2Uf3 Replacement No R-Bracket Lisega N/A N/A 3SI307H005 7fj- I Replacement No Pipe-Clamp Lisega N/A N/A 3SI307H005 "001 Replacement No
- 7. Description of Work Replacement of snubber with Rigid Strut I.A.W.EDC#94-00467
- 8. Test Conducted: Hydrostatic J Pneumatic [J Nominal Operating Pressure N-416-1 J Exempt I Other j Pressure psi Test Temp. .F I
I NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8 1/2 x 11 in.,
(2) information in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.
730P-52Z17 PV-ESOa2 PV-r:WS2 ye,. I Ver. 73DP-gZZ17
I FORM NIS-2 (Back)
- 9. Remarks W .0#84227 3SI307H005 CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this replacement conforms to the rules repair or replacement of the ASME Code, Section Xl.
Type Code Symbol Stamp N/A Certificate of Authorization No. N/A Expiratior Date N/A Signed - / gqc-n.I-*' Date 2j-/?ý-,*/
Owner or Owner's Designee, Title CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province of A,-izona and employed by HSBI & I CO.
of Hartford, Connecticut , have inspected the components described in this Owner's Report during the period , to 0 - ,*-aOk , and state that to the best of my knowledge and and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code,Section XI.
By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any manner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
A4 Commissions S 'S' 1 A`2t Inslktor's Signature National Board, State, Province, and Endorsements 1 \
2i Date 0,:-,, 6P i Ver. I1 F'VoE0092ye,.
PV.E5092 BAcK BACK 730P-eZZ17 73DP-gZZ17