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
PV-E0092 Vet. 6 FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
- 1. Owner A-izona Public Service Company. et. al.
Date 08/23/01 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. WhiterbrgR.TooaiAizn 85354-7529.
2413887 Address Work Order Number
- 3. Work Performed by Westinghouse Type Code Symbol Stamp None Authorization No.
N/A 911 W. Main St., Chattanooga, TN 37402 Expiration Date N/A Address
- 4. Identification of System Reactor Coolant
- 5. (a) Applicable Construction Code ASME M1[ Class 1 19_71 Edition, W '73 Addenda, N/A 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 Name of Manufacturer National Other Year Repaired ASME Code Item Manufacturer Serial No.
Board No. Identification Built Re lacement Yes or No Steam Generator CE 65273-1 22860 3MRCEEO1A 1981 Repaired Yes Tube Plugs Westinghouse N/A 2001 Replacement No
- 7. Description of Work Plug SG 3-1 Hot leg tubes per DFWO 2406659. See attached list.
- 8. Test Conducted:
[
Pneumatic Q Nominal Operating Pressure DJ Exempt RI N-416-1 j*
Other Q1 Pressure psi Test Temp, OF NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is B 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.
7*DP-gZZ i?
FORM NIS-2 (Back)
- 9. Remarks SEE DFWO 2406659 FOR TUBES PLUGGED (PLUGGING LIST ATTACHED).
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 replacemen Type Code Symbol StampN/A Certificate of Authorization No. N/A
.Expiration Date
-i Signed.
...I.4.4.4 Si Date Signed o wner 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.
, 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 Xl.
By signing this certificate, neither the Inspector nor his employer makes any warranty, expressed or implied, conceling 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.
S,
&cCommissions kr-
're-Az2,S lr4~crs Signature
-National Board, State, Province, and Endorsements Date
(.c_
5E-,o
- 24.2D k_
PV-E0092 Ver. 6 BACK 73DP-SZZ17
STEAM GENERATOR 3MRCEE01A WORK ORDER 2413887 "HOT LEG" ASME SECTION XI-REPAIR/REPLACEMENT COMP. ID PART NO.
SERIAL NO.
HEAT NO.
MR No.
3MRCEE0IA R79/C14 0307-1601 7857 J-9161-2 521386 3MRCEEOIA R45/C30 0307-1601 7856 J-9161-2 521386 3MRCEE01A R66/C39 0307-1601 7877 J-9161-2 521386 3MRCEEOI1A R1 081C39 0307-1601
.7852 J-91 61-2 521386 3MRCEE01 A R127/C44 0307-1601 7851 J-9161-2 521386 3MRCEE01 A R133/C48 0307-1601 7881 J-9161-2 521386 3MRCEE01A R147/C82 0307-1601 7882 J-9161-2 521386 3MRCEEOI1A R145fC68 0307-1601 7858 J-9161-2 521386 3MRCEEOI1A R133/C82 0307-1601 7883 J-9161-2 521386 3MRCEE1 A R135/C82 0307-1601 78584 J-9161-2 521386 3MRCEE01 A 51 R133/C82 0307-1601 7885 J-9161-2 518 3MRCEE01 A R12/C83 0307-1601 7881 J-9161-2 521386 3MRCEE01 A R14/C86 0307-1601 7863 J-9161-2 521386 3MRCEEOItA R44/C87 0307-1601 7886 J-9161-2 521386
-3MRCEE01 A R453C88 0307-1601 7862 J-9161-2 521386 3MRCEE01A R14/C89 0307-1601 788 J-9161-2 621386 3MRCEE0 7A R1450C90 0307-1601 7852 J-9161-2 521386 3MRCEEO1A R47/C92 0307-1601 7872 J-9161-2 521386 3MRCEE08A R145/C90 0307-t1601 7879 J-9161-2 521386 3MRCEE01A 518 R145tC92 0307-1601 7879 J-9161-2 518 3MRCEE01A R143/C92 0307-1601 7880 J-9161-2 521386
-3MRCEE01A R141_/C93 0307-1601 7882 J-9161,2 521386 3MRCEE01A 3,5 *-Ct'8o 0307-1601 7858 J-9161-2 521386 Page 1 of 3
STEAM GENERATOR 3MRCEE01A WORK ORDER 2413887 "HOT LEG" 3MRCEE01 A R44/C95 0307-1601 7869 J-9161-2 521386 3MRCEEOIA R45/C96 0307-1601 7877 J-9161-2 521386 3MRCEEOIA R1591C96 0307-1601 7254 J-9161-1 521386 3MRCEE01A R44/C97 0307-1601 7875 J-9161-2 521386 3MRCEEO1A R144/C97 0307-1601 7890 J-9161-2 521386 3MRCEE01A R15/C097 0307-1601 7278 J-9161-1 521386 3MRCEEOIA R45/C100 0307-1601 7874 J-9161-2 521386 3MRCEE01A R44/C 103 0307-1601 7864 J-9161-2 521386 3MRCEEOIA R36/C109 0307-1601 7866 J-9161-2 521386 3MRCEE01A R1401C109 0307-1601 7891 J-9161-2 521386 3MRCEEOIA R54/C 111 0307-1601 7860 J-91 61-2 521386 3MRCEE01A R31/C 112 0307-1601 7873 J-9161-2 521386 3MRCEEO1A R54/Cl 13 0307-1601 7867 J-9161-2 521386 3MRCEE01A R48/C 115 0307-1601 7898 J-9161-2 521386 3MRCEEIA R1451C116 0307-1601 7251 J-9161-1 521386 3MRCEE01A R56/C117 0307-1601 7865 J-9161-2 521386 3MRCEE01A RI08/C119 0307-1601 7892 J-9161-2 521386 3MRCEE01A R40/C123 0307-1601 7893 J-9161-2 521386 3MRCEEO1A R48/C123 0307-1601 7870 J-9161-2 521386 3MRCEEOIA R57/C124 0307-1601 7894 J-9161-2 521386 3MRCEE01A RI12/Cl 33 0307-1601 7280 J-9161-1 521386 3MRCEEOIA R125/C134 0307-1601 7895 J-9161-2 521386 3MRGEE01A R1 03fCl 38 0307-1601 7896 J-9161-2 521386 3MRCEE01A R121/C138 0307-1601 7897 J-9161-2 521386 3MRCEE01A RI118/C1 39 0307-1601 7898 J-9161-2 521386 Page 2 of 3
Page 3 of 3 M GENERATOR 3MRCEEOIA "HOT LEG"
ASME SECTION XI - REPAIR/REPLACEMENT
- 1. Component ID 3MRCEE01A
- 2. Code Class ASME SECTION Ii, CLASS 1
- 3. Item Description STEAM GENERATOR #3-1
- 4. N-5 Package Number 3RCOI-2
- 5. W.O. Number 2414006
- 6. Original Construction Code Edition 1971 EDITION & 1973 WINTER ADDENDA
- 7. Original Installation Code Edition.1974 EDITION & 1975 WINTER ADDENDA
- 8. Work Description INSTALL WESTINGHOUSE ROLL PLUGS IN 3MRCEE01A COLD LEG TUBES PER ENGINEERING DFWO 2406661 EVALUATION AND DISPOSITION.
- 9. [*j ISI Flaw NDE Method of Flaw Detection EDDY CURRENT Report Number 3R09 EDDY CURRENT EXAM. REPORT
- 10. Evaluation of the suitability of this work as per the requirements of IAW-4150.
EVALUATION PER ENGINEERING DFWO 2406661.
- 11. Repair/Replacement Work Organization WESTINGHOUSE
- 12. Replacement Item Construction or reconciled Code/Edition f071 EI5ITION-& 1973 WINTER ADDENDA
- 13. Repair/Replacement Activity Construction Code/Edition 1974 EDITION: & 1975 WINTER ADDENDA
- 14. ASME Section XI Code/Edition 1992 EDITION & 1992 ADDENDA.
- 15. Preservice Inspection Required.
yES I[NO 08/23/01 If required, include a step in'the W.O. to perform Preservice Inspection.
Initial Date
- 16. ASME Section XI Pressure Test Required
- YES, NO T08/23/01 If required, include a step in the W.O. for ISI & ANITTCEnspection.
- 20. E/ Eninee 17 ldease in th-W.O tcoprinte NaS2ome priorN P.
reainDAhecop oet Initial Date Initial Date 08/23/01 18, Include a step in the W.O. to record below all applicable numbers for repaired or Initial Date replacement items.
ITE I P.
.D, PART NO.
"SERIAL NO.
HEAT NO.
MRI-,HU NOu.
TUBE PLUGS SEE ATTACHED LIST SE TAL*DIIq SEE ATTACHED LIST SEE ATTACHED LIS:
- 19. Plannero--"
"-*b*
Print Name MICHAEL ]B. NEWrELL Sign~ature-f Dat 6,1 A,,I
,-4---
Print Name ROBERT G. HOGSTROM Print Na1 PV-E0093 Vet. 6 I
71 73DP-gZ2
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
- 1. Owner Aan.
et. al.
Date 08/23/01 Name P.O. Box 5399 oenix Arizona 85072-2034 Sheet 1
of 2
Address
- 2. Plant Pauar Generatin9 Station Unit 3
S........
Name2406 5801 S. Wintersbur Rd.. Tono ah Arizona 85354-7529 O2414006 Address
- 3. Work performed by Westinghouse Type Code Symbol Stamp None Authorization No.
N/A 911 W. Main St., Chattanooga, TN 37402 Expiration Date N/A__
- 4. identification of System Reactor Coolant
- 5. (a) Applicable Construction Code ASME I]I Class 1 19 71 Edition, W '73 Addenda, N/A 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 Name of Manufacturer National Other Year or StampeS d
Item Manufacturer Serial No.
Board No. Identification Built Re lacement es or N Steam Generator CE 65273-1 22860 3MRCEEOIA 1981 Repaired Tube Plugs Westinghouse N/A
-2001 Replacement INo
- 8. Test Conducted:
Pneumatic [*
Nominal Operating Pressure
- Exempt Ia N-416-1 [
Other ID Pressure_
_ psi Test Temp. -
.F NOTE: Supplemental sheeti in form of lists, sketches, or drawings may be used, provided (1) size is 8 112 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-EO092 Vet. 6 73OP-9ZZ7
FORM NIS-2 (Back)
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.
, have inspected the components described in this Owner's Report during the period
- -2-o to
-,.-oi
,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
~~~~~~
V... tt,
- ^4 inn Yl Report in accordance with the requirements 0t me AS,vI= U.o By signing this certificate, neither the Inspect or 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/
rt Commissions r.> ',41
- 4. z t.2(,S-k
- rs Signature National Board,. State, Province, and Endors-eints Date C _ C7*o6FoP_.
73DP-9ZZ1 PV-E0092 Ver. 6 BACK 7
II
- 9. Remarks SEE DFWO 2406661 FOR TUBES PLUGGED (PLUGGING LIST ATTACHED).
- Jo
- "t 'kOO*Lo 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. N/A Expiration Date Sige
_51Z or
,fwners fesignee,
- n.
Date Signed owner or Owner's Designee, Title ~
STEAM GENERATOR 3MRCEE01A WORK ORDER 2414006 "COLD LEG" ASME SECTION XI.REPAIRIREPLACEMENT COMP. ID PART NO.
SERIAL NO.
HEAT NO.
MR NO.
3MRCEEO1 A R791C14 0307-1601 9867 J-9162-2 521386 3MRCEEOIA R451C30 0307-1601 9892 J-9162-2 521386 3MRCEEO1 A
R66tC39 0307-1601 9893 J-9162-2 521386 3MRCEE01 A R108/C39 0307-1601 9861 J-9162-2 521386 3MRCEE01A R127/C44 0307-1601 9854 J-9162-2 521386 3MRCEE01A R133/C48 0307-1601 9857 J-9162-2 521386 I
3MRCEEOIA R134/C49 0307-1601 9856 J-9162-2 521386 3MRCEEOIA R1375C52 0307-1601 9855 J-9162-2 521386 3MRCEE01A R145/C68 0307-1601 9876 J-9162-2 521386 3MRCEE01A R141/C80 0307-1601 9879 J-9162-2 521386 3MRCEEOIA R35/C82 0307-1601 9872 J-9162-2 521386 3MRCEEOIA R133/C82 0307-1601 9888 J-9162-2 521386 3MRCEE01 A R532/C83 0307-1601 9890 J-9162-2 521386 3MRCEE01A R149/C86 0307-1601 9885 J-9162-2 521386 3MRCEEOIA R44/C87 0307-1601 9865 J-9162-2 521386 3MRCEEOIA R53t/C8 0307-1601 9873 J-9162-2 521386 3MRCEEO1A R140/C89 0307-1601 9880 J-9162-2 521386 3MRCEEOIA R45/C90 0307-1601 9874 J-9162-2 521386 3MRCEE08A R47/C90 0307-1601 9863 J-91 62-2 521386 3MRCEE01A R1 45/C90 0307-1601 9881 J-91 62-2 521386 3MRCEE01A
- 0 R4/C92 0307-1601 9865 J-9162-2 521386 3MRCEE01Ai R143/C92 0307.1601 9882 J-9162-2 521386 3MRCEE01A R142/C93 0307-1601 9895 J-9162-2 521386 3MRCEE01A R143~C94 0307-1601 9884 J-91 62-2 521386 Page 1 of 3
STEAM GENERATOR 3MRCEEOIA "COLD LEG" WORK ORDER 2414006 3MRCEEOIA 9
521386 R44/C95 0307-1601 9869 J-9162-2 521386 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 R441C115 0307-1601 9868 J-9162-2 521386 R 521C97 3MRCJ-9162 R144/C117 0307-1601 9891 J-9162-2 521386 3MRCEEO1A 521386 R61C58 17 0307-1601 9860 J-91 62-2 521386
.RE0C 19 07A 9875 J-9162-2 521386 R145IC100 0307-1601953 3R40C123I 0307-1601 9898 J-9 162-2 521386 3MRCEE J-962-2 521386 RR44/C 123 0307-1601 9859 R7*"C0A 9858 J-9162-2 521386 R36/C109 0307-1601 9869 j-9162-2 521386 3MRCE1A 521386 R125/C109 0307-1601 9889 J-9162-2 3MRCEE01A 9887 J-9162-2 521386 R54/C 117 0307-1601 97 3RE01"--9875 J-9162-2 521386 R310/C19200-6199 3MRCEE0IA 99J9122521386 R540/C123 0307-16 9W7 RCE I0A 989J-9162-2 521386._
R48tC123 0307-1601 96 3MRCEE01A 988J-9162--2 521386L_.
R457/Cl 1602-61941 3MRCE"E01A 989J-9162-2 521386..__
R561/C1133 0307-1601 96 3MRE0E--"-988-J-9162-2 521386__
! R108/Cl 19 0307-1601985 "3"M"*E01A 983J-9162-2 521386_.
R4 01C1238 0307-1601 99 3MCEE01A 90J-122521386 R481/C123 0307-1601 95 3MRCEE01A J-9162-2 521386; R118/C 3 3710 89J96-Page 2 of 3
STEAM GENERATOR 3MRCEE01A "COLD LEG" Page 3 of 3
ASME SECTION XI - REPAIRPREPLACEMENT
- 1. Component ID 3MRCEE0IB
- 2. Code Class ASME SECTION I1I. CLASS 1
- 3. Item Description STEAM GENER.ATOR #3-2
- 4. N-5 Package Number 3RCO1-2
- 5. W.O. Number 2414008
- 6. Original Construction Code Edition 1971 EDITION & 1973 WINTER ADDENDA
- 7. Original Installation Code Edition 1974 EDITION & 1975 WINTER ADDENDA
- 8. Work Description INSTALL WESTINGHOUSE ROLL PLUGS IN 3MRCEE01B HOT LEG TUBES PER ENGINEEi.NGWrWk6TION ISPOSITION.
- 9. 1 ISI Flaw NDE Method of Flaw Detection EDDY CURRENT Report Number 3R09 EDDY CURRENT EXAM. REPORT
- 10. Evaluation of the suitability of this work as per the requirements of IAW-4150.
EVALUATION PER ENGINEERING DFWO 2406663.
- 11. Repair/Replacement Work Organization WESTINGHOUSE
- 12. Replacement Item Construction or reconciled Code/Edition 1971 EDITION & 1973 WINTER ADDENDA
- 13. Repair/Replacement Activity Construction Code/Edition 1974 EDITION & 1975 WINTER ADDENDA
- 14. ASME Section XI Code/Edition 1992 EDITION & 1992 ADDENDA.
- 15. Preservice Inspection Required.
YES
[j NO
ý 08/23/01 If required, include a step in the W.O. to perform Preservice Inspection.
In I
Date
- 16. ASME Section XI Pressure Test Required
[
YES
[j NO S.
_ 08/.23/01 If required, include a step in the W.O. for ISI & ANII Inspection.
iio Date 08/23/01
- 17. Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
Inta Date 08/23/01
- 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/ROS NO.
TUBE PLUGS SEE ATTACHED LIST EE ATTACHED LIST SEE ATTACHED LIST SEE ATTACHED LIS
- 19. Planner--
Print Name MICHAEL B. NEWELL Si ire.
Date
- 20. IS, Engineer 2-_C%._.) Print Name RAMAKANT P.
INDAP
/Siglaure Date
- 21.
ISI Enn24ee Print Name ROBERT G. HOGSTR DM Signature Date J
7SD P -9Z Z 7 PFVEO093 Ver. 6 I
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
- 1. Owner zona. Public Servic COmafly. et. al.
Date 08/23/01 P.O. Box 53999 Phoei" Arizona 85072-2034 Sheet_
of Address
- 2. Plant Palo Verde Nuclear Gnen
-Station Unit 3
5801 S. Wjntersbur Rd. Tonopah Arizona 85354-7529 2414008 Address WI(OdrNme
- 3. Work Performed by Westinghouse Type Code Symbol Stamp None Name Authorization No.
N/A 911 W. Main St., Chattanooga, TN 37402 Expiration Date N/A Addrss
- 4. Identification of System Reactor Coolant
- 5. (a) Applicable Construction Code ASME IIn Class 1
19 71 Edition, W '73 Addenda, N/A 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 Name of Manufacturer National Other Year or Stamped Item Manufacturer Serial No.
Board No. Identification Built Re lacement Yes or No Steam Generator CE 65273-2 22861 3MRCEE01B 1981 Repaired Yes Tube Plugs Westinghouse
-NA 2001 Replacement No
- 7. Description of Work P_nMjSG j3-:2 Ho emg_.L~rDW 466.Seatced list.
- 8. Test Conducted:
Pneumatic E3 Nominal Operating Pressure [
Exempt [
N-416-1 [
Other Q 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-E0092 Vet. 6 73DP-9ZZ17
I We certify that the statements made in the report are correct and this repair conforms to the rules of the ASME Code, Section Xl.
repar or replacement Type Code Symbol Stamp N/A Certificate of Authorization No. N/A Expiration Date Signed
£2'I-Po
- Zf Date.L10L S
Owner or ownees Designee, Wel 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 Ari-zona' and employed by HSBI & I CO.
of H*rtford.
Connectcut
, have inspected the components described in this Owner's Report during the period
-- 4-c' 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 inspecion.
Commissions t,.
4tu, S 4 z" t" 2Az.
SNatOnal Board, State, Proince, and En=ott, Date ArR..
..2cc> k 730P-9=17 PV-E-009 Ver. 6 BACK Pv-E*
Ve*, 6 BACK FORM NIS-2 (Back)
- 9. Remarks SEE DFWO 2406663 FOR TUBES PLUGGED (PLUGGING LIST ATTACHED).
CERTIFICATE OF COMPLIANCE
<;
lnSpeS Snatiite I
STEAM GENERATOR 3MRCEE01 B WORK ORDER "HOT LEG" SASE SEC ION )XMI-REAIRRE illl MMENT.
COMP. ID PART NO.
SERIAL NO.
HEAT NO.
3MRCEED15B R61C13 0307-1601 9723 J-9162-2 521386 3MRCE01 b
-9162-2 521386B R81C13 0307-1601 9722 3MR E01B 521386 R81/C2 0 0307-1601 9711 521386 3MRCE01 B J-9162-2 521386 R83/C22 0307-1601 9724 J._16.--
521386 3MRCEE01 b 521386 R95/C22 0307-1601 9702 J-9162-2-5 3MCE01 B J-9162-2 521386 R103/C26 0307-1601 9458 3-9RCEE2 521386 R37/C28 0307-1601 9721 J-9162-2
, 3MRcE B
2 J-9162-2 521386 R62/C29 0307-1601 9705 521386 R102/037 0307-1601 9712 J-9162-2 521386 R 1307 979 J-9162-2 521386 R1 12/C33 30-1601959---.-
3MRCEE01 B 9-9162-2 521386 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 RC 6
0 9451 J-9162-2 521386 R1 04/C37 0307-1601 90 RCEE01 B 0971 J-9162-2 521386 R114/C5 3 0307-1601 945 521386 3NRCE01 970 J-9162-2 521386 SR40/C55 0307-1601 90 3ICE01 B 973
-9162-2 521386 R1 12/C57 0307-t 601 99 3NIR16C57 137-B 9750 J-9162-2 521386 3M-RCE 0I B 977J-9162-2 521386 RI R13/C58 0307-1601 99 3MRCEE01 B 94519 J-9162-2 521386 R110/C,61 0307-1601-----"-""
3MREE01B 941
-9162-2 521386 R81I /C62 0307-1601 91 3MIRCEE015 971
-9162-2 521386 8101C362 0307-1601 90
-NRCE01 B
9423-9162-2 "521386R R1 12=C3 '
0307-1601 95 Page 1 of 4
WCPI( flPflFP 414.00S STEAM GENERATOR 3MRCEE01 B "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".
WORK ORDER 2414008 3MRCEE01 B R691C92 0307-1601 9738 J-9162-2 521386 3MRCEEOIB R44/C93 0307-1601 9701 J-91 62-2 521386 3MRCEEOI 5 R69/C98 0307-1601 9739 J.9162-2 521386 3MRCEE01 B R44/C099 0307-1601 9717 J-9162-2 521386 3MRCEEOI B R65/C100 0307-1601 9734 J-9162-2 521386 3MRCEE01 B R1 2/C1 01 0307-1601 9793 J-9162-2 521386 3MRCEEOI-B R65/1C 02 0307-1601 9735 J-9162-2 521386 3MRCEE 01 R7OIC103 0307-1601 9724 J-9162-2 521386 3MRCEEO1 B R30/C1 06 0307-1601 9791 J-9162-2 521386 3MRCEEOIB R36/C107 0307-1601 9715 J-9162-2 521386 3MRCEE01B R40tC109 0307-1601 9720 J-9162-2 521386 3MRCEE01 B R134/C111 0307-1601 9454 J-9162-2 521386 3MRCEE01 B R152/0115 0307-1601 9472 J-9162-2 521386 3MRCEEOI B R43/C116 0307-1601 9714 J-9162-2 521386 3MRCEE01 B R31C15 11 0307-1601 9457 J-9162-2 521386 3MRCEEOI B RICER/C 150 0307-1601 9467 J-9162-2 521386 3MRCEE01 B RI143/Cl 26 0307-1601 9471 J-9162-2 521386 3
CER125/Cl130 0307-1601 9470 J-9162-2 521386 3MRCEEOI B R110/C120 0307-1601 94567 J-9162-2 521386 3MRCEE01 B 3MRCEEOI B R143/C128 0307-1601 9471 J-9162-2 521386 Page 3 of 4
STEAM GENERATOR 3MRCEE01 B "HOT LEG"
_____O Page 4 of 4
ASME SECTION X1l REPAIR/REPLACEMENT
- 1. component~ ID 3MRCEE01B p2. Code Class ASM-E SECTION III CLASS I
- 3. Item Description STEAM GENERATOR #3-2.
- 4. N-5 package Number 3RC01-2
- 5. W.O. Number 2414011
- 6. Original Construction Code Edition 1971 EDITION &
1973 WINTER ADDENDA
- 7. Original installation Code Edition 1974 EDITION & 1975 WINTER ADDENDA
- 8. Work Description INSTALL WESTINGHOUSE ROLL PLUGS IN 3MRCEE01B COLD LEG TUBES PER ENGINEERING DWO 2406664 EV ION AND DISPOSITION.
- 9. E! ISI Flaw NDE Method of Flaw Detection EDDY CURRENT Report Number 3R09 EDDY CURRENT EXAM. REPORT
- 10. Evaluation of the suitability of this work as per the requirements of JAW-41 50..
EVALUATION PER ENGINEERING DFPWO 2406664.
- 11. Repair/Replacement Work Organization WESTINGHOUSE.
- 12. Replacement Item Construction or reconciled Code/Edition 1971 EDITION & 1973 WINTER ADDENDA
- 13. Repair/Replacement Activity Construction CodeIEddition 1974 EDITION & 1975 WINTER ADDENDA
- 14. ASME Section Xl CodefEdition 1992 EDITION & 1992 ADDENDA.
- 15. Preservice inspection Required.,
YES-f NO 08/23/01 If required, include a step in the W.O. to perform Preservice Inspection.
D a teia
[.-DN O
- 16. ASME Section Xl Pressure Test Required ID YES D
NO 08/23/01 If required, include a step in the W.O. for ISI & ANII Inspection.
08/23/01
- 17. Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
Date l
ppial numbers for repaired or 08/23/01
- 18. Include a step in the W.O. to record below all applicable
ýitij'aereplacement items.
ITMID.ATNO.
SEILNO ET Os O
O
- 19.
Print Name MICHAEL B.
NEWELL
- 19. Plannerre Date
- 20. IS! Engineer_
Print Name RAMAj(ANT P. INDAP Eierae.sD
- 21. ANlI KC*
Da.Z V
te Print Name ROBERT G. HOGSTROM e
_73EP.9ZZ7 PV.EDO93Vflr. e
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 08/23/01 Name P.. Box 539 Phoenix Arizona 85072-2034 Sheet_
of 2
Address
- 2. Plant Palo Verde Nuclear Generatirl Station.
Unit Name 2414011 5801 S. Wintersbur Rd. Tono ah Arizona 85354-7529 W7414rd0r1N1
__er A d d r e s sW r k O d r N m e
- 3. Work Perforrned by Westin house Type Code Symbol Stamp None Authorization No.
N/A 911 W. Main St., Chattanooga, TN 37402 Expiration Date N/A
- 4. Identification of System Reactor Coolant
- 5. (a) Applicable Construction Code ASME II1 Class 1
- 19.
71 Edition, W '73 Addenda, N/A 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 Name of Manufacturer National Other Year Repaird ASMECode eManufacturer Serial No.
Board No. Identification acement e
Item cture ent Yes Steam Generator CE 65273-2 22861 3MRCEE0IB red Tube Plugs Westinghouse N/A Replacement No
- 7. Description of Work P SG 3-2 Cold le tubesr DFWO 2406664. See attached list
- 8. Test Conducted:
Pneumatic j*
Nominal Operating Pressure [
Exempt II N-416-1 [
Other Q 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-EO092 Vet. 6 73DP-9ZZ17
FORM NIS-2 (Back)
- 9. Remarks SEE DFWO 2406664 FOR TUBES PLUGGED (PLUGGING LIST ATTACHED).
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 XI.
rpair or replacement Type Code Symbol Stamp N/A Certificate of Authorization No. N/A Expiration Date Signe J
Ct/ K-0ate to-2, 0-0 Signed Owner or Owner's Designe, 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.
Co-nncticut
, have inspected the components described in this Owner's Report during the period 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 inspection.
Commissions AS.L A.
24.4
- ."-P. A Signat-re National Board, State. Province, and Endorsements Date c)o'e*-
.2.._.-
PV-E0092 Ver. 6 BACK 73DP-9ZZ17
STEAM GENERATOR 3MRCEE01 B WORK ORDER 2414011 "COLD LEG" ASME ECTION X1-REPAIR/REPLCMN
-- ~MR N""---O.
COMP. ID ARNO.
ERIALNO.
HEAT NO.
3MRCEE1B
-9162-2 521386B R6/C13 0307-1601 9477 J-9162-2 521386 3MRCEE019 521386B R8/C13 0307-1601 9439 J-9162-2 3MRCEE01 B R81/C20 0307-1601 9480 J-9162-2 521386 3MRCEE01 B R831C22 0307-1601 9489 J-9162-2 521386 3MRCEE01B 521386 R95/C22 0307-1601 9485 J-9162-2 3RC9-9162-2 5213860011 R13/C26 0307-1601 9488 3MRCEE01B 521386 R2I/C29 0307-1601 9424 J-9162-2 RC0E01 B 9437 J-9162-2 521386 RI 02/C33 0307-1601 943 521386 3R2C0E01B 9436 J-9162-2 521386 R12/C33 0307-1601
-- '-521386 3MRCE01B 521386 R71/C33 0307-1601 9466 J-9162-2 521386 R8EE0C34 0307-1601 9425 J-9162-2 521386 3MRCEE01 B 3-9162-2 521386 R87/C36 0307-1601941-.---
3 "R8EE012B 9478 J-9162-2 521386 R9504C37 0307-1601 3MRCEE01 B J-9162-2 521386 R1041C53 0307-1601 9465 3MRCEE 521386 R140IC53 0307-1601 9424 3MRCEE01 B 93J9122521386 RI41/C57 0307-1601 98
"-3M-RCEE01 1393 J-9162-2 521386 R1126/C57 0307-1601934-.----------'-""-'"
[
R13C58E007160 9437 J-9162-2 521386 R77.6 0307-1601 96
-122518 3*MRCEE01 13 9425 J-9162-2 521386 RI C6 0307-1601 3-MRCEE01 B 96
-122518 R8/6 0307-1601 97
-122518 3MRCEE01 B 942J9 22521386 R801/C6203760948312 3MRCEE01 B 94J9122521386 R1 12/C603-60940-922 Page 1 of 4
STEAM GENERATOR 3MRCEE01B "COLD LEG" WORK ORDER 2414011 "ODLG 3MRCEEO1 B RI091C66 0307-1601 9485 J-9162-2 521386 3MRCEE01B 521386 R7701C67 0307-1601 9476 3MRCEEOIB J-9162-2 521386B R771C74 0307-1601 9444 521386
"-'-MRCEE01BJ-122538 R681C74 0307-1601 9484 R68/C77 0307-1601 9464 3MRCEEO1 B R359C76 0307-1601 9499 J-9162-2 3MRCEEOIB R65/C80 0307-1601 9463 J-9-162-2 521386 3MRCEEO1B J-9162-2 521386 R62/C80 0307-1601 9412 2-.,521386 3MRCEE01B J9162-2 521386B R64/C81 0307-1601 9495 3MRCEEOI B
R62/C81 0307-1601 9410 J-9162-2 521386 R3"M EEC 0307-1601 9411 J-9162-2 521386 R96/C81 3710 49 3MRCEE01 B R71JC84 0307-1601 949 J-9162-2 521386 3MRCEEOI B R102/C81 0307-1601 9401 J-9162-2 521386 3MRCEE01B J-9162-2 B21386 R351C82 0307-1601 9500 52138 3MRCEEOIB R97/C82 0307-1601 9431 J-9162-2 521386 3MRCEEO B R571C88 0307-1601 9412 J-9162-2 521386 3MRCEEO1 B R59/C88 0307-1601 9492 J-9162-2 521386
3MRCEEOIB R71/8C4 0307-1601 9494 J-9162-2 521386 S3MRCEE01 B 947J-9 162-2 521386 R1 02/C85 0307-1601947.---
R70/C87 0307-1601 9500 J_-916-2-----
3MRCEE01 B1 518 R76/CB7 0307-1601 9448 521386-3MRE01B J-122521386 R57/C88 00-619413 J-16 3MRCEE01BJ-622 518 R59/C88 0307-1601 9490J9122538 3MRCEE01B5238 R 1818C89 0307-1601 9446 J-9162-Page 2 of 4
STEAM GENERATOR 3MRCEEOIB "COLD LEG" Page 3 of 4 W,R)"K* O.,RDELR:.
2'r4u 14 1
3MRCEE0 3B R69/C92 0307-1601 9408 J-9162-2 521386 3MRCEE01B R44/C93 0307-1601 9403 J-9162-2 521386 3MRCEE01 B R69/C98 0307-1601 9491 J-9162-2 521386 3MRCEEOIB R44/C99 0307-1601 9498 J-9162-2 521386 3MRCEE01 B R65/C100 0307-1601 9405 J-9162-2 521386 3MRCEEOI B R128/C101 0307-1601 9445 J-9162-2 521386 3MRCEE01 B R65/C102 0307-1601 9407 J-9162-2 521386 3MRCEEOI B R44/C103 0307-1601 9497 J-9162-2 521386 3MRCEE01B R152/C103 0307-1601 9443 J-9162-2 521386 3MRCEEO1B R95/C 104 0307-1601 9430 J-9162-2 521386 3MRCEE01B R706C105 0307-1601 9493 J-9162-2 521386 3MRCEE01 B R39/CI06 0307-1601 9496 J-9162-2 521386 3MRCEE01B R36/C 107 0307-1601 9402 J-9162-2 521386 3MRCEE01 B R40tCl 09 0307-1601 9495 J-9162-2 521386 3MRCEEO1 B R134/C111 0307-1601 9435 J-9162-2 521386 3MRCEE01 B R152/Cl 15 0307-1601 9429 J-9162-2 521386 3MRCEE01 B R43/Cl16 0307-1601 9404 J-9162-2 521386 3MRCEEO1 B R23/C 118 0307-1601 9406 J-9162-2 521386 3MRCEE01 B RI 15/C1 20 0307-1601 9449 J-91 62-2 521386 3MRCEE01 B R111/C122 0307-1601 9426 J-9162-2 521386 3MRCEEOI B R110/C127 0307-1601 9442 J-9162-2 521386 3MRCEE01 B R143/C128 0307-1601 9421 J-9162-2 521386 3MRCEE01 B R125/C130 0307-1601 9427 J-9162-2 521386 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
STEAM GENERATOR 3MRCEE01B "COLD LEG" Page 4 of 4
ASME SECTION XI - REPAIRIREPLACEMENT
- 1. Component ID 3PRCEL032
- 2. Code Class AS3E SECTION III, CLASS 1
- 3. Item Description REACTOR VESSEL TO STEAM GENERATOR #1 PIPING
- 4. N-5 Package Number 3RC01-2
- 5. W.O. Number 2428231
- 6. Original Construction Code Edition ASME SECTION III, CLASS 1, 1974, SUMMIER 1974 ADDENDA
- 7. Original Installation Code Edition ASME SECTION m, CLASS 1, 1974, WINTER 1975 ADDENDA
- 8. Work Description Install a Mechanical Nozzle Seal Assembly (MNSA) on the RCS piping to stop the RCS leakage at-RTD nozzle location
-jrCDT 1121D. Reference DFWO 2427755.
- 10. Evaluation of the suitability of this work as per the requirements of IAW-4150.
Evaluation of the installation of the MNSA is described in engineeriDWO 2427755
- 11. Repair/Replacement Work Organization Arizona Public Service
- 12. Replacement Item Construction or reconciled Code/Edition ASME Sec. IlI, 1, 1989 Edition
- 13. Repair/Replacement Activity Construction Code/Edition ASME Sec. III, Cl 1, 1974 Ed., Winter 1975 Addenda
- 14. ASME Section XI Code/Edition 1992 Edition, 1992 Addenda, NRC Relief Request, NRC Docket number STN 50-5
- 15. Preservice Inspection Required.
@j YES I1J NO S/0/1A/6, If required, include a step in the W.O. to perform Preservice Inspection.
tA l
date
- 16. AS E Section XI Pressure Test Required Ej YES Q NO i_
14./0 a If required, include a step in the W.O. for ISI & ANII Inspection.
/04?(v:'
/
- 17. Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
-y *#pitlj¢ Date
- 18. Include a step in the W.O. to record below all applicable numbers for repaired or tal De replacement items.
ITEM I.D.
PART NO.
SERIAL NO.
HEAT NO.
MR/ROS NO.
ly~ ~~~
~
R
('ýN/
A.
56 Compression Collar APN/A S*7
- 19. Planner 47i'~
Print Name He rbert L.
Green
- 20. IS, Engineer
/a.
Print Name,
/
Signature
- 21. LAA.
NNI 1,,,-
Print Name
°
- 6.
k S signature Date PV-EO093 Ver. 6 73DP-9ZZ17 I
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI Date JI1,<,\\J-
- 1. Owner Arizona Public Service Company, et. al.
Name P.O. Box 53999, oenix. Arizona-85072-2034 Date e__*_
o Sheet 1
-of 2
- 2. Plant Palo Verde Nuclear Generating Station Unit 3
1-alV Name2423 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 2428231 Address
- 3. Work Performed by Arizona Public Service Name P.O. Box 53999, Phoenix, Arizona 85072-7529 Address Type Code Symbol Stamp None Authorization No.
N/A Expiration Date N/A
- 4. Identification of System Reactor Coolant System, line number 3PRCEL032, Spool 001
- 5. (a) Applicable Construction Code ASME Sec.
III 19 74 Edition, S'75
- Addenda, (b) Applicable Edition of Section Xl Utilized for Repairs or Replacements 19 92 Edition, 1992
- 6. Identification of Components Repaired or Replaced and Replacement Components
- 7. Description of Work Install a Mechanical Nozzle Seal Assembly (MNSA) iaw DFWO 2427755.N-
- 8. Test Conducted:
Hydrostatic U Pneumatic []
Nominal Operating Pressure [@1 Exempt IQ Pressure psi 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 Ver. 6 73DP.9ZZi7 Other QJ I
Code Case Addenda N-416-1 Q*
Test Temp.
° F
FORM NIS-2 (Back)
Install a Mechan~~~~~~~~~~~~~~~ica ozeSa seby(NA nteRSppn oso h
C ekg 9
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 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 ______
Certificate of Authorization No.
N.a p Expiration Date Signe/
/-,
41
/,_I/ rDate
,./, 2 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 Xl.
By signing this certificate, neither the Inspectornor 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.
inspt rs Signature Commissions
)S -
"'-h A-z. -
.- k National Board, State, Province, and Endorsements Date 2Qt PV-E0092 Ver. 6 BACK
. Remarks 73ur-YZ-,
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.
nala Date Da4te. -*
- 17. Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
7Fbha Date j*.
r u
i 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 Print Name (2.. (1 S Inature Date 73DP-97-Z1 7 PV-E0093 Vet. 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.
Name P.O. Box 53999, Phoenix. Arizona 85072-2034 Address
- 2. Plant Palo Verde Nuclear Generating Station Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 Address
- 3. Work Performed by Arizona Public Service Co.
Name 5801 S. Wintersburg Rd., Tonopah, Az. 85354 Date 10/07/01 Sheet 1
of 2
Unit 3
2429127 Work Order Number Type Code Symbol Stamp None Authorization No.
N/A 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 Name of Manufacturer National Other Year Repaired ASME Code 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.
- 8. Test Conducted:
Hydrostatic [J Pneumatic [J Nominal Operating Pressure C Other Q Pressure psi Te Exempt r1 N
st Temp.
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 730P-9ZZ1 7
-416-1 Ij OF PV-E092 er.I 730P-9ZZ17
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 Pv.E0092 ver. 6 BACK 730P-BZZI 7 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
,,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.
s NB 9685 "N" "I" Az 264 National Board, State, Province, and Endorsements (Ipector's Signature Date o2_
-200k Commissions PV-E0092 Vet. 6 BACK 73DP-9ZZ17
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.
al n-a 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 73DP-9ZZ17 PM-E0093 Vet. 5
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.
Name P.O. Box 53999, Phoenix, Arizona 85072-2034 Address
- 2. Plant Palo Verde Nuclear Generating Station Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 Address
- 3. Work Performed by Arizona Public Service Co.
Name 5801 S. Wintersburg Rd. Tonopah, Arizona 85354-752S Date Sheet Unit 10/06/01 1
of 2
3 2430049 Work Order Number Type Code Symbol Stamp None Authorization No.
N/A 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 Other fj Pressu natic *j Jre Nominal Operating Pressure []
psi Test Temp.
Exempt N-416-1 I*1 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.
PV-Eoog2 Ver. 5 BACK 73DP*9ZZ1 7 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 N /A Type Code Symbol Stamp Certificate of Authorization No.
4 /A-Expiration Date 1-/_'A Signed n
/
C'&-
b..
"'-'.,K 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.
PV-E0092 Ver. 5 BACK 73DP-gZZ17
ASME SECTION Xl - REPAIR/REPLACEMENT
- 1. Component ID 3PRCEL018, 3PRCEV244
- 2. Code Class ASMt Section Ji, C1 I
- 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
- 8. Work Description Replace the installed check valve body (3PRCEV244) with new pipe per Appendix "A" of 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
/ -
inature 7 Date/
- 21. ANII Print Name C.o,,gcE Si,ature Date I
7"* n lO077 1*7 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.
Narize P.O. Box 53999, Phoenix. Arizona 85072-2034 Address
- 2. Plant Palo Verde Nuclear Generating Station Name 5801 S. Wintersbur2 Rd.. Tonopah, Arizona 85354-7529
- 3. Work Performed by APS Address Name 5801 S. Wintersburg Rd. Tonopah, AZ. 85354-7529 Date 10, Sheet 1
Unit
/14/01 of 2
3 2431286 Work Order Number Type Code Symbol Stamp None Authorization No.
N/A 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 Name of Name of Manufacturer National Other Year Repaired ASME Code or Stamped Item Manufacturer Serial No.
Board No. Identification Built Replacement (Yes or No) 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.
PV-E0092 Ver. 6 730P-9ZZ1 7 PV-E00g2 Ver. 6 73DP-9ZZ17
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 of the ASME Code, Section Xl.
repair or replacement Type Code Symbol Stamp N/A Certificate of Authorization No. N/A Signed,e L.*'ze.,A
?Ak-
,/
L/-
ISI Engineer Owner or Owners Designee, Title Expiration Date Date
,,/,z/*
PV-E0092 ver. 6 BACK 7SDP-9ZZ17 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.
NB 9685 "N" "I" AZ264 National Board, State, Province, and Endorsements spectoes Signature Date Zo,,.
., 20ook Commissions 73DP-9ZZt7 PV-EO092 Ver. 6 BACK
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
- 7. Original Installation Code Edition ASME SECT. III, CL 2, 1974 EDITION W'75 ADD
- 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
- 12. Replacement Item Construction or reconciled Code/Edition ASME SECT. III, CL 2 1974 EDITION W'75 ADD
- 13. Repair/Replacement Activity Construction Code/Edition ASME SECT. III; CL 2 1974 EDITION W'75 ADD
- 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
- 20. ISI Engineer 5 '
/t/12/1e Print Name
^,,rev A-*
k,*oV-*
Si ljture 10,d-e 7r(,.$/_ cco9ate t.J/
- 21. ANII
- /P Name ROBERT H TROM O
4eoa z
Signature Date PV-EO093 Ver. 6 I
PV-E00g3 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.
Name P.O. Box 53999, Phoenix, Arizona 85072-2034 Address
- 2. Plant Palo Verde Nuclear Generating Station Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 Address
- 3. Work Performed by Arizona Public Service Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85 3 54-7 52S Date io - Q, - 0" Sheet 1
of 2
Unit 3
2431785 Work Order Number Type Code Symbol Stamp None Authorization No.
N/A 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 Other [J Pressure psi ng Pressure [J Exempt [j 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.,
(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.
N-416-1 Ej OF 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
" Exj Signed 4 :::.;e "5.r
'1"2 "Q'! '
Owner or Owner's Designee, Title piration Date
/_//_4 Date 1c1/.1of 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" National Board, State, Province, and Endorsements
- 3. 2C6 Date OcTor.FP-.
(3 Inspector's Signature PV-E0092 Ver. 6 BACK 73DP-gzzl 7 f
73DP-9ZZ17 PV-E0092 Ver. 6 BACK
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 I
_C)
(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
- 1. Owner Arizona Public Service Company, et. al.
Nan02e P.O. Box 53999. Phoenix. Arizona 85072-2034 Address
- 2. Plant Palo Verde Nuclear Generating Station Name 5801 S. Wintersburg Rd., Tonopah,_Arizona 85354-7529 Address
- 3. Work Performed by Arizona Public Service Co.
Name 5801 S. Wintersburg Rd. Tonopah, Arizona 85354-7529 Date 10/17/01 Sheet 1
of 2
Unit 3
2433026 Work Order Number Type Code Symbol Stamp None Authorization No.
N/A Expiration Date N/A Address
- 4. Identification of System (EW) Essential Coolifig Water
- 5. (a) Applicable Construction Code Section III, C1.3 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 Manufacturer Manufacturer Serial No.
National Board No.
Other Identification Year Built Repaired or Reolacement I,'
Stamped (Yes or No)
B EW Ht. Exch.
Struthers Wells 17606329152 N/A MEWBE01 80 Repaired Yes
- 7. Description of Work
- 8. Test Conducted:
Hydrostatic Ij Other QJ Pneumatic [*j Pressure Nominal Operating Pressure [j Exempt fJ N-416-1 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 Name of Item 73DP-9ZZ17 L
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 We certify that the statements made in the report are correct and this repair of the ASME Code,Section XI.
repair or replacement conforms to the rules Type Code Symbol Stamp Certificate of Authorization No.
Signed z
ý
,VfA
Expiration Date A//
O1OsDe "r11e 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.
NB 9685 "N` AZ264 National Board, State, Province, and Endorsements ots-*
r's Signature Date caLz
£ Commissions 73DP.gzzl 7 PV-E0092 Ver. 6 BACK Date Lo/Z Y1201 73DP-gZZ17
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 m S
ýZlItt WS!.)
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
9/c/il/b &
If required, include a step in the W.O. to perform Preservice Inspection.
Initial Date
- 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 S9/*Z Vo rj17. Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
Initial
~Date 9
p//jZ 7 n 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 1,%3____-,
-cc>otO 9//Q/,4 Print Name GERALD OSMUNDSON
[ate
_____ Print Name 4-N-DA Date
'-1-2%-O0 Print Name
- . (.
PV-E0093 Vet. 6 73OP-9ZZ17 a
PV-EO0O3 Vet. 6 73DP-gZZ17
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASMVE Code Secti on X1
- 1. Owner Arizona Public Service Company, et. al.
-Date 09120/00 Name P.O. Box 53999, Phoenix, Arizona 85072-2034 Sheet 1
of 2
Address
- 2. Plant Palo Verde Nuclear Generating Station Unit 3
Name000293 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 00-00219434 Address
- 3. Work Performed by APS Type Code Symbol Stamp None Authorization No.
N/A 5801 S Wintersburg Rd, Tonopah, Arizona 85354-7529 Expiration Date N/A Address
- 4. Identification of System RC, ASME SECTION III, CLASS 1
- 5. (a) Applicable Construction Code Section III, CLASS 1 19 74 Edition, 75W 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 Name of Manufacturer National Other Year Repae Stm e
Item Manufacturer Serial No.
Board No. Identification Built Re lacement Yes or No VALVE Target Rock
.N/A 3jrcbhv108 Replacement
-s
- 7. Description of Work Remove valve and install new style 1
INCH valve model#
- 8. Test Conducted:
Hydrostatic [*
Pneumatic {J Nominal Operating Pressure [j Exempt [a N-416-1 U Other UIJ Pressure psi Test Temp.
__OF NOTE: Supplemental sheets ih 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 Jq.c.
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 X1.
repair or replacement Type Code Symbol Stamp Certificate of Authorization No. ___
Expiration Date Signed 1 *%$ý"
52?-
- r.
Date 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 Hrtford Connecicut.r
, have inspected the components described in this Owner's Report during Sut nve ispectd thoconenent the period C--
o to nec t
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 k
2LA Inspector's Signature National Board, State, Province, and Date C,.
3o-o PV-E0092 Ver. 6 BACK 730P.9ZZ17
I I ASME SECTION XI - REPAIR/REPLACEMENT
- 1. Component ID 3JRCBHV0 109
- 2. Code Class ASME SECTION III 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#00-002194 35
- 6. Original Construction Code Edition 1977 EDITION, ADDENDA WINTER 1978
- 7. Original Installation Code Edition 1974 EDITION, ADDENDA WINTER4974
- 8. Work Description REMOVE AND REPLACE VALVE PER PLANT CHANGE TO NEW STYLE VALVE 1 INCH MODEL# 98F-001
- 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 III BOUNDRY.
- 11. Repair/Replacement Work Organization APS
- 12. Replacement Item Construction or reconciled Code/Edition -97 TA,
'3 Renair/Replacement Activity Construction Code/Edition 1974 EDITION, ADDENDA WINTER497+ t 97-
- 14. ASME Section Xl Code/Edition 1992 EDITION, ADDENDA 1992
- 15. Preservice Inspection Required.
U YES
@ NO I-_/
9/f Vtuei If required, include a step in the W.O. to perform Preservice Inspection.
- 16. ASME Section XI Pressure Test Required
[*
YES
[D NO IE IlD.P If required, include a step in the W.O. for IS[ & ANII Inspection.
Nam;!ia-eat4e 20/.Tý00_ 17. Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
Iiv<aY
-- Date SelC/]
/Vo
- 18. include a step in the W.O. to record below all applicable numbers for repaired Or Iiil
/ bat4 replacement items, ITEM I.D.
PART NO.
SERIAL NO.
HEAT NO.
MRIHOS NOu.
3JRCBH-V0109 98F-00
""dA 66 7
.od
- 19. Planner..,'
Prn Name GERLDStooS Signature-D ate
- 20. ISI Engineer.
Lafl P
?J!tz rint Name."**
7ZS naur DateJ**
211 ANII
-Z-o Print Name e.-
PV-EO093 Ver. 6 I
H'Ot I
-730P-gZZ17 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 09/20/00 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 00-00219435 Address Work Order Number
- 3. Work Performed by APS Type Code Symbol Stamp None Name Authorization No.
N/A 5801 S Wintersburg Rd, Tonopah, Arizona 85354-7529 Expiration Date N/A Address
- 4. Identification of System RC, ASME SECTION III, CLASS 1
- 5. (a) Applicable Construction Code Section III, CLASS 1 19 74 Edition, 75W
- 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 Item Manufacturer Serial No.
Board No. Identification Built Replacement (Yes or No VALVE Target Rock
-7 N/A 3jrcbhv0109 zec Replacement
'&v,
- 7. Description of Work Remove valve and install new style 1 INCH valve model# 98F-001
- 8. Test Conducted:
Hydrostatic [J Pneumatic tJ Nominal Operating Pressure [
Exempt [*
N-416-1 [
Other
- 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) 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 of the ASME Code,Section XI.
repair or replacement Type Code Symbol Stamp __/__
Certificate of tAuorization No.
A/.//,.
Signed
,,S" z----
/-
V '-
Owner or Owner's Designee. Title Expiration Date N/A Date /O-,,q8--C/
73DP-gZZ17 PV-EO092 Ver. 6 BACK 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 Date -o ctor. s Signature Date Oc-rorwr,E?
M, t200 r/
-7
ASME SECTION X - REPAIRIREPLACEMENT Component ID 3S1067H003
- 2.
Code Class ASME III, NF / CLASS 2
- 3.
Item Description SNUBBER
- 4.
N-5 Package Number 3S107-3 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.
ISI Flaw NDE Method of Fia"W' bet.i.dn Rep 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 T'eplaced 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 XI Code/Edition 1992 Edition_,_.99 2 Addenda
- V c-
& 15. Include step in the W.O. to perform.Preservice Inspection Initial Date Zx,:
C
) g-
'x
- 16. Include a step in the *W.O. to send'completed copy of this form to ISI Group.
Initial Date c-
- 17. Include a step in the W.O. to completeWNlS-2 Form prior to releasing the component.
Initial Date
__Q 0 -b 9
- 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.
3S1067H003 Strut#3961 2 9 N/A N/A PLO182621 Rear Bracket #356959 N/A N/AROS#904 1 3 6 8 7 Pipe Clamp#364 16 3 N/A N/A PL0182621
- 19. Planner P).
- f I Print Name J. Cruse
'9. Pla Engineer__________________________
Print Name Signature Date
,21.
ANI Print Name__________________
Signature Date7DPgZ7 t'V-E0093 Vet. 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.
Name P. 0. Box 53999, Phoenix, Arizona 85072-2034 Address
- 2.
Plant Palo Verde Nuclear Generating Station Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 Address
- 3.
Work Performed by
- 4.
Identification of System APS Name Same as (Item#2)
.Date 08/06/98 Sheet Unit 1
of 2
3 W.O.#684229 Repair Organization P.O. No., Job No., etc.
Type Code Symbol Stamp None Authorization No.
N/A Expiration Date N/A Address 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 Exempt [A Other 1-Pressure Nominal Operating 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.
I N-416-1 o F PV-ED092 Ver, 1 73DP-97Z-I7
FORM NIS-2 (Back)
Remarks 3-S1-06.
W.O>#6 84229 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 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 Date
-*30 /
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.
- <KZ~
Commissions 2(- q*g
,z 6
Dectors Siqnature
/
National Board, State, Province, and Endorsements PV-E0092 Ver. I BACK 11-9-17 3-SI-067-HOO3 I-
. P--
(Zi ned ZI I
ASME SECTION XI - REPAIR/REPLACEMENT Component ID 3CH142H003
- 2.
Code Class ASME III Item Description SNUBBER N-5 Package Number 3CH02-5
- 5.
W.O. Number #684229 Original Construction Code Edition 1974 Edition,Winter 1975 Addenda Original Installation Code Edition 1974 Edition, Winter 1975 Addenda Work Description Replacement of snubber with Rigid Strut.
,NF/CLASS 2
- 9.
3 ISI 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 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
- 3.
- 4.
- 6.
- 7.
8.
PV-EOOF)3 Vr., I 73DP-SZZ17
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. O. Box 53999, Phoenix, Arizona 850 7 2 -2 03 4 Sheet 1
of 2
Address U i
- 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 (ItemgQ Expiration Date N/A
- 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 Yea RepaIed ASME Code Component Manufacturer Serial No.
Board No.
Identification Built Replacement (Yes or No)
":,id Strut Lisega N/A N/A 3CH142H003 Replacement No
- 7. Description of Work Replacement of snubber with Rigid Strut I.A.W. EDC#94-00 4 6 7
- 8.
Test Conducted:
Hydrostatic J Pneumatic j Nominal Operating Pressure j N-416-1 Exempt jl Other,
Pressure psi Test Temp.
._'17 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 730P.9ZZ17
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 Signed
/5/'
&(-
t:
Owner or Owner's Designee, Title Date N/A Date-/,-?
.- C' 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-Date T0-ro.-
%i.nspectors Signature
'3 Commissions
,.)
6 Az A
National Board, State. Province. and Endorsements 0/
.t3Ct V
PV-E0092 Vr i eACK 730P-eZZlT 3
PV-EO092 Vet-I BACK 730P-OZ717
ASME SECTION XI - REPAIRIREPLACEMENT Component ID 3CH424H002
- 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 197, AdtoinVwinter 1975 Addenda
- 8.
Work Description Replacement of snubber with Rigid Strut.
- 9.
j ISI 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 XI Code/Edition 1992 Edition,1992 Addenda
.._15.
Include step in the W.O. to performýPreservice Inspection Initial Date D-) c t"7-7.°tj
- 16. Include a step in the W.O. to send completed copy of this form to lSI Group.
Initial Date
)YD <
"I 17. Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
Initial Date
-i 9 1k 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.
3CH424H002 Strut #395049 N/A N/A 90S04136;1; Rear Bracket #35 5 9 5 9 N/A N/A Rear Bracket#3559 5 9 N/A N/A
- 19. Planne, -
C -,-.%
Print Name J. Cruse Signature Date
-0. ISI Engineer Print Name i;'C-t11P4
- 21.
,N-,
!I-
-Print Name o&.ot, Signature Date 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.
Name P. 0. Box 53999, Phoenix, Arizona 85072-2034 Address
- 2.
Plant Palo Verde Nuclear Generating Station Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529
- 3.
Work Performed by
aoress APS' Name Samne as (Ltem#2)
Address Date 08/06/98 Sheet 1
of 2
Unit 3
W.O.#684229 Repair Organization P.O. No., Job No., eta Type Code Symbol Stamp None Authorization No.
N/A Expiration Date N/A
- 4.
Identification of System ST
- 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 (YesorNo)
",,gid Strut Lisega N/A N/A 3CH424H002
,01 Replacement No Rear Brackets Lisega N/A N/A 3CH424H002 1(1 Replacement No
- 7. Description of Work Replacement of snubber with Rigid Strut I.A.W. EDC#94-00467 Test Conducted:
Hydrostatic J Pneumatic Nominal Operating Pressure 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.
PV.EOg02 Vet. I 8.
N-416-1 j OF Address SI 7
FORM NIS-2 (Back)
- 9. Remarks W.O.#684229 3CH424H002 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 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.
Inspectors Signature Date D[
Commissions
,P
-1"
,A7 26c(
National Board, State, Province, and Endorsements PV-E0092 Ver. 1 BACK 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
_5/
2t-'4-,---i Date 6
Owner or Owner's Designee, Title 73OP-OW11 7
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
- 9.
[
ISI 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
)
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
- 19. nr-q -K. /?
Print Name J. Cruse
- 19. Planner A,'..7.w,-_----Y
--L/L--t Signature Date
- 1. IS. Engineer -
6..9 Print Name R
,-il-7 )A P-I21. ANII Print Name Q?. 6
- o. -rf*.,.4 I i
Data PV-EOag3 Ver. I gn r
73DP-9ZZ1 Signature Date Dnln 7
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.
Name P. 0. Box 53999, Phoenix, Arizona 85072-2034 Address
- 2.
Plant Palo Verde Nuclear Generating Station Date 08/06/98 Sheet Unit 1
of 2
3 Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529
- 3.
Work Performed by Address APS Name Same as (Itemn#2)
Address W.O.#684229 Repair Organization P.O. No., Job No., etc.
Type Code Symbol Stamp None Authorization No.
N/A Expiration Date N/A
- 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, ASME Code Replaced or 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
- 8.
Test Conducted:
HydrostaticFj Exempt FA Pneumatic IF Nominal Operating Pressure J 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.
PV-E0092 Ver. 1 I.
N-416-1
. F 73DP]-SZZ 17
FORM NIS-2 (Back)
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 of the ASME Code,Section XI.
repair or replacement Type Code Symbol Stamp N/A Certificate of Authoriza Signed tion No. N/A Expiration Date N/A hyi/-.fj,S"* d-sx'i1
- -/*i
- A0-/.4*,Date le',--5-"
Owner or Owner's Designee, Tille PV-E0092 Ver. I BACK J,.
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 I
ASME SECTION XI - REPAIR/REPLACEMENT I
Component ID 3S1002H002
- 2.
Code Class ASME III, NF / CLASS 2 Item Description Snubber N-5 Package Number 3S107-3
- 5.
W.O. Number #684229 Original Construction Code Edition 1974 Edition, Winter 1975 Addenda Original Installation Code Edition 1974 Edition, Winter 1975 Addenda 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 Subsectiion NF, Class 2 / 74 Edition.'75 Winter Addenda
- 13. Repair/Replacement Activity Construction Code/Edition Same as (Item#12) 114. ASME Section X1 Code/Edition 1992 Edition, 1992 Addenda
- 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 C
- -t
- 17. Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
Initial Date ai-DQ.
Y-" -t9
- 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.
3S1002H002 Strut # 396049RR1 N/A N/A TL 64
% 0
- 21. ANII I
Signature 9--19
, Print Name J. Cruse Date qf*TL* *"Print Name o* " *"
"4-2AP Date Dae Print Name 2&
PV-EO093 Ver. 1
- 3.
- 4.
- 6.
- 7.
8.
730P.gZZ17 Date 7
I
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 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 "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-EO092 Vet. 1
FORM NIS-2 (Back)
Remarks W.O.#684229 3SI002H002 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 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.
t
? :pector's Signature
.1,
Date
)c~-to, A-I.
.2C0(
Commissions
-, 6ýs 1
iY, I
k" 26.3, National Board, State, Province, and Endorsements PVoE0092 Ver. 1 BACK 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 XI.
repair or replacement Type Code Symbol Stamp N/A Certifircate of Authorization No. N/A Expiration Date N/A sJ~i r isr Owner or Owners tjesignee, title I
73DP.SZZ17 I 9.
Date lo-/'3,
ýJ owner or owner's Designee, I ille 7
ASME SECTION XI - REPAIR/REPLACEMENT
- 1. Component ID 3SI002H004
- 3. Item Description SNUBBER
- 2. Code Class ASME IIl, NF / CLASS 2
- 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 APS
- 12. Replacement Item Construction or reconciled Code/Edition Subsection NF, CLASS 2 /74 Edition, '75Winter Adde
- 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
,*-,t
-,z, ý ýlrl If required, include a step in the W.O. to perform Preservice Inspection.
Initial/
et
- 16. ASME Section XI Pressure Test Required
[lj YES
@j NO 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 V*
6f Xi5//6 18. Include a step in the W.O. to record below all applicable numbers for repaired or Initial D
Datd replacement items.
-7 ITEM I.D.
3S1002H004 PART NO.
STRUT#395049S Rear bracket#355959 Pipe clamp #362261 SERIAL NO.
N/A N/A N/A i1 It I.
I-1
~I._
HEAT NO.
N/A N/A N/A
- 19. Planner
- /.,*
t /ii.
OStY/,/Print Name Robert M Burtsell Date
- 20. ISI Engineer (S/. C_
Print Name R.P. Indap la-,4 -0 Print Name R. G. Hogstrom
- 21. ANII uae 73DP-gZZ17 PVME0093 Ver. 6 Date ignature uata
- . *inn*ttlr*
I
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI L
PVMEN0U2 Ver. 1 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 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 3SI002H004 2ff 1 Replacement No Rear Bracket Lisega N/A N/A 3SI002H004 al Replacement No Pipe Clamp Lisega N/A N/A 3 SI002H004 7J* J Replacement No
- 7. Description of Work Replacement of Snubber with Rigid Strut I.A.W.EDC#94-00467
- 8. Test Conducted:
Hydrostatic I Pneumatic Ij Nominal Operating Pressure J N-416-1 Ll Exempt
- Other Li 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.,
l (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.
7 7
FORM NIS-2 (Back)
- 4.
Remarks "I qVTC ")
111n 445Z19 JJ TtnJi 1JU 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 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 XA.
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.
t ipector,s Signature Date X_-20T0 lo Commissions 3,1 4 National Board, State, Province, and Endorsements PV.IO002 Vet. I BACK i
I 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 XI.
repair or replacement Type Code Symbol Stamp N/A Certificate of Authoriti N/A Expiration Date N/A Signed_
I Z'lý.
Date &'-3--o(
Owner or Owners Designee, Title I
J 73DP-OZ7.1 i
t*(*nA 7
ASME SECTION Xl - REPAIR/REPLACEMENT
- 1. Component ID 3SI009H001
- 2. Code Class ASME III, NF / CLASS 2
- 3. Item Description SNUBBER
- 4. N-5 Package Number 3SI01-2
- 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 Xi Code/Edition 1992 Edition, 1992 Addenda
- 15. Preservice Inspection Required.
- j YES L NO 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.
ý*S e
- 17. Include a stop in the W.O. to complete NaS-2 Form prior to releasing the component.
igtnala Date
./47/
18. Include a step in the W.0 to record below all applicable numbers for repaired or Initial Date replacement items.
ITEM I.D.
PART NO.
SERIAL NO.
HEAT NO.
NH/I-OU NOl.
3SI009H001 STRUT # 396079 N/A N/A ROS#90398233 Rear Bracket #356959 N/A NIA
'_,.,,J-5 Z-:,t.
ROS#90397384 Pipe Clamp #363263 N/A N/A RO#0378 r19. Plannner _X-z¢'*,,,ýý--,
- ./:
rn Name Robert M. BurtseI1
.5*
ignaiure Date
- 20. ~l nginer k*
,;*/l*/g t.Print Name R.P.Indap
'Signature 5 ate 21., ANI t4-04,-.
Print Name R.G. Hogstrom 21 A
I1
¢
'Signature Date
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.
Name P. 0. Box 53999, Phoenix, Arizona 85072-2034 Address
- 2.
Plant Palo Verde Nuclear Generating Station Name Date 08/05/98 Sheet Unit 1
of 2
3 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529
- 3.
Work Performed by Same as (Item# 2)
- 4.
Identification of System Address APS Name W.O.#684229 Repair Organization P.O. No., Job No., etc.
Type Code Symbol Stamp None Authorization No.
N/A Expiration Date N/A Address 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, ASME Code Replaced or Stamped Component Manufacturer Serial No.
Board No.
Identification Built Replacement (Yes or No)
-id Strut Lisega N/A N/A 3SI009H001 f'fij Replacement No R-Bracket Lisega N/A N/A 3 SIO09HOO1 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
- 8.
Test Conducted:
Hydrostatic j Pneumatic j Nominal Operating Pressure Exempt [A 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.,
(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.
PV.500a2 Ver. 1
,,ur.aa,,
N-416-1 o F 730P-OZZ17 PV-EO092 Ver. 1
FORM NIS-2 (Back)
- 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 Signed
.1 Owner or Owner's Designee, Title Expiration Date
,] / i
,./*d.-'....
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.
Inspector's Signature Date O*-o *-
I'S Commissions qi'&s " " "f:
t
,-z&.k National Board, State, Province, and Endorsements
,v-eee
ver. 1 BACK 73DP.aZZl7 I
N/A
/57-,*3 -c/
F-Date P'V-EO02z Ver. I BACK 73DP-9ZZ17
ASME SECTION XI - REPAIRIREPLACEMENT
- 3.
- 4.
- 6.
- 7.
8.
Component ID 3SI067H001
- 2.
Code Class ASME III, NF / Class 2 Item Description Snubber N-5 Package Number 3SI07-3
- 5.
W.O. Number #684229 Original Construction Code Edition 1974 Edition,Winter 1975 Addenda Original Installation Code Edition 1974 Edition, Winter 1975 Addenda 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 in the 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 I
Eng e
Signature Date
-(--1 9' Print Name 1
T jM
""0. ISD Engineer a
Signature Date S21. ANI,
/'
7 4*t* *.intur 4'-11-DT6 Print Name "d
-e" PV-EO093 Ve. I I
I IFI 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.
Name P. 0. Box 53999, Phoenix, Arizona 85072-2034 Address
- 2.
Plant Palo Verde Nuclear Generating Station Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529
- 3.
Work Performed by Address A.PS Name Same as (Item#2)
Date 08/06/98 Sheet 1
Unit 3
- 684229 of 2
Repair Organization P.O. No., Job No., etc.
Type Code Symbol Stamp None Authorization No.
N/A 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 Exempt J Pneumaticj Nominal Operating Pressure 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.,
(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.
ivso e.73Pe1 N-416-1
, F FV*E0092. Ver. I*
FORM NIS-2 (Back)
- 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 of the ASME Code, Section Xl.
repair or replacement
.Type Code Symbol Stamp N/A Date N/A Date/O -/55 Certificate of Authorization No. N/A Exl V
Owner or Owner's Designee, Ttie
- iration I
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
.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 ez t "Z--"""
. 2L.(
National Board. State, Province, and Endorsements IliAspector's Sionature Date __c--,
R_
PV-EO092 Ver. I BACK I
/;ý17
/ý rz-,
t I
I/
I l 3DP J-SZZ17-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.
Name P. 0. Box 53999, Phoenix, Arizona 85072-2034 Address
- 2.
Plant Palo Verde Nuclear Generating Station Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 Address
- 3.
Work Performed by
- 4.
Identification of System APS Name Same as (Item#2)
Date 08/07/98 Sheet Unit 1
of 2
3 W.O.#684229 Repair Organization P.O. No., Job No., etc.
Type Code Symbol Stamp None Authorization No.
N/A Expiration Date N/A Address 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 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:
Hydrostatic,i Exempt Pneumatic Other [A Pressure Nominal Operating Pressure N-416-1 j 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.,
(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.
° F PV-ED092 VeW. I 73DP-9ZZ17
FORM NIS-2 (Back)
- d.
Remarks 3SI241H0(
W.O.#684229 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*
XJ Inspector's Signature "
Commissions
-S`.'"
4.
26-`
/
National Board, State. Province, and Endorsements is PV-ee592 Ver I eACK 73DP.ezzll 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 6'J 4
Date 0p-/,.-Oi Owner or Owner's Designee, Title Date I
-- t.-.I."v t I
I 73DP-gZ7Z17 PV-EO092 Ver. I BACK
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.
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
-1 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, ASME Code Replaced or Stamped 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 Exempt ;
Pneu m atic J
Nominal Operating Pressure J Other F 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.,
(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 Vet. i N-416-1 73DP.gZ717 0 F
I FORM NIS-2 (Back)
I Remarks W.O.#684229 3SI241H008 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 Autho.zation No. N/A Expiration Date N/A Signedror One.s Designee, Tte Date /C)//5' 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
,.1,1-
, 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.
lrnipectoes Signature
./
- J/
C om m issions National Board, State. Province. and Endorsements 73DP-9ZZ17 PV-EO092 Ver. I BACK Date I
Date I
7
ASME SECTION Xl - REPAIR/REPLACEMENT Component ID 3SI241H009
- 2.
Code Class ASME IIINF, / 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.
- 9.
j 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 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 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 0
- . -q;,
- 17. Include a step in the W.O. to complete NIS-2 Form prior to releasing the component.
Initial Date
ýýD e--
ci -.7 -' 1 Z,
- 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.
'3S1241H009 Strut #39610 9 N/A N/A PL0182621 zeal-R-Bracket #356959 N/A N/A ROS#90413712
- 19. Planner qj kAL._
CV7
-C Print Name J. Cruse Signature Date
'0. 151 Engineer Print Name P.' ~
N' P
Signature t1I Date
- 21. ANII
-,-q--t?
Print Name 9.6. L 0rrIZ*,.
Signature Date PV-E0093 Ver. I 73DP-9ZZ17
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.
Name P. 0. Box 53999, Phoenix, Arizona 85072-2034 Address
- 2.
Plant Palo Verde Nuclear Generating Station Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 Address
- 3. Work Performed by Same as (Item #2)
APS Name Date 08/06/98 Sheet Unit 1
of 2
3 W.0.#684229 Repair Organization P.O. No., Job No., etc.
Type Code Symbol Stamp None Authorization No.
N/A 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 3 SI241H009 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
- 8. Test Conducted:
Hydrostatic 1J Exempt Pneumatic Other 1 Pressure Nominal Operating 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.,
(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 I
I N-416-1F]
7
FORM NIS-2 (Back)
Remarks W
3S1941 1-f1009
.0. #684229 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 Signed 5/
- X&/A-'*,
/
Owner or Owner's Designee, Title iDate N/A Date 16 -(3---(
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.
Commissions 7-5 A
\\j Inspectors Date a-* 06-e-s Signature National Board, State, Province, and Endorsements I3WSL1 PV-E0092 Ver. I SACK I
I 3SI241HOO9 I
I A
73DP-SZ.Z17
ASME SECTION XI - REPAIRIREPLACEMENT
- 3.
- 4.
- 6.
- 7.
8.
10.
- 11.
- 12.
- 13.
14.
Component ID 3S1241H011
- 2.
Code Class ASME II]
Item Description Snubber N-5 Package Number 3SI07-3
- 5.
W.O. Number #684229 Original Construction Code Edition 1974 Edition, Winter 1975 Addenda Original Installation Code Edition 1974 Edition, Winter 1975 Addenda Work Description Replacement of Snubber with Rigid Strut.
[,NF/CLASS2 15 IS[ Flaw NDE Method of Flaw Detection Report Number_
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.
Repair/Replacement Work Organization APS Replacement Item Construction Code/Edition SubsectionNF, Class 2 / 74 Edition.'75 Winter Addenda Repair/Replacement Activity Construction Code/Edition.-Same as(Item#12)
ASME Section Xl Code/Edition 1992 Edition, 1992 Addenda Dc.
C- -7 7ý- -
- 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.
Name P. 0. Box 53999, Phoenix, Arizona 85072-2034 Address
- 2.
Plant Palo Verde Nuclear Generating Station Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 Address
- 3.
Work Performed by APS Name Same as (Item#2)
- 4.
Identification of System Address SI Date 08/07/98 Sheet Unit 1
of 2
3 W.O.#684229 Repair Organization P.O. No., Job No., etc Type Code Symbol Stamp None Authorization No.
N/A Expiration Date N/A
- 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 3SI241H011 I 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:
Pneumatic Exempt A.
Other l
Pressure Nominal Operating 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.,
(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.
N-416-1 ý,*
OF PV-E0092 Ver. I 73DP-gZZ1 7
FORM NIS-2 (Back)
- z.
Remarks 3SI2410HO W.O.#684229 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 Expiratior Signedow ine Title Owner or Owner's Designee, Title Date N/A Date /0 -/'3-6V 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.
t.- pector's Signature Date Oco-sew 'Z,5 Commissions _ý '
A `
National Board, State, Province, and Endorsements tZ CA PV-Ese92 ver. I eACK 7DP-9ZZi7 "1
73DP-9ZZ17 PV-E0092 Vet. I BACK
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 PV-EO093 Ver. 6 73DP)I--9Z.Z17
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 Test Conducted:
Hydrostatic f Pneumatic,j Nominal Operating Pressure N-416-1 J Exempt jP Other Pressure psi Test Temp.
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.
PV.E0092 Var. I 7DP.9ZZ11 8.
OF 73DP-SZZ17 pV-EO092 Vet. I
FORM NIS-2 (Back)
- 9.
Remarks 3SI241 W.O. #684229 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 Signed 9A Expiration Date N/A Datehj>--/*-oi/
Owner or Owner's Designee, Title Pv-euea2 Ver. I BACK 730P.aZZ17 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
Commissions SlJispector's Signature De-Z 12oc; I
National Board. State, Province. and Endorsements Commissions Date Dc-mser--
PV-EO092 Ver, I BACK 73DP-9ZZ17
ASME SECTION XI - REPAIRIREPLACEMENT Component ID 3SI307H006
- 2.
Code Class A
Jtem Description SNUBBER N-5 Package Number 3SI01-2
- 5.
W.O. Number #
Original Construction Code Edition 1974 Edition,Winterl975 Addend Original Installation Code Edition 1974 Edition, Winter 1975 Addenda Work Description Replacement of snubber with rigid strut.
SME IIINF / CLASS 2 684229 a
- 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 4L
/7au-Print Name
- 1. 6*.
-(
-r1.o,4 I,* Signature Date I.
- 3.
- 4.
- 6.
- 7.
8.
73DP-9ZZ17 PV-EO093 Ver. 1
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 Address
- 2.
Plant Palo Verde Nuclear Generating Station Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 Address
- 3.
Work Performed by
- 4.
Identification of System APS Name Same as.(Item#2)
Sheet Unit 1
of 2
3 W.O.#684229 Repair Organization P.O. No., Job No., etc.
Type Code Symbol Stamp None Authorization No.
N/A Expiration Date N/A Address 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 Exempt,1 Pneumatic Other Pressure Nominal Operating Pressure N-416-1 I 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.,
(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-C0052 Ver. I 730P.SZZI7 I
I PV-E0092 Ver. I 73DP-9ZZt7
FORM NIS-2 (Back)
- 9. Remarks W.0.4684229 3S1307H006
'-02 r.I ec(7D.Z1 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 Expiration Date N/A Certificate of Authorization No. 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.
-1Z-"
-I"A,. 2 L~k Commissions 3.-
"S National Board, State, Province, and Endorsements k' Inspector's Signature 1-4 1
i Date Oc-roTep-I
- 9.
Remarks W.O.#684229 3SI307H006 P-V-E0092 Vet. I BACK 730P-gZZ17
ASME SECTION XI - REPAIRIREPLACEMENT Component ID 3SI307H007
- 2.
Code Class ASMIE III, NF / CLASS 2
- 3. Item Description SNUBBER
- 4.
N-5 Package Number 3SI01-2 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 M ethod of Flaw Detection Report Number _____________________
io. Evaluation of the suitability of this work as per the requirements of IWA-4150.
Design Mod. LiA.W. EDC# 94-00467. Snubber Being replaced with Rigid Strut.
- 11. Repair/Replacement Work Organization
- 12. Replacement Item Construction Code/Edition SubsectionN, Class 2 / 74 Edition.'75 Winter Addenda
- 13. Repair/Replacement Activity Construction Code/Edition Sae a----
'4. ASME Section Xl Code/Edition 1992 Edition, 1992iAddenda--
.=,7r) -15.
include step in the W.O. to perform PreserVIce Inspection S.nit a
eat ý) 9
- 16. Include a step in the WO. to send completed coft initialDt nl d t pint eW 0 oC m lt N1S-2 Form prior to releasing the com o e t
"-Z:
() - 7
- 17. Icuease nteWO ocmlt initial Date 0DQ i -, -Pe6
- 18. Include step in the W.O. to record below all applicable numbers.
Initial COMP I.D.
PART NO.
SERIAL NO.
HEAT NO.
ROSIEROS NO.
Stut N/A N/A ROS#9041 3 6 9 0 393707Strut
- 397O59S R/
90/A4,01 2
8 261_____
- 357 9 5 9 N/A N/A__----OS9457 Pipe Clamp #376162 N/A N/A P-018262
- 9. Planner\\.--
(1 -- 7 C
Print Name J. Cruse.
/Signature
-c- -,cr Print N am e -
";ý P-" o C.
T D
'r). IS] Engineer________________________
Printae1
.IiJA
- 21. ANi 4et6Print Name o
S ig n a tu re-'
-a-eS7gD P -ga 7
t7 pV-E0 93 Vet. 1
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 08/05/98 Name P. 0. Box 53999, Phoenix, Arzona 850 7 2-2 03 4 Sheet 1
Of 2
- 2. Plant Palo Verde Nuclear Generating Station Unit 3
Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 W.0.4684229 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 X1 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
- Rep laired, or S
tmpeC de Component Manufacturer Serial No.
Board No.
Identification Buil Replacement (Yes or No)
Component~~
Relaemn (Ysoro igid Strut Lisega N/A N/A 3SI307H1007 7.*)f3)
Replacement No R-Bracket Lisega N/A N/A 3S1307H007 200 l Replacement No Pipe Clamp Lisega N/A N/A 3SI307H007 2f*l Replacement No
- 7. Description of Work Replacement of snubber with Rigid Strut I.A.W. EDC#94-00 4 67
- 8. Test Conducted:
Hydrostatic j Pneumatic j Nominal Operating Pressure J1 N-416-1 FA Exempt I 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 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.
PV-E0092 Ver. I 73OP-SZZ17
FORM NIS-2 (Back)
- j.
Remarks W.O.#684229 3 SJ307H007 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 Signed v' Expiration Owner or Owner's Designee, Title Date N/A Date,'6-/'2-of(
Pv-Ema2 ver. 1 BACK 7SDP-9Z217 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 National Board, State, Province, and Endorsements Inspector's Signature Date 0c-r-*
f PV-E0092 Ver. 1 BACK 7"3DP-9ZZ17
ASME SECTION XI - REPAIR/REPLACEMENT
- 3.
- 4.
- 6.
- 7.
8.
Component ID 3SI008H004
- 2.
Code Class ASME III Item Description Snubber N-5 Package Number 3SI01-2
- 5.
W.O. Number #684229 Original Construction Code Edition 1974 Edition, Winter 1975 Addenda Original Installation Code Edition 1974 Edition, Winter 1975 Addenda Work Description Replacement of Snubber with Rigid Strut.
,NF/CLASS2
- 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 I
73DP-9ZZ17 PV-EOO9'.
Ver. 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 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 3S1008H004 210J Replacement No Rear Bracket Lisega N/A N/A 3SI008H004 Replacement No Pipe Clamp Lisega N/A N/A 3SI008H004 U
Replacement No
- 7. Description of Work Replacement of Snubber with Rigid Strut I.A.W. EDC#94-00467
- 8.
Test Conducted:
Hydrostatic L]
Pneumatic J Nominal Operating Pressure [1 N-416-1 Other L 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.,
(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-ED022 Ver. 1 Exempt I
I
,3op.a 730P.9=17 7
I FORM NIS-2 (Back)
- 9.
Remarks 3SIO08HOC W.O.#684229 REAR END BRACKET WELDING WAS DONE ON 05/30/97 UNDER ASME SECTION XI '80 W '81.
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.
Commissions
-S AZ 26"-
'ýJ Inspector's Signature Date 01
'C' f
National Board, State, Province, and Endorsements 1,9 PV-E0092 Ver. 1 eACt(
73Dp-eZZi7 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 Signed
,49-*:
Date N/A Date/
f Owner or Owner's Designee, Title S....
v Expiration I
PV-E002 Ver. 1 BACK 73DP-gZZ17
ASME SECTION XI - REPAIR/REPLACEMENT Component ID 3SI241H005
- 2.
Code Class ASME III Item Description Snubber N-5 Package Number 3SI07-3
- 5. W.O. Number #684229 Original Construction Code Edition 1974 Edition, Winter 1975 Addenda Original Installation Code Edition 1974 Edition, Winter 1975 Addenda Work Description Replacement of Snubber with Rigid Strut.
,NFF/CLASS2
- 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
--- c L
-.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.
0 *-7 Print Name J. Cruse Signature Date
- 20. ISI Engineer__
______-_--f___a_____
Print Name_____________
- 21. ANII Print Name Q.6.
-o&*-co*
(-ignature Date PV-E*0093 Ver. I I
II
- 3.
- 4.
- 6.
- 7.
8.
73DP-9-7 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.
Name P. 0. Box 53999, Phoenix, Arizona 85072-2034 Address
- 2.
Plant Palo Verde Nuclear Generating Station Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 Address
- 3.
Work Performed by APS Name Same as (Item# 2)
Address Date 08/07/98 Sheet Unit 1
of 2
3 W.O.#684229 Repair Organization P.O. No., Job No., etc.
Type Code Symbol Stamp None Authorization No.
N/A Expiration Date N/A
- 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, ASME Code Replaced or Stamped I
Component Manufacturer Serial No.
Board No.
Identification Built Replacement (Yes or No) igid Strut Lisega N/A N/A 3S1241H005
'0f A Replacement 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 Exempt 0
Pneumatic !
Nominal Operating Pressure 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 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.
PE02 e.I 7fPZ1 I
N-416-1 FA I
I o F I
PVoED092 Ver. 1 73DP-0ZZ17
FORM NIS-2 (Back)I
- j.
Remarks 3SI241H0(
W.O.#684229 REAR END BRACKET WELDING WAS DONE ON 01/31/97 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 XI.
repair or replacement Type Code Symbol Stamp N/A Certificate of Authq N/A Expiratior Signed
.7 11 Owner or Owner's Designee, Title Date N/A Date/a-,3.-&rf 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 S Date o eL.
ignature t
J'20 1
National Board, State, Province, and Endorsements PV-eflee2 Veri SACK 730P-9Z217 73DP-9ZZ17 W.O.#684229 FI I
PV-ED92 Ver..1 BACK
ASME SECTION X! - REPAIR/REPLACEMENT
- 3.
- 4.
- 6.
- 7.
8.
Component ID 3SI241H012
- 2.
Code Class ASME U Item Description Snubber N-5 Package Number 3SI07-3
- 5.
W.O. Number 684229 Original Construction Code Edition 1974 Edition, Wimter 1975 Addenda Original Installation Code Edition 1974 Edition, Winter 1975 Addenda Work Description Replacement of snubber W/rigid strut I, NE/CLASS 2
- 9.
D ISI 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 LAW EDC #94-00467 Snubber replaced with a rigid strut.
- 11. Repair/Replacement Work Organization APS
- 12. Replacement Item Construction or reconciled Code/Edition Subsection NF, Class 2/74 Edition, '75 Winter
- 13. Repair/Replacement Activity Construction Code/Edition Subsection NF, Class 2/74 Edition, '75 Winter
- 14. ASME Section XI Code/Edition 1992 Edition, 1992 Addenda
- 3. Preservice Inspection Required.
FA YES j
NO
___09/21/98 If required, include a step in the W.O. to perform Preservice Inspection.
/'*i~lDate
- 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 8In9 8nal Daap 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.
3SI241H012 Strut #3962RR1 N/A N/A PL0007422 Planne
_\\X 09/21/98 Print Name L.D. Pagan
//
Signatu e Date
- 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 V
,, NF/CLASS 2
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.
Name P. 0. Box 53999, Phoenix, Arizona 85072-2034 Address
- 2.
Plant Palo Verde Nuclear Generating Station Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 Address
- 3.
Work Performed by APS Name Same as (Item#2 Address Date 08/06/98 Sheet 1
of 2
Unit 3
W.0.#684229 Repair Organization P.O. No., Job No., etr Type Code Symbol Stamp None Authorization No.
N/A Expiration Date N/A
- 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 Manufacturer National Other Year
- Repaired, ASME Code IReplaced or 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 Other Pressure psi 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 I
Exempt N-416-1 Test Temp.
0 F 73DP-OZ-Z1I
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 Signed
/. "
r Owner or Owner's Designee, Title Date N/A Date /,_
Pv.Esee2 Ver. I sAcK 7OP-eZZ17 I
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.
Commissions
-ý
- i Az. 2'-'
National Board, State, Province, and Endorsements Inspector's Signature Date 73Dp-9ZZ1 7 PV-E0092 Ver. 1 BACK
ASME SECTION Xl - REPAIR/REPLACEMENT
- 1. Component ID 3SI307H002
- 3. Item Description SNUBBER
- 2. Code Class ASME III, NF / CLASS 2
- 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 1*'-*'
.z-2zco/
- 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 I
PV-EO093 Vet. 6 73DP-9ZZ17
IFORM 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.
Name P. 0. Box 53999, Phoenix, Arizona 85072-2034 Address
- 2.
Plant Palo Verde Nuclear Generating Station Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529 Date 08/06/98 Sheet 1
of 2
Unit 3
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 Exempt,
Other 1-Pressure Nominal Operating Pressure Ij 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.
N-416-1 PV-E0092 Ver' I 73DP-gZZ17
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 of the ASME Code,Section XI.
repair or replacement Type Code Symbol Stamp N/A Certificate of Authorization No. N/A E
Sianed 1-51,
95/
Owner or Owner's Designee, Title xpiration Date N/A Date/0 -,-ý--)(
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.
Commissions ct-t 2.G(
/1 National Board, State, Province, and Endorsements
"/
Inspectors Signature Date cr o-:, t-a-PVEO2Ve.I BCK70 Zi7 I
PV-E0092 Ver, 1 BACK 73DP-OZZ17
ASME SECTION XI-REPAIR/REPLACEMENT
- 1.
- 3.
- 4.
- 6.
- 7.
8.
Component ID 3SI307H005
- 2.
Code Class ASME III, NF / CLASS 2 Item Description Snubber N-5 Package Number 3S101-2
- 5. W.O. Number W.O.#684229 Original Construction Code Edition 1974 Edition, Winter 1975 Addenda Original Installation Code Edition 1974 Edition, Winter 1975 Addenda 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
-7 1-9 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 N IS-2 Form prior to releasing the component.
Initial Date
-- - C
- 18. Include step in the W.O. to record below all applicable numbers.
IntialDate 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 (r 7 Signature Date "20. ISI Engineer q--c7 cA Print Name
.T*'Nr4D Signature',
Date
- 21. ANII i4Laa Print NameDat LSignature Date PV-EO093 Vet. 1 I
7"3DP-9Z.717
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.
Name P. 0. Box 53999, Phoenix, Arizona 85072-2034 Address
- 2.
Plant Palo Verde Nuclear Generating Station Name 5801 S. Wintersburg Rd., Tonopah, Arizona 85354-7529
- 3.
Work Performed by Address APS Name Same as (Item#2)
Address Date 08/06/98 Sheet 1
Unit 3
W.O.#684229 of 2
Repair Organization P.O. No., Job No., etc.
Type Code Symbol Stamp None Authorization No.
N/A Expiration Date N/A
- 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 Exempt I Other j Pressure psi Test Temp.
N-416-1 J
.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-ESOa2 ye,. I 730P-52Z17 I
I I I
PV-r:WS2 Ver. I 73DP-gZZ17
FORM NIS-2 (Back)
- 9.
Remarks W
3SI307H005
.0#84227 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 N/A Certificate of Authorization No. N/A Expiratior Signed
/
gqc-n.I-*'
Owner or Owner's Designee, Title PV.E5092 ye,. 1 BAcK 730P-eZZ17 Date Date 2j-/?ý-,*/
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 National Board, State, Province, and Endorsements Inslktor's Signature 1
2i
\\
Date 0,:-,, 6P i
I 73DP-gZZ17 F'VoE0092 Ver. I BACK