ML19290A100
| ML19290A100 | |
| Person / Time | |
|---|---|
| Site: | Crane  |
| Issue date: | 01/18/1978 |
| From: | METROPOLITAN EDISON CO. |
| To: | |
| References | |
| PROB-780118, TM-0965, TM-965, NUDOCS 7910010531 | |
| Download: ML19290A100 (2) | |
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TMI DOCUMENTS h.k b Y
DOCUMENT NO:
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COPT MADE ON OF DOCUMDIT PROVIDED BT NEIROPOLITAN. EDISON CO. ANY.
T Supervisor, Doct=nent Control, NRC
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2221 149
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' ATTACM1ENT NO.1
%,3 g y 1026 Revision 0 N MS/'? */
07/22/77 d.-. 71 & feny /?F - -
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~T WORK REQUEST APPROVAL TM! Nuclear Station n
Unit No.
Work Req st No.
W.01 Account No. 4 7' : /P// '-/ ?s '
NPRD Form Reg'd
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Priority
'J sQ ltems 1 through 5 comofeted by orininntar 1.
System:
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Component (name & number) 3.
Describe malfunction and cause of malfuriction (if 1.nown) or modification desired.
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Oriainator: f k ik e
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Date/ Time:
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Originator's Suoerviscr's Signature b
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Does work represent a change or modification to an existing system or component?
If yes, an approved change modification is required par AP 1021.
C/M No.
Yes No
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Does work require an RWP Yes No 1 3 7 b.
Is an approved procedure required to minimize personnel exposure.
Yes No
'7 83.
Is work on a 0 C component as defined in GP 1008.
Yes No 8b. If 8a is yes does work have an effect on Nuclear Safety? If 8b is yes, PO R C reviev.ed Superintendent approved must be used.
Yes No 9.
Agreement that a PORC reviewed, Superintandant approved procedure is not required for this work because it has no effect on nuclear safety. (Applies only if Ba isYes and Ob is No).
Unit Superintendent Date 10a. Is the system on the Environmental impact listin AP 1026 Yes No 10b. If 10a is Yes, is an approved procedure required to limit environmental impact Yes No 100. Agreement that 10b is No. (Roquire 1 onfy if 10a is Yes).
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Unit Superintendent / Supervisor of Operwons Date 11.
Plant status or prcrcquisite conditions required f or work.
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Comply with the Pre cisens
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Attachment I Set forth i.~. /'.P 1C0.I dayf 1026 Revision 0 Met E,d Gaf nj Manual 07/22/77
- 12. Lirmts and Precautions-
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a) Personnel b) Equipment c) Environment
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SUPT. APPROVpl.
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- 13. Post Maintenance Testing required and Acceptance Criteria.
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- 14. Estimate'd manhours to perform job:
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- 15. Maintenance Foreman Acigned:
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Date O.h 7 Date /0
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- 17. Supervisor of Maintenance approval to commence work:
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- 18. Shi!t Foreman's approval to commence worIO ' ff, Date
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Foreman Tagng Appicatson No.
Racnon Won Parmit f.o.
signature is not required
- 19. Comments on work perf ormed:
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Retest met acceptance criteria Yes Work Performed by date/ time Work Reviewed. Maintenance Foreman's Signatura
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- 20. Work rnmpleted and component.iligned f or testing.
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Initial if S.F. signature is not required.
Shif t Foremsn's S ature Date
- 21. Testing completed and component released f r normal use.
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Initial if S.. signature is not required s
Form s simre Date
- 22. Quality Control Department review of work and testing completed (QC work only).
Su ve.slance ideport No.
OC Depas ament Date r
- 23. Supervisor of Maintanapce Work request and procedure are complete and signed off as required. Change / modification f orm hn been sign'e(off as rfatslred.(Machinery history entry has been made,if rer;uired.
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Actual Mannours to perform too Supervisor of entenance Serwture Date 32.0 e==p-*
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