LER-1978-031, /03L-0:on 780325,control Room Ventilation Air Intake Chlorine Detectors 12-h Channel Check Not Recorded. Caused by Procedural Deficiency.Chlorine Detector Reading Inadvertently Deleted During Reading Sheet Revision 771111 |
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LICENSEE EVENT REPORT (l ' ~
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8 EVENT DESCRIPTION AND PROBABLE CONSECUENCES h it was determinedJ l o l a l l While reviewing surveillance requirements at 1800 hours0.0208 days <br />0.5 hours <br />0.00298 weeks <br />6.849e-4 months <br /> on 3/25/78, l
l o I 31 I that the 12' hour channel check of the Control Room Ventilation Air Intake Ch J
[ o 141 l Detectors was not b.2ing recorded as required by Technical Specification Surveillance l o i s j l Require =ent 4.3.3. 7.
There was no danger to the health and safety of the public or l
IoI6I l unit personnel. The operators continued to monitor the detectors although the infor-I The monthly surveillance test verified ocerability of these i l o j 7 l j mation was not recorded.
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47 CAUSE DESCRIPTION AND CORRECTIVE ACTIONS i
li j o j l The failure to record the 12 hour1.388889e-4 days <br />0.00333 hours <br />1.984127e-5 weeks <br />4.566e-6 months <br /> channel check of the chlorine Detectors was caused i i #, j l by a procedural deficiency. On Novenber 11, 1977, the Chlorine Detector readine i
j requirement was inadvertently deleted from the Hourly Reading Sheet during a revision J On E rch 25, 1978, a modification was I
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I l i=nediately implemented to assure the surveillance requirements were comoleted.
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TOLEDO EDISON COMPANY DA*.*IS-;** S S i~.;1T 03.
3"C'_~M. D.~..Zu ST.".! ION O-SUPPLEMENTAL INFORMATION FOR LER NP-33-78-37 DATE OF EVEUT: March 25, 1978 FACILITY: Davis-Besse Unit 1 IDENTIFICATIONOFOCCURRENCb:
Control Room Ventilation Air Intake Chlorine Detec-l tors' channel check was not being recorded 4
Conditions Prior to Occurrence: The unit was in Mode 3, with Power (MWT) = 0, and Load (MWE) = 0..
l Description of Occurrence: While reviewing surveillance requirements at 1800 hours0.0208 days <br />0.5 hours <br />0.00298 weeks <br />6.849e-4 months <br />
.l on March 25, 1978, it was determined that the twelve hour channel check of the Control Room Ventilation Air Intake Chlorine Detectors was not being recorded.
Technical Specification Surveillance Requirement 4.3.3.7 states "The chlorine Detection System shall be demonstrated operable by performance of a channel check at least once per twelve hours, a channel functional test at least.once per 31 days and a channel calibration at -least once per 18 months."
Designation of Apparent Cause of Occurrence: The failure to record the 12 hour1.388889e-4 days <br />0.00333 hours <br />1.984127e-5 weeks <br />4.566e-6 months <br /> channel check of the Chlorine Detectors was caused by a procedural deficiency.
Until November 11, 1977, the chlorine Detectors were monitored every shif t and recorded on the Auxiliary Building Hourly Reading Sheet 2.
On November 11, 1977, the Chlorine Detector reading requirement was inadvertently deleted from the Hourly Reading Sheet during a revision which combined the Hourly Reading Sheets.
The operators continued to monitor the Chlorine Detectors, but did not record the information. As a result, the deficiency occurred from November 11, 1977 until its discovery on March 25, 1978, at which. time Modification T-2638 was -
written for Surveillarice Test ST 509.9.01, " Miscellaneous Instrument Shift check" ~
to include the monitoring of the' Chlorine Detectors. The deficiency also occurred on March 26, 27, 28 and 29, 1978, as the result of operators using an unrevised Surveillance Test ST 5099.01 procedure.
Analysis of Occurrence: There was no danger to the health and safety of the public or to unit personnel. The operators continued to monitor the Control Room Ventila-tion Air Intake Chlorine Detectors without recording the information. The opera-tors continued to inspect the general area in concern on a routine basis every shift.
Surveillance Test ST 5037.02 " Chlorine Detector System Monthly Test" verified the operability of these detectors on a monthly basis for November.1977 through March 1978.
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TOLEDO EDISON COMPANY 4
. DAVIS-BESSE UNIT ONE NUCLEAR POWER STATION PACE 2 SUPPLEMENTAL INFOPliATION FOR LER NP-73-78-37
Corrective Action
On March 25, 1978, Modification T-2638 was written for the Surveillance Test ST 5099.01, " Miscellaneous Instrument Shif t Check" to include This l
the required monitoring of the Control Room Air Intake Chlorine Detectors.
modification was immediately implemented in an attempt to assure the surveillance 4
requirements were co=pleted.
Failure Data: There has been one previous occurrence of a log sheet deficiency l
causing a failure to complete the surveillance requirement (Licensee Event Raport :. 77-05).
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| 05000346/LER-1978-002-03, /03L-0:on 780103,control Rod Group 5 Rod 12 Absolute Position Indication Declared Inoperable.Caused by Component Failure of Absolute Position Indicator Reed Switch.Switch Replaced | /03L-0:on 780103,control Rod Group 5 Rod 12 Absolute Position Indication Declared Inoperable.Caused by Component Failure of Absolute Position Indicator Reed Switch.Switch Replaced | | | 05000346/LER-1978-002, Forwards LER 78-002/03L-0 | Forwards LER 78-002/03L-0 | | | 05000346/LER-1978-003-03, /03L-0:on 780103,unidentified RCS Leakage Greater than 1,66 Gallon Per Minute.Caused by Loose Packing on Valve DH2735.Valve Repacked & Stroked | /03L-0:on 780103,unidentified RCS Leakage Greater than 1,66 Gallon Per Minute.Caused by Loose Packing on Valve DH2735.Valve Repacked & Stroked | | | 05000346/LER-1978-003, Forwards LER 78-003/03L-0 | Forwards LER 78-003/03L-0 | | | 05000346/LER-1978-004, Forwards LER 78-004/03L-0 | Forwards LER 78-004/03L-0 | | | 05000346/LER-1978-004-03, /03L-0:on 780105,inlet Balancing Dampers to Emergency Ventilation Sys Fans 1-1 & 1-2 Found Closed.Cause Unknown.Dampers Returned to Balance Position & Locknut Tightened | /03L-0:on 780105,inlet Balancing Dampers to Emergency Ventilation Sys Fans 1-1 & 1-2 Found Closed.Cause Unknown.Dampers Returned to Balance Position & Locknut Tightened | | | 05000346/LER-1978-005-03, /03L-0:on 780106,auxiliary Feed Pump Turbine 1-1 Speed Control Lost & Declared Inoperable.Caused by Short Circuits & Blown Fuses Due to Design Deficiency.Higher Current Rated Relays Installed & Circuit Modified | /03L-0:on 780106,auxiliary Feed Pump Turbine 1-1 Speed Control Lost & Declared Inoperable.Caused by Short Circuits & Blown Fuses Due to Design Deficiency.Higher Current Rated Relays Installed & Circuit Modified | | | 05000346/LER-1978-005, Forwards LER 78-005/03L-0 | Forwards LER 78-005/03L-0 | | | 05000346/LER-1978-006-03, /03L-0:on 780107,computer Alarm Indicated That Steam & Feedwater Rupture Control Sys Steam Generator to Feedwater Differential Pressure Channel 1 Had Tripped.Caused by Component Failure.Input Buffer 1-3 in Channel 1 Replaced | /03L-0:on 780107,computer Alarm Indicated That Steam & Feedwater Rupture Control Sys Steam Generator to Feedwater Differential Pressure Channel 1 Had Tripped.Caused by Component Failure.Input Buffer 1-3 in Channel 1 Replaced | | | 05000346/LER-1978-006, Forwards LER 78-006/03L-0 | Forwards LER 78-006/03L-0 | | | 05000346/LER-1978-007-03, /03L-0:on 780109,during Monthly Surveillance Test ST 5081.01,diesel Generator 1-1 Tripped on High Crankcase Pressure.Caused by Dirty Crankcase Vent Oil Collector.Vent Oil Collector Disassembled & Cleaned | /03L-0:on 780109,during Monthly Surveillance Test ST 5081.01,diesel Generator 1-1 Tripped on High Crankcase Pressure.Caused by Dirty Crankcase Vent Oil Collector.Vent Oil Collector Disassembled & Cleaned | | | 05000346/LER-1978-007, Forwards LER 78-007/03L-0 | Forwards LER 78-007/03L-0 | | | 05000346/LER-1978-008-03, /03L-0:on 780112,both Containment Spray Pumps Found Inoperable.Caused by Personnel Error.Spray Pump Circuit Breakers re-energized | /03L-0:on 780112,both Containment Spray Pumps Found Inoperable.Caused by Personnel Error.Spray Pump Circuit Breakers re-energized | | | 05000346/LER-1978-008, Forwards LER 78-008/03L-0 | Forwards LER 78-008/03L-0 | | | 05000346/LER-1978-009-03, /03L-0:on 780112,component Cooling Water Heat Exchanger 1-1 Outlet Isolation Valve SW 1424 Declared Inoperable.Caused by Component Failure.Solenoid Valve in Control Scheme Found Burned Out.Unit Removed | /03L-0:on 780112,component Cooling Water Heat Exchanger 1-1 Outlet Isolation Valve SW 1424 Declared Inoperable.Caused by Component Failure.Solenoid Valve in Control Scheme Found Burned Out.Unit Removed | | | 05000346/LER-1978-009, Forwards LER 78-009/03L-0 | Forwards LER 78-009/03L-0 | | | 05000346/LER-1978-010-03, /03L-0:on 780115, Reactor Coolant Pump Monitor on Channel 1 Found Out of Tolerance & Reactor Protection Sys Declared Inoperable.Caused by Defective Module.New Module Calibr & Installed | /03L-0:on 780115, Reactor Coolant Pump Monitor on Channel 1 Found Out of Tolerance & Reactor Protection Sys Declared Inoperable.Caused by Defective Module.New Module Calibr & Installed | | | 05000346/LER-1978-010, Forwards LER 78-010/O3L-0 | Forwards LER 78-010/O3L-0 | | | 05000346/LER-1978-011, Forwards LER 78-011/03L-0 | Forwards LER 78-011/03L-0 | | | 05000346/LER-1978-011-03, /03L-0:on 780116,during Surveillance Test,Decay Heat Pump 1-1 Failed to Start.Caused by Fuses in Breaker for Decay Heat Motor Failing to Make Proper Contact.Control Power Fuese Pulled & Reinserted.Pump Returned to Svc | /03L-0:on 780116,during Surveillance Test,Decay Heat Pump 1-1 Failed to Start.Caused by Fuses in Breaker for Decay Heat Motor Failing to Make Proper Contact.Control Power Fuese Pulled & Reinserted.Pump Returned to Svc | | | 05000346/LER-1978-012, Forwards LER 78-012/03L-0 | Forwards LER 78-012/03L-0 | | | 05000346/LER-1978-012-03, /03L-0:on 780124,personnel Airlock Failed Leak Rate Test.Caused by Loose Shaft Seal Due to Routine Use of Personnel & Escape Lock (Exit/Entry to Containment).Shaft Seals Tightened to Prevent Excessive Leakage | /03L-0:on 780124,personnel Airlock Failed Leak Rate Test.Caused by Loose Shaft Seal Due to Routine Use of Personnel & Escape Lock (Exit/Entry to Containment).Shaft Seals Tightened to Prevent Excessive Leakage | | | 05000346/LER-1978-013-03, /03L-0:780119,Cell 32 in Station Battery 1N Electrolyte Specific Gravity Decreased 0.003 Greater than Allowed by Tech Spec 3.8.2.3.Caused by Electrolyte Stratification Due to Low Battery Loading | /03L-0:780119,Cell 32 in Station Battery 1N Electrolyte Specific Gravity Decreased 0.003 Greater than Allowed by Tech Spec 3.8.2.3.Caused by Electrolyte Stratification Due to Low Battery Loading | | | 05000346/LER-1978-013, Forwards LER 78-013/03L-0 | Forwards LER 78-013/03L-0 | | | 05000346/LER-1978-014, Forwards LER 78-014/03L-0 | Forwards LER 78-014/03L-0 | | | 05000346/LER-1978-014-03, /03L-0:on 780123,quandrant Power Tilt in Excess of Steady State & Transient Limits Indicated by Unit Process Computer.Caused by Detector Inadvertently Left Off Scan After Testing.Test Procedure Being Modified | /03L-0:on 780123,quandrant Power Tilt in Excess of Steady State & Transient Limits Indicated by Unit Process Computer.Caused by Detector Inadvertently Left Off Scan After Testing.Test Procedure Being Modified | | | 05000346/LER-1978-015, Forwards LER 78-015/03L-0 | Forwards LER 78-015/03L-0 | | | 05000346/LER-1978-015-03, /03L-0:on 780131,feedwater Steam Generator 1 Channel 2 Pressure Differential Switch Did Not Actuate at Desired Setpoint During Surveillance Test.Caused by Pressure Differential Switch Out of Tolerance | /03L-0:on 780131,feedwater Steam Generator 1 Channel 2 Pressure Differential Switch Did Not Actuate at Desired Setpoint During Surveillance Test.Caused by Pressure Differential Switch Out of Tolerance | | | 05000346/LER-1978-016-03, /03L-1:on 780202,absolute Position Indicator for Group 5,Rod 12,declared Inoperable.Caused by Component Failure in Penetration Area.Containment Conductors Connected to Spare Penetration Connector | /03L-1:on 780202,absolute Position Indicator for Group 5,Rod 12,declared Inoperable.Caused by Component Failure in Penetration Area.Containment Conductors Connected to Spare Penetration Connector | | | 05000346/LER-1978-016, Forwards LER 78-016/03L-1,LER 78-021/03L-1,LER 78-100/03L-1, LER 78-034-03L-1 & LER 78-024/03L-1 | Forwards LER 78-016/03L-1,LER 78-021/03L-1,LER 78-100/03L-1, LER 78-034-03L-1 & LER 78-024/03L-1 | | | 05000346/LER-1978-017, Forwards LER 78-017/03L-0 | Forwards LER 78-017/03L-0 | | | 05000346/LER-1978-017-03, /03L-0:on 780126,all Meteorological Channels Became Inoperable During Blizzard.Caused by Instrumentation Power Loss Due to Tripped Breaker at Meteorological Tower. Breaker Reset on 780128 | /03L-0:on 780126,all Meteorological Channels Became Inoperable During Blizzard.Caused by Instrumentation Power Loss Due to Tripped Breaker at Meteorological Tower. Breaker Reset on 780128 | | | 05000346/LER-1978-018-03, /03L-0:on 780208,diesel Generator 1-1 Making Unusual Noises During Monthly Test.Unusual Noise Traced to Turbocharger.Exact Cause Undetermined.Turbocharger Replaced & Diesel Generator Monthly Test Completed | /03L-0:on 780208,diesel Generator 1-1 Making Unusual Noises During Monthly Test.Unusual Noise Traced to Turbocharger.Exact Cause Undetermined.Turbocharger Replaced & Diesel Generator Monthly Test Completed | | | 05000346/LER-1978-018, Forwards LER 78-018/03L-0 | Forwards LER 78-018/03L-0 | | | 05000346/LER-1978-019-03, /03L-1:on 780210,decay Heat Cooler Outlet Valve DH14A & DH14B Mechanical Stops Found Incorrectly Opened. Caused by Personnel Incorrectly Resetting Stops After Previous Work Completion.Stops Tagged & Records Marked | /03L-1:on 780210,decay Heat Cooler Outlet Valve DH14A & DH14B Mechanical Stops Found Incorrectly Opened. Caused by Personnel Incorrectly Resetting Stops After Previous Work Completion.Stops Tagged & Records Marked | | | 05000346/LER-1978-020, Forwards LER 78-020/03L-0 | Forwards LER 78-020/03L-0 | | | 05000346/LER-1978-020-03, /03L-0:on 780210,reactor Protection Sys Channel 3 Hot Leg Temp String TI-RC3B4 Declared Inoperable.Caused by Loose Wire Connection.Loose Terminal at Temp Element Tightened,Rendering TI-RC3B4 Operable | /03L-0:on 780210,reactor Protection Sys Channel 3 Hot Leg Temp String TI-RC3B4 Declared Inoperable.Caused by Loose Wire Connection.Loose Terminal at Temp Element Tightened,Rendering TI-RC3B4 Operable | | | 05000346/LER-1978-021-03, /03L-1:on 780220,absolute Position Indicator for Control Rod 12 of Group 5 Declared Inoperable.Caused by Component Failure in Penetration Area.Conductors Connected W/Spare Penetration Connectors | /03L-1:on 780220,absolute Position Indicator for Control Rod 12 of Group 5 Declared Inoperable.Caused by Component Failure in Penetration Area.Conductors Connected W/Spare Penetration Connectors | | | 05000346/LER-1978-022-03, /03L-0:on 780223,flow Transmitter FTRC1A3 Found Inoperable.Caused by Defective Flow Transmitter Amplifier. Amplifier Replaced & Flow Transmitter FTRC1A3 Returned to Svc on 780226 | /03L-0:on 780223,flow Transmitter FTRC1A3 Found Inoperable.Caused by Defective Flow Transmitter Amplifier. Amplifier Replaced & Flow Transmitter FTRC1A3 Returned to Svc on 780226 | | | 05000346/LER-1978-022, Forwards LER 78-022/03L-0 | Forwards LER 78-022/03L-0 | | | 05000346/LER-1978-023-03, /03L-0:on 780224,temp Indication for Reactor Protection Sys Channel 2 Spiked Tripping Channel & Shut Down Reactor.Caused by Faulty Connector Due to Dirt on Contacts. Channel 2 Temp String Modules Removed & Connectors Cleaned | /03L-0:on 780224,temp Indication for Reactor Protection Sys Channel 2 Spiked Tripping Channel & Shut Down Reactor.Caused by Faulty Connector Due to Dirt on Contacts. Channel 2 Temp String Modules Removed & Connectors Cleaned | | | 05000346/LER-1978-023, Forwards LER 78-023/03L-0 | Forwards LER 78-023/03L-0 | | | 05000346/LER-1978-024-03, /03L-1:on 780228,MSIV MS-101 Rendered Inoperable to Allow Maint Personnel to Remove Raised Metal on Two of Four Spring Guide Tubes.Cause of Raised Metal Unknown.Metal Filed Down,Valve Closing Time Adjusted & Valve Tested | /03L-1:on 780228,MSIV MS-101 Rendered Inoperable to Allow Maint Personnel to Remove Raised Metal on Two of Four Spring Guide Tubes.Cause of Raised Metal Unknown.Metal Filed Down,Valve Closing Time Adjusted & Valve Tested | | | 05000346/LER-1978-025-03, /03L-0:on 780304,RCS Leakage Found Greater than 1 Gallon Per Minute.Leakage Cause Undetermined.Leakages Processed Through Normal Containment Sump.Unidentified RCS Leakage Reduced Below 1 Gallon Per Minute in 5.5-h | /03L-0:on 780304,RCS Leakage Found Greater than 1 Gallon Per Minute.Leakage Cause Undetermined.Leakages Processed Through Normal Containment Sump.Unidentified RCS Leakage Reduced Below 1 Gallon Per Minute in 5.5-h | | | 05000346/LER-1978-025, Forwards LER 78-025/03L-0 | Forwards LER 78-025/03L-0 | | | 05000346/LER-1978-026, Forwards LER 78-026/03L-0 | Forwards LER 78-026/03L-0 | | | 05000346/LER-1978-026-03, /03L-0:on 780309,radiation Monitor Re 5029 Found Inoperable Due to Low Sample flow.12 Previous Radiation Monitor Inoperabilities Not Reported.Caused by Pump Motor Bearing Seizure Due to High Ambient Temp | /03L-0:on 780309,radiation Monitor Re 5029 Found Inoperable Due to Low Sample flow.12 Previous Radiation Monitor Inoperabilities Not Reported.Caused by Pump Motor Bearing Seizure Due to High Ambient Temp | | | 05000346/LER-1978-027, Forwards LER 78-027/03L-0 | Forwards LER 78-027/03L-0 | | | 05000346/LER-1978-027-03, /03L-0:on 780316,stop Valve AF3870 Failed to Open During Testing.Caused by High Differential Pressure Due to Check Valve AF39 & AF72 Leakage.Motor Operator Initially Not Adjusted for This Pressure,Causing Operator to Torque | /03L-0:on 780316,stop Valve AF3870 Failed to Open During Testing.Caused by High Differential Pressure Due to Check Valve AF39 & AF72 Leakage.Motor Operator Initially Not Adjusted for This Pressure,Causing Operator to Torque Out | | | 05000346/LER-1978-028-03, /03L-0:on 780318,channel 1 Steam Generator 1-1 Declared Inoperable.Caused by Water in Level Transmitter SP09B8 Connecting Box Due to Steam Leak.Connection Box Cleaned & Dried.Waterproof Fitting Will Be Installed | /03L-0:on 780318,channel 1 Steam Generator 1-1 Declared Inoperable.Caused by Water in Level Transmitter SP09B8 Connecting Box Due to Steam Leak.Connection Box Cleaned & Dried.Waterproof Fitting Will Be Installed | |
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