ML19316A593

AO-270/75-16:on 750808,operable Bldg Spray Train Not Provided During Startup.Caused by Personnel Error.Control Operator Relied on Out of Normal Checklist.Deficiencies in Personnel Performance Pointed Out.Startup Procedure Changed

ML19316A593
Person / Time
Site:	Oconee
Issue date:	08/22/1975
From:	DUKE POWER CO.
To:
Shared Package
ML19316A590	List: ML19316A589 ML19316A593
References
NUDOCS 8001130101
Download: ML19316A593 (2)

Text

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l Duke Power Company Oconce Unit 2 I

Report No.: A0-270/75-16 1.

e Report Date: August 22, 1975 4

Occurrence Date: August 8, 1975 >

Facility: Oconec Unit 2, Seneca, South Carolina i

Failure to provide an operable building Identification of Occurrence: spray train as required Heatup in progress, RC temperature and Conditions Prior to Occurrence: pressure greater than 2500 F and 350 psig respectively Description of Occurrence:

On August 8, 1975, while in the process of conducting a unit startup for Oconee Unit 2, it was determined that the Reactor Coolant System had been elevated above 2500F and 350 psig without an operable Reactor Building spray train as required by Technical Specification 3.3.1.a.

The sequence of events which led to this condition is presented below:

August 7, 1975 1100 Unit shutdown was initiated Valves 2BS-3 and 2BS-4 (Reactor Building spray pump 2014 suction valves) were shut per the controlling procc- l l

dure for unit shutdown )

August 8, 1975 ,

Unit startup began 0500 Contrei operator signed off as complete, the step 1

0709 in the unit startup pro,cedure which states that the Reactor Building Spray (RBS) system is in the ES standby mode. He had checked the "Out of Normal" checklist as a basis for signing off this step.

1 With the Reactor Coolant System at 3100F and 450 1515 psig, the shift supervisor noted that valves 2BS-3 and 2BS-4 were shut. The hentup was halted until the Reactor Building Spray System could be lined up l in the ES Standby mode.

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Designation of Apparent Cause of Occurrence:

The apparent cause of this occurrence was personnel error. The controlling

procedure for unit startup required the Reactor Building Spray System to j be lined up in the ES standby mode per the operating procedure for this system. The control operator failed to follow the procedure and relied instead upon the "Out of Normal" checklist to verify that the Reactor Building Spray System was lined up correctly. Thus the control operator's misunder-standing of the purpose and usage of the "Out of Normal" checklist was the primary cause of this incident.

Analysis of Occurrence: '

The reactor coolant temperature and pressure were elevated slightly above the limits in the Technical Specifications before a train of Reactor Building spray was lined up in the ES standby mode. The stored energy in the Reactor

{ Coolant System would not have been sufficient to cause Reactor Building pressure to exceed design limits in the event of an accident. It is concluded that this occurrence did not affect the health and safety of the public.

i Corrective Action:

The Superintendent of Operations has personally talked with the individuals involved pointing out the deficiencies in their performance. He also reviewed this incident with other operating personnel. A change has been ,

made to the startup procedure to preclude another incident of this type. l 1 ,

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