ML17334B455

Forwards Amend to Recent Inservice Insp Rept for DC Cook Nuclear Plant,Unit 2 for Period of 901110-920701

ML17334B455
Person / Time
Site:	Cook
Issue date:	02/05/1993
From:	John Rutkowski INDIANA MICHIGAN POWER CO. (FORMERLY INDIANA & MICHIG
To:	Davis A NRC OFFICE OF INFORMATION RESOURCES MANAGEMENT (IRM)
References
NUDOCS 9302160071
Download: ML17334B455 (20)

Text

Indiana Michigan ~

Power Company Cook Nuclear Plant One Cook Place Bridgman, Ml 49106 616 465 5901 U. S. Nuclear Regulatory Commission Attn:

Document Control Desk Washington, D.

C.

20555 Attn:

A. B. Davis February 5,

1993

Dear Mr. Davis:

Attached please find an amendment to the recent Inservice Inspection Summary Report for Donald C.

Cook Nuclear Plant, Unit 2, for the period of November 10, 1990 through July 1, 1992.

Please replace the respective pages in the Summary Report with the amended pages as follows:

Form NIS-1 Owner's Snubber Functional Form NIS-2 Owner's Replacements Report For Testing Report For Repairs or Page 46 Page 65 Inservice Inspections.

Form NIS-2 Owner's Replacements Form NIS-2 Owner's Replacements Report For Repairs or Report For Repairs or Page 69 Page 166 Add the following addenda:

For NIS-2 Owner's Reports For Repairs or Replacements Page Al thru Page AS If you have any questions regarding this documentation, please contact Jim Fitchuk at (616) 465-5901, Ext.

1410.

Res ct' E. Rutko ski Assistant Plant Manger D.

C.

Cook Nuclear Plant

/cbm Attachment c:

File 930216007i 930205 PDR ADQCK 05000316 8

PDR

S DOCUMENT CONSISTS OF 29 AGES INCLUDING ADDENDUM PAGES Al thru A8 FORM NIS-1 OWNERS'ATA REPORT FOR INSERVICE INSPECTIONS As required by the Provisions of the ASME Code Rules Owner Indiana Michigan Power Coeh One Summit Square, Ft. Wayne, IN 46802 (Name and Address of Owner) plant Donald C.

Cook Nuclear Plant, One Cook Place, Brid an, MI 49106 (Name and Address of Plant)

3. Plant Unit

4. Owner Certificate of Authorization (ifrequired)

$. Commercial Bereiee Date0~7Ci 2B

d. National Board Number for Unit l Mich. M-324232-M

7. Componencs Inspected Component or Appurtenance Manufacturer or Installer Manufacturer or Inscaller Serial No.

State or Province No.

National Board No.

Reactor Vesse Stm. Generato dl Stm. Generato

!/2 Stm. Generato I)'3 Stm. Generato 84 Pressurizer Regenerative Ht Exchan er Boron In ection Tk Chica o Brid e and Iron Westin house Westin house Westin house Westinghouse Westinghouse Westin house Strothers Wells Cor M-324232-M MMGL 11445 M-324235-M MMGL 11446 M-324236-M MMGL 11447 M-324237-M 1231 M-324233-M 1831-7-II Spin No.

AMP-SIATB1-0 MMGL 11444 M-324234-M 37 38-

'-'9 40

'8 94 430 13344 Note: Supplemental sheets in form of lists, sketches, or drawings may be used provided (1) size is SA in. x 11 in (2) information in items 1 through 6 on this data 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.

This form (E00029) msy be obtained from the OrderDept., ASME, 346 E 47th SC., New York, N.Y.

10017

INDIANA MICHIGAN POWER COMPANY COOK NUCLEAR PLANTg BRIDGMANg MI ~

UNIT 2 COMMERCIAL SERVICE DATE 7-1-1978 NATIONAL BOARD NUMBER 1 UNIT 2 SNUBBERS FUNCTIONAL TEST SURVEILLANCES (cont.)

nubber o.

2-MSS-5 2-MSS-8 2-GSI-S47 2-GSI-S51 2-GSI-S657 2-GSI-S707 2-GCTS-S113(E) 2-GCTS-S113(W)

'2-GCTS-S115(N) 2-GFW-S891 S/N25.12620.007-18 S/N25.12620.007-28 S/N25.12620.007-30 Date Removed 04-03-92 04-21-92 04-30-92 04-27-92 04-03-92 04-02-92 04-30-92 03-29-92 04-01-92 04-09-91 03-16-92 03-17-92 03-17-92 Date Reinstalle 04-21-92 05-03-92 05-02-92 04-28-92 04-16-92 04-10-92 05-06-92 04-01-92 04-22-92 04-15-91 05-04-92 05-04-92 05-05-92 As-Found Fail-Low Tension and Compression Bleed Rates Pass Pass Pass Pass Pass Pass Pass Fail-Air Entrapment Pass Pass Pass Pass These snubbers were tested due to functional failures at the previous testing period (last outage).

This snubber was tested to verify OPERABILITY as a result of the Visual Examination.

Page 46

Ig l'I '

AMENDED NIS-2 (ITEM 5) 11-19-92

+(/-)~

FORM NXS 2 OWNER S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI 1.

Owner INDIANA MICHIGAN POWER COMPANY Name Date 11-29-90

.O.

Box 60 Fort.

Wa ne IN 46801 Address 2.

Plant D ~ C.

COOK UCLEAR POWE PLANT Name Sheet Unit 1

of 2

One Cook Place Brid an MI 49106 Address 3.

Work Performed by CIMCO Name P.O.

BOX 218 Stevensville Mi. 49127 Address Job Order B-014742 Repair Org.

P.O. No., Job No., etc Type Code Symbol Stamp V

Authorization No.

0252-V Expiration Date 12 31 90 4.

Identification of System EMERGENCY CORE COOLI G SYSTEM 5.

(a) Applicable Const.

Code SEC. III 1971 Ed.,SUMMER 71Add.

Code Case

~AD @N~D 6.

Identification of Components Repaired or Replaced and Replacement Components Name of Component 2-TK-86 2-TK-87 5/8" NUTS HEX Name of Manufacturer N/A N/A Manuf.

Serial No.

N/A N/A Nat.

Board No.

N/A N/A Other Identi-fication N/A SA-194 2H ASP-12757 Year Built N/A N/A Repaired Replaced or Replace-ment N/A REPLACE-MENT ASME Code Stamped (Yes or No)

N/A NO 7.

Description of Work R PLACED ALL HEX NUTS ON MANWAY COVER OF 2-TK-86 AND 2-TK-87.

8.

Test Conducted:

Hydrostatic ~

Pneumatic t

j Nominal Operating Pressure N/A LX~

other ~

Pressure si Test Temp.

NOTE:

Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8-1/2 in. 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.

INDIANAMICHIGANPOWER COMPANY COOK NUCLEAR PLANT, BRIDGMAN, Ml UNIT 2 COMMERCIALSERVICE DATE 7-1-1978 NATIONALBOARD NUMBER 1

AMENDED NIS-2 (ITEM 7) ll-FORM NIS 2 OWNER~8 REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XZ l.

owner IND CHIGAN POWER COMPANY Name Date APRIL 11 1991 O

Bo 60 o

46801 Sheet 1

of 2

Address 2.

Plant D.C.

COOK NUCLEAR POWER PLANT Name Unit O e Coo Pace B id Address I 49106 J ~ 0-B43372 Repair Org.

P.O. No., Job No., etc 3.

Work Performed by CIMCO Type Code Symbol Stamp V

Name Authorization No.

0252-V

.O.

BO 218 Stevensville Mi; 491 7

Expiration Date 12 31 91 Address 4.

Zdentification of System CH ICAL AND VOL E

CO ROL SYST

• AEP Specifications /

MDS Standards / ANSI B31.1-83 / AZSC 5.

(a) Applicable Const.

Code 19 Ed.,

Add.

Coda Case ADI+~D

6. > Zdentification of Components Repaired or Replaced and Replacement Components Name of Component 1/8" PLATE 2"X S/8" U-BOLT Name of Manufacturer N/A N/A Manuf.

Serial No.

N/A N/A Nat.

Board No.

N/A N/A other Zdenti-fication SA-36 ASP-12776 GRIN FZG137 ASP-9182 Year Built N/A N/A Repaired Replaced or Replace-ment REPLACE-MENT REPLACE-MENT ASME Code Stamped (Yes or No)

NO NO 7.

Description of Work COMPONENT E E LOG IT 78 LOCATED ON PE S

OO 2-CS-794L 6'E SO 2-CS-794L4.6 ALSO SEE REMARKS 8.

Test Conducted:

Hydrostatic ~

Pneumatic ~

Nominal Operating Pressure N/A ~X>

Other ~

Pressure si Test Temp.

DF NOTE:

Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8-1/2 in. 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.

INDIANAMICHIGANPOWER COMPANY COOK NUCLEAR PLANT, BRIDGMAN,Ml UNIT2 COMMERCIALSERVICE DATE 7-1-1978 page 69 NATIONALBOARD NUMBER 1

AMENDED NIS-2 (ITEM 5) 11-19-92

~II+

FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI

,1.

Owner INDIANA MICHIGAN POWER COMPANY Name P.O.

Box 60 Fort Wa ne IN 46801 Address 2.

Plant D. C.

COO NUCLEAR POWER PLANT Name One Cook Place Brid an MI 49106 Address Date 4-25-92 sheet 1

of 2

Unit J.O.

C1808-07 RFC-N A Repair Org.

P.O. No., Job No., etc rk Performed by CIMCO Name P.O.

BOX 218 Stevensville Mi. 49127 3.

Wo Type Code Symbol Stamp V

Authorization No.

0252-V Expiration Date 12 31 92 Address 4.

Identification of System RESIDUAL HEAT REMOVAL SYSTEM (n) Applicable Edition of Section XZ Utilized for Repairs or Replacements 19~83 W 9 1983 ADDENDA 6.

Identification of Components Repaired or Replaced and Replacement Components Name of Component 1 1/4,"

STUDS 1 1/4" NUTS Name of Manufacturer N/A N/A Manuf.

Serial No.

N/A N/A

'at.

Board No.

N/A N/A Other Identi-fication SA-193 GRB7 ASP-13237 SA-194 2H ASP-13779 Year Built N/A N/A Repaired Replaced or Replace-ment REPLACE-MENT REPLACE-MENT ASME Code stamped (Yes or No)

NO NO 7.

Description of Work INSTALL 13 NEW 1

1 4" STUDS AND 19 NEW 1

1 4" NUTS AT THE COVER FLANGE OF 2-TK-87.

8.

Test Conducted:

Hydrostatic ~

Pneumatic ~

Nominal Operating Pressure N/A LX Other ~

Pressure si Test Temp.

oF INDIANAMICHIGANPOWER COMPANY COOK NUCLEAR PLANT, BRIDGMAN,Ml UNIT 2 COMMERCIALSERVICE DATE 7-1-1978 NATIONALBOARD NUMBER 1 Page 166 NOTE:

Supplemental sheets in form of 1'ists,

sketches, or drawings may be used, provided (1) size is 8-1/2 in. 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 I V'

[

V

el yl

'v

FORlC MXS-2 OWNKRiS REPORT FOR REPAIRS OR RBPZACEMEHTS Aji -Rictuired.by the. Provisions of the ASME code Section XI l.

Owner INDI Name I AN P WE MP 4-1 P

. Bx Fr W

Address Sheet 1

of 2.

Plant D

K LEAR WE PLANT Unit Name Pl Bi Address 3.

Work Performed by in n

Name S

a 2

M 4

1 D

rmn Repair Org. P.O. No., Job No., etc Expiration Date Address 4.

Identification of System REA T R LANT Y T BER 6.

Identification of Components Repaired or Replaced and Replacement Components Name of Component 2-GRC-8538 shock 6

sway strut suppressor assembly Name'f Manufacturer.

GRINNELL CORP Manuf.

Serial No N/A Nat.

Board No.

N/A Other Identi.-

fication ASPIC 11873 Year Built 1989 Repaired Replaced or Replace-ment REPLACED ASME'Code Stamped (Yes or No)

NO 7.

Description of Work R

rk 8.

Test Conducted:

Hydrostatic Pneumatic Nominal Operating Pressure N/A Other VT-3/4 Pressure si Test Temp.

oF NOTE:

Supplemental sheets in form of lists, sketches, or drawings may be u'sed, provided

.(1) size is 8-1/2 in. x ll 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.

INDIANAMICHIGANPOWER COMPANY COOK NUCLEAR PLANT, BRIDGMAN,MI, ~

page Al.

UNIT 2 COMMERCIALSERVICE DATE 7-l-i978 NATIONALBOARD NUMBER 1

Page 2 of 2 FORX NIS 2 (Sack) 9.

Remarks Applicable Manufacturer's Data Reports ta be attached t

w wa ANB11rd S

Cifi ti D

402 R f Fil 2

R X

1 CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this re lacement conforms to the rules of the ASME Code,Section XI.

repair or replacement Type Code Symbol Stamp N A Expiratioa Date

~Signed F ank Pisar Maint.En.Su ervisor Date Owner or er's Designee, Title 19 N A CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler by ARKWRIGHT MUTUAL INS. CO.*

of NORWOOD MASS.

have inspected the components described in this Owner's Report during the period to

-9L 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 in)ury or property damage or a loss of any kind arising from or connected with this inspection.

Commissions Mic.l oS'S'nspec r's ignature National Bo rd, Stat

, Province, Endorsements

• FACTORY MUTUAL SYSTEM Date 19 RX.

INDIANAMICHIGANPOWER COMPANY COOK NUCLEAR PLANT, BRIDGMAN,Ml UNIT 2 COMMERCIALSERVICE DATE 7-i-i978 NATIONALBOARD NUMBER 1 Page A2

~

FORK NZS 2 O~iS REPORT FOR REPAIRS OR REPZACEMENTS As Required by the Provisions of,the ASME Code Section XZ 1.

Owner

'Name

~,

O.

Box 60 o

W Address 2.

Plant D. C.

COO C

Name IN 46801 PO Date 0

Sheet ~of 2

Unit 0 e Coo e

B Address a

MI 49106 Jib C-7-

2 FC 3077 Repair Org.

P.O. No., Job No., etc 3.

Work Performed by C

CO

'"ype Code Symbol Stamp V

Name Authorisation No.

0 52-V P.O.

BO S eve svi e

M 49 Expiration Date 12 3 1 92 Address 4.

Zdentification of System CONTAINMENT SPRAY SYST

+ AEP Specifications /

MDS Standards

/ ANSI B31.1-83 / AZSC 5.

( a) Applicable Const.

Code 19 Ed.,

Add Code Case A~DD ~D 6.

$dentification of Components Repaired or Replaced and Replacement Components Name of Component WT3X6 Name of Manufacturer N/A Manuf.

Serial No.

N/A Nat.

Board No.

N/A Other Zdenti-fication SA-36 ASP-14422 Year Built N/A Repaired Replaced or Replace-ment REPLACE-MENT ASME Code Stamped (Yes or No)

NO 7.

Description of Work..

DESIGN FO R C-307 LL NEW WT 3

X 6 BRACE FOR SUPPORT 2-CTS-L68 PER I

8.

"Test Conducted:

Hydrostatic ~

Pneumatic I Nominal Operating Pressure ~

V/A "2 I

i Other ~

Pressure

..>si Test Temp.

OTE:

Supplemental sheets in form of 1'sts,

sketches, or drawings may be used, provided

(

)

ice is 8-1/2 in. x 11 in., (2) information in items 1 through 6 on this report, 's included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.

INDIANAMICHIGANPOWER COMPANY NZS92 91 COOK NUCLEAR PLANT, BRIDGMAN, Ml UNIT2 COMMERCIALSERVICE DATE 7-1-1978 Page A3 NATIONALBOARD NUMBER 1

0 J1, Q ~

Page 2 of 2 9.

Remarks FORM NIS-2 (Back) 6 0 Applicable Manufacturer's Data Reports to be attached G

0 R C-3077.

AS C

SS II ISI CLASS II J.O.

C-2 97-22 CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this e

cd e t=

conforms to the rules of the ASME Code,Section XI.

repair or replacement Type Code Symbol Stamp N A Certificate. of 2ta4horization No.

V Expiration Date Signed c i

~:~ ~.

Date

/

Owner or Owner's Desigaee, Titl CERTIFICATE OF INSERVICE INSPECTION Commissions I

National Board, State,

Province, Endorsements I

I

• FACTORY MUTUAL SYSTEM I, the undersigned, holding a valid commission issued by the National Board of Boiler by IGHT MUTUAL INS. CO.*

of NORWOOD S

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 XZ.

By signing this certiiicate neither the Inspector'or his employer makes any

warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report.

Furthermore, neither the Znspector nor his employer shall be liable in any manner for any personal in)ury or property damage or a loss of any kind arising from or connected with this inspection.

/

Inspector's Sicpyature Date 19 NZS92-91 INDIANAMICHIGANPOWER COMPANY COOK NUCLEAR PLANT, BRIDGMAN, Ml UNIT 2 COMMERCIALSERVICE DATE 7 j.978 NATIONALBOARD NUMBER 1 Page A4'>>

4 ~I cr ~

4 l+g I'l

Name PO CO Date FORM HIS 2 OWNER~S REPORT POR REPAIRS OR REPLACEMEMTS As Required by the Provisions of the ASME Code Section XZ Bo 60 o

Wa e

IN 4680 Address Sheee ~of 2

2.

Plant COO PO l

Unit Name I

0 e Cook ace r d a ~

MI 49106 Z 0. R-3730-07 C-N A Address Fepair Org. P.O. No., Job No., etc 3.

Work Performed by C

CO Type Code Symbol Stamp V

Name Authorisation No.

02

-V 0

0 Steye SVille M

49 Expiration Date 3

Address 4.

Zdentification of System'EACTOR COO S

S

"' "a

'4.JVJl

~ADD ~D 6.

Zdentification of Components Repaired or Replaced and Replacement Components Name of.

Component BOLT (S/G STUD)

NUT W/WASHERS Name of Manufacturer N/A N/A Manuf.

Se=ial N>.

N'/A N/A Nat.

Board No.

N/A N/A Other Zdenti-fication SA-193 GRB7 ASP-11674 SA-194 GR7 ASP-11674 Year Built N/A N/A Repaired Replaced or Replace-ment REPLACE-MENT REPLACE-MENT ASME Code Stamped

'Yes or No)

NO NO 7.

Description of Work:

2 LL 2 NEW STUDS W NUTS D WASHE ASS L

0 S

G SEE REMARK 2-OME-3-1 I

8.

Test Conducted:

Hydrostatic ~

Pneumatic ~

Nominal Operating Pressure

<)(-l N/A "~

l Other ~

Pressure

.".si Test Temp.

ow

~

~

~

~

TE:

Supplemental sheets in form o: lists, sketches, or drawings may be used, provided (1) ae is 8-1/2 in. x 11 in.,

(2) information in items 1 through 6 on this report 's included n each sheet, and (3) each sheet is numoered and the number of sheets is recorded at the top of this form.

NZS92-94 INDIANAMICHIGAN POWER COMPANY COOK NUCLEAR PLANT, BRIDGMAi"',Ml UNIT 2 COMMERCIALSERVICE DATE 7-1-1978 NATIONALBOARD NUMBER 1 Page A5

Page 2 of 2 FORM NZS-2 {Back) 9.

Remarks Applicable Manufacturer's Data Reports to be attached LOCATION 1-CL-6 COLD G

AND 1-HL-4 HOT LEG.

A VT-1 WAS PERFORMED AND FOUND ACCEP AB FOR THE ABOVE.

CERTIFICATE OF COMPLZPBfCE We certify that the statements made in the report are correct and this Re la e e conforms to the rules of the ASME Code,Section XI.

repair or replacement Type Code Symbol Stamp N

Certific e o Authorization No.

N A

/

Signed

/.,(

Owner or Owner s'esignee, itle Expiration Date N

Date E<o, 19 V2 CERTIFICATE OF ZNSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boi.ler by Ia MU U S

CO.*

of NO WOOD S

have inspected the components described in this Owner's Report during the period A

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 requiiements of the ASME

Code, Section XZ-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

~ ~ i ~.--::...r'rrr~

Znspector's gadfure National Board, State,

Province, Endorsements

• FACTORY MUTUAL SYSTEM Date 19 NZS92-94 INDIANAMICHIGANPOWER COMPANY COOK NUCLEAR PLANT, BRIDGMA",Ml UNIT 2 COMMERCIALSERVICE DATE 7-1-1978 NATIONAI BOARD NUMBER 1 Page A6'

FORM HIS OWNER'S REPORT FOR RBMZ R RBPuaegggMTS As Requ ed by the Provisions of the AS~Code Section XI Name Address Date Sheet ~ot 2.

Plant Name Unit 3.

Work Performed by Address Name Repair Org. P.o. No., Job No., etc Type Code Symbol Stamp Expiration Date Address 4.

Identification of System HEJIXLL JS

~~

6.

Identification of Components Repaired or Replaced and Replacement Components Name of Component 2-IMO-316 BONNET'TUDS

& NUTS Name of Manufacturer Cardinal Ind.

Products Inc.

Manuf.

Serial No.

N/A Nat.

Board Noi N/A Other Identi-fication ASPjf 13301 Year Built 1990 Repaired Replaced or Replace-ment REPIJLCED ASM'ode Stamped (Yes or No)

NO 7.

Description of Work 8.

Test Conducteds Hydrostatic Pneumatic Nominal Operating Pressure N/A /

Other Pressure si Test Temp.

NOTE>

Supplemental sheets in form of lists, sketches, or drawings may be used, provided e

(1) slse is 8-1/2 in. 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.

INDIANAMICHIGANPOV!ER COMPANY COOK NUCLEAR PIANT, BRIDGMAN,Ml UNIT2 COMMERCIALSERYICE DATE 7-1-1978 NATIONALBOARD NUMBER 1 Page A7

FORX NIS-1 (back)

Page 2 of 2 9.

Remarks Applicable Manufacturer' Data Reports to be attached CERTZFICATC OF CONFLZAXCS We certify that the statements made in the report are correct and this re lacement conforms to the rules of the ASME Code,Section XI.

repair or replacaaent Type Code Symbol Stamp N A Expiration Date N

Signed P an p s Maint. En

. Su rvieox Date

- /

5~,

19 Owner o er's Designee, Title CERTIFICATE OF INSERVZCI INSPBCTZCW I, the undersigned, holding a valid commission issued by the National Board of Boiler by MKWRIOHT MUTUAL INS. CO.*

of NORWOOD MASS have inspected the components described in this owner's Report dur ng the period Y'.3-~ ~

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 ASMS 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 in)ury or property damage or a loss of any kind ari ing from or connected with this inspection.

Commissions

~'= 4 045'5 Inspector' ature National Boax, State,

Pxovince, Endoxsements

• FACTORY MUTUAL 5TSTEMfyi~cws<yR~ist'4 Date FG b 19 INDIANAMICMIGANPOWER COMPANY COOK NUCLEAR PLANT, BRIDGMAN,Ml UNIT2 COMMERCIALSERVICE DATE 7-1-1978 NATIONALBOARD NUMBER 1 Page AB