ML20133P695
| ML20133P695 | |
| Person / Time | |
|---|---|
| Site: | McGuire, Mcguire  |
| Issue date: | 07/29/1985 |
| From: | Dance H, William Orders, Pierson R NRC OFFICE OF INSPECTION & ENFORCEMENT (IE REGION II) |
| To: | |
| Shared Package | |
| ML20133P668 | List: |
| References | |
| 50-369-85-21, 50-370-85-22, NUDOCS 8508140422 | |
| Download: ML20133P695 (9) | |
See also: IR 05000369/1985021
Text
.
.
[csR Ric
o
UNITED STATES
'
NUCLEAR REGULATORY COMMISSION
\\
REgloN 11
?hI
,
101 MARIET Y A STREET. N.W.
- ' .
' s
ATL ANTA, GEORGI A 30323
s, m /
+...+
.
Report Nos.:
50-369/85-21 and 50-370/85-22
Licensee: Duke Power Company
422 South Church Street
Charlotte, NC 28242
Docket Nos.
50-369 and 50-370
License Nos.
Facility Name: McGuire 1 and 2
Inspection Conducted: M y 21 - June 20, 1985
_ _
_
_
_j[_h
Inspectors:
_
,_
W. T. Orders deni
Reside 4
nspector
te Si ned
-
Ah.
M ' U _./. - %
-R. C. Pief o
Re
nt insp cjgF
at
g ed
s
Approved by:
b
de-<a.-.-.
_7M T
C. Danc ,
ection Cnief
ate igned
Division of Reactor Projects
SUMMARY
Scope:
This routine, unannounced inspection entailed 300 inspection hours on
site in the areas of operations, safety verification, surveillance testing,
maintenance activities and refueling activities.
Results: Of the 5 areas inspected, no violations or deviations were identified
in 2 areas; I apparent violation was identified in each of the areas of opera-
tions, surveillance and refueling.
1)
Failure to follow procedures and inadequate procedure resulting in valve
misidentification, failure to reposition interlock, and failure to complete
shift turnover.
2)
Failure to perform surveillance on unlocked /open fire doors.
3)
Breach of containment integrity.
8500140422 050002
ADOCK 05000369
o
-
__
4
.
.
'
,
REPORT DETAILS
1.
Persons Contacted
1
Licensee Employees
T. McConnell, Plant Manager
- G. Cage, Superintendent of Operations
- D. Rains, Superintendent of Maintenance
B. Hamilton, Superintendent of Technical Services
- L. Weaver, Superintendent of Administration
- B. Travis, Superintendent of Integrated Scheduling
E. McCraw, License and Compliance Engineer
- D. Mendezoff, License and Compliance Engineer
- W. McDowell, Technical Specialist-Licensing
'
- G. Gilbert, Operations Engineer
- R. Phillips, Operations Engineer
- R. Michael, Station Chemist
P. Huntley, Health Physicist
- K. Carney, Shift Supervisor
- R. Johansen, Performance Engineer
4
- D. Motes, Maintenance Engineer
Other licensee employees contacted included construction craftsmen,
technicians, operators, mechanics, security force members, and office
personnel.
- Attended exit interview
2.
Exit Interview
The inspection scope and findings were summarized on June 25, 1985, with
those persons indicated in paragraph 1 above.
The licensee acknowledged
understanding of the issues discussed and offered no substantive related
discussion.
The licensee did not identify as proprietary any of the
mate. rials provided to or reviewed by the inspectors during this inspection.
l
3.
Licensee Action on Previous Enforcement Matters
No licensee action on previous enforcement items is discussed.
4.
Unresolved Items *
Unresolved items were not identified in this inspection.
5.
Plant Operations
The inspection staff reviewed plant operations during the report period,
May 21 - June 20, 1985, to verify conformance with applicable regulatory
t
requirements.
Control room logs, shift supervisors logs, shift turnover
!
- An Unresolved Item is a matter about which more information is required to
determine whether it is acceptable or may involve a violation or deviation.
!
i
i
__
_ _ _ _ _ _ _ _ _ _
-
.
-
'
2
records and equipment removal and restoration records were routinely
perused.
Interviews were conducted with plant operations, maintenance,
chemistry, health physics, and performance personnel.
Activities within the control rooms were monitored during shif ts and at
shift changes.
Actions and/or activities observed were conducted as
prescribed in applicable station administrative directives.
The complement
of licensed personnel on each shif t met or exceeded the minimum required by
technical specifications.
Plant tours were taken during the reporting period on a systematic basis.
The areas toured included but were not limited to the following:
Turbine
Buildings, Auxiliary Buildings, Units 1 and 2, Electrical Equipment Rooms,
Units 1 and 2, Cable Spreading Rooms, Station Yard Zone within the protected
area, and Unit 1 Reactor Building.
During the plant tours, ongoing
activities, housekeeping, security, equipment status and radiation control
practices were observed.
McGuire Unit 1 began the reporting period in Mode 6 in its second refueling
outage with core reload in progress.
Fuel loading was completed at 6:29 a.m.
on Sunday May 26, 1985.
The unit entered Mode 5 at 11:45 p.m. on June 5,
1985 where it remained until 9:48 a.m. on June 19, when the unit entered
Mode 4.
The unit remained in Mode 4 recovering from a refueling outage for
the duration of the reporting period.
McGuire Unit 2 began the reporting period in Mode 1 operating at 100%
reactor power and remained at or about 100% power until 9:19 a.m. June 1,
1985 when the unit tripped from a turbine trip.
This reactor trip is
discussed in paragraph 6.
All systems responded normally following the
trip.
The unit was restarted and entered Mode 2 on June 2,1985.
The
reactor was critical at 5:29 a.m. and entered Mode 1 at 7:25 a.m.
At
3:40 a.m. on June 3, the reactor reached 100% reactor power and remained at
or about 100% throughout the duration of the reporting period.
6.
On June 2,1985, at 9:19 a.m. Unit 2 experienced a reactor trip from 100%
power.
The reactor trip resulted from a feedwater isolation induced feed
pump trip and turbine trip.
Subsequent evaluation determined that the
{
i
feedwater isolation resulted from a dc ground in the exterior " doghouse"
(mechanical penetration room) water level instrumentation.
This water level
sensor, designed to isolate the feedwater system in the event of a feedwater
pipe rupture, has three level sensors providing an input to a relay which
subsequently initiates the feedwater isolation signal.
One level sensor
provides alarm indication upon reaching 6" with hi-hi level at 12" from two
out of three sensors initiating the feedwater isolation.
The ground appeared
on the wiring between the sensor and the relay which caused the hi-hi level
isolation signal to be initiated without a hi level alarm indication.
Following a determination of the cause of the trip the reactor was restarted
l
l
l
--a
_
.
.
3
with the unit reaching criticality at 5:29 a.m. on June 2,1985 and 100%
power at 3:40 a.m. on June 3, 1985.
7.
Safety Injection Procedures
On June 5,1985 at 2:10 p.m. during a routine procedure required / actual
position equipment verification, the inspector detected that on page 1 of 8
of the valve lineup checklist, of procedure OP-2-A-6200-06 Safety Injection
System that valve 2 NI-162 was listed as the NI pump min flow valve.
In
actuality valve 2 NI-162 is the safety injection discharge cold leg isola-
tion valve.
A review of the master file copy of the procedure revealed that the procedure
deficiency dates back to at least December 1983.
The above event constitutes an example of an inadequate procedure.
This
example, in conjunction with events detailed in paragraphs 8 and 9 consti-
tutes a violation (370/85-22-01).
8.
Personnel Airlock Integrity
On March 20, 1985, at approximately 11:00 a.m. , while Unit I was at 65%
power, two Performance Technicians discovered an interlock keyswitch inside
the Unit 1 lower personnel airlock in the " bypass" position.
With the
keyswitch in this position, it was possible to open both the Reactor side
airlock door and the Auxiliary side airlock door, thus losing containment
integrity.
With the keyswitch in the " bypass" position, the interlock
function is inoperable and consequently the containment airlock is techni-
cally inoperable.
The containment airlock is required by Technical Specifications (TS) and is
verified operable by TS 4.6.1.3c surveillance performed at least once per
six months.
The discovery was made while performing section 12.8 of
PT/1/A/4200/01F, Lower Containment Personnel Lock Leak Rate Test, which is
performed pursuant to TS 4.6.1.3c.
The technicians immediately ensured both
doors were closed and sealed and informed Control Room personnel of the
discovery.
Containment integrity was not lost.
There is no record of both lower airlock doors being opened simultaneously
af ter 1:00 p.m. on 0?cember 18, 1984.
Unit 1 entered Mode 4, at 2:12 a.m.
on December 19, 1984, af ter containment integrity was verified.
This
included having at least one airlock door closed at all times.
Operations personnel sometimes white tag both doors open on the upper and
lower personnel airlocks if the associated unit is to be in Mode 5 or 6
(with containment integrity not required) for an extended time.
Opening and
closing both doors is performed using OP/0/A/6700/06, Personnel Airlock
Operations, which was revised and reissued in August 1984 with all sign-off
lines deleted.
With no sign-offs required, the possibility of not fully
f
implementing the procedure was increased.
Further there were no steps in
I
the unit start-up procedure to verify the airlock interlocks were properly
positioned prior to entering a mode in which they were required.
. _ _ _ _ _ _
-
.
.
.
4
Performance personnel found the interlock inside the lower airlock in the
" bypass" position.
Since there is no documentation reflecting the posi-
tioning of the interlock keyswitch, no determination can be made as to when
the interlock failed to cet changed to the " active" position. It is highly
probable that the failure to reposition the keyswitch occurred when the
airlock was returned to service prior to the unit entering Mode 4 in
December 1984.
TS 6.8.1.a requires that current written approved procedures be established,
implemented and maintained for safety related activities. Implicit in that
stipulation is the requirement that procedure guidance be specific enough to
facilitate the successful accomplishment of the task.
The interlock keyswitch inside the personnel airlock as specified in procedure
OP/0/A/6700/06 was not returned to the active position in December 1984
prior to the unit entering mode 4.
Further complicating and perhaps leading
to this event is the fact that operations procedure CP/0/A/6700/06, Personnel
Airlock Operations, does not require a sign-off step to verify tnat the
interlock key switches are in the " active" position when returning the
airlock to service.
Further Units 1 and 2 operating procedures OP/1/A/6700/01
and OP/2/A/6100/01, Controlling Procedures for Unit Start-up, do not verify
the airlock interlock pcsition prior to entering Mode 4.
The failure to
return the airlock inter'ock to normal is an example of a failure to follow
procedure. This in conjtnction with items discussed in paragraphs 7 and 9
constitutes a violation (369/85-21-01).
9.
Shift Relief
On June 12 at 9 : 10 a .m. , while reviewing the current Shift Supervisor
Turnover Checklist, the inspector noted that the checklist had not been
completed. The inspector brought this matter to the attention of the Senior
Reactor Operator who then completed the form.
Station Directives 3.1.9, Relief at Duties of Plant Operation, specifies
procedures to promote continuity of safety and efficiency during the process
of relief of persons at duties of plant operation.
Included in this shift
relief process is the compl-etion of the Shift Supervisor Turnover Checklist.
Secticn 4 of Station Directive 3.1.9 requires that the shif t supervisors
fill out and follow the "Snift Supervisor Turnover Checklist", during shift
,
turnover. The oncoming Shift Supervisor must determine the required minimum
'
shift composition for h15. shift, and identify the individuals that will man
the positions.
TS 6.8.1.a requires that current written approved procedures be established,
implemented and maintained covering shift relief and turnover.
Contrary to those requirements, on June 12, the Shift Supervisors Turnover
Checklist was not completed and followed during shift turnover, in that page
3 of 4 was not completed identifying shift crew composition.
This in
I
conjunction with the items discussed in paragraphs 7 and 8 constitutes a
violation (369/85-21-01, 370/85-22-01).
.
.
.
.
5
r
10.
Fire Door Inspections
On April 14, 1985, during a routine QA audit of completed copies of procedure
PT/0/A/4250/12, Fire Door Inspections, the licensee noticed that PD-1 and
PD-2, fire doors for the Units I and 2 ETB switchgear rooms respectively,
were found unlocked on each weekly surveillance since February 14, 1985. It
was determined that no daily surveillance was being performed on these two
unlocked doors as required by TS 4.7.11.2a.
On April 18 and 25,1985,
Health Physics personnel again listed fire doors PD-1 and PD-2 as unlocked
during weekly surveillance. Again no daily surveillance was performed on
these docrs by any group.
Evaluation of the missed surveillances revealed that the security organiza-
tion for McGuire was initially given the responsibility for the daily and
weekly fire door inspections.
TS 3.7.11 weekly and daily fire door inspections
were performed under PT/0/A/4250/11, Fire Door Inspections.
In August of 1984, a meeting was held between the Security Compliance
officer, a Security Specialist, the Mechanical Maintenance Technical
Specialist (MMTS) responsible for fire door repairs and the Station Health
Physicist to discuss fire door responsibilities in the Radiation Control
Area (RCA). Since Security personnel must contact Health Physics personnel
for access to the twelve fire doors located in the RCA, Health Physics
agreed to perform the weekly inspections on those doors.
Procedure
PT/0/A/4250/12 (Fire Door Inspections) was written for Health Physics to use
for the inspections.
Health Physics personnel performed the weekly :urveillance of the twelve
fire doors from September 6, 1984 until April 30, 1985.
From February 14,
to April 11, 1985, Health Physics personnel listed fire doors PD-1 and PD-2
as unlocked during the weekly surveillance.
Tersely stated there was a great deal of confusion as to which group was
responsible for the twelve fire doors in question following the August 1984
meeting.
As a result no action was taken when PO-1 and PD-2 were found
unlocked. The matter was complicated further by the unclear delineation of
respensibiltty in PT/0/A/4250/11 and PT/0/A/4250/12.
In both procedures,
Maintenance was identified as responsible for the review of completed
'
procedures.
Both Security and Health Physics assumed this review would
ensure that appropriate action was taken on fire doors if needed.
The net result is that fire doors PD-1 and PD-2, which are normally locked
closed, were unlocked from February 14, 1985 to April 14, 1985 during the
Unit 2 refueling outage.
The doors were . then locked by operations but
l-
subsequently were unlocked and remained unlocked, even though this problem
was identified by a QA audit conducted on April 14, 1985.
The problem was
corrected on April 30, 1985 when daily inspections of the unlocked doors
commenced. As previously stated, the doors are normally verified closed on
a weekly basis ir, accordance with PT/0/A/4250/12 (Fire Dcor Inspections) and
TS 4.7.11.2c. While unlocked, the doors were not verified closed daily as
required by TS 4.7.11.2a.
m
_
_ _ _ _ _ _ _ _ _ _ _ _ _ _
-
.
.
6
10 CFR 50, Appendix B, Criterion XVI as implemented by Duke Power Company
(DPC) Topical Report, Quality Assurance Program Duke-1-A, Amendment 7,
Section 17.2.16 requires that conditions adverse to quality be promptly
identified and corrected.
In as much as this condition was identified by
Quality Assurance two weeks before corrective action was implemented, the
i
intent of Criterion XVI was not met.
In summary, the requirements of 10 CFR 50, Appendix B, Criterion XVI,
corrective action was not taken until April 30, 1985 to verify fire doors
PD-1 and PD-2 were closed daily following identification of this problem by
a routine QA audit conducted on April 14, 1985.
As a result the require-
ments of TS 4.7.11.2a, fire doors PD-1 and PD-2 were not verified closed
daily during the time April 14 - 30, 1985 while these fire doors were
unlocked.
This is a violation (369/85-21-02, 370/85-22-02).
11.
Containment Integrity
On May 25,1985 at 8:05 p.m., Unit I was in mode 6 actively reloading the
core, when the licensee detected that valve 1 RV-429, a containment ventila-
tion cooling water vent valve outside containment, was found open during the
performance of a containment integrity verification procedure PT-1-A-4200-02C.
This valve being open in conjunction with valve 1 RV-365, a vent valve on the
same line inside containment being open, resulted in a breach of containment
integrity. Valve 1 RV-429 was immediately closed and locked as required.
Valve 1 RV-429 had been verified closed during be performance of
PT-1-A-4200-02C which had been run during the period spanning May 17 and
May 19, 1985.
Sometime during the period between May 19 and May 25, 1985,
valve 1RV-429, a valve which is required by procedure to be locked closed,
was unlocked and misaligned.
No documentation can be found either authoriz-
ing or documenting the realignment.
Apparently a personnel error during the
above period resulted in mispositioning of this valve.
Procedure OP-0-A-6400-09, Containment Ventilation Cooling Water System,
specifies the inboard and outboard vent valves to be closed and locked
during operation.
This procedure is specified for completion before unit
startup and placing the ventilation cooling water in service.
TS 3.9.4, Containment Building Penetrations, requires during core altera-
tions that each penetration providing direct access from the containment to
the outside atmosphere, shall either be closed by an isolation valve, blind
flange, manual valve or be exhausting through operable reactor building
containment purge exhaust system HEPA filters and charcoal absorbers.
Contrary to those requirements, penetration M 385, Containment Ventilation
Cooling Water In, was not isolated or exhausting through an operable filter
during the period May 19 - May 25,1985 when core alterations were in
progress.
This is a Violation (369/85-21-03).
Licensee Event Report
370/85-06 also described a containment integrity problem during core
alterations involving maintenace/ surveillance activities.
_ _ _ _ _ _
~
.
.
'
.
7
12.
Surveillance Testing
The surveillance tests categorized below were analyzed and/or witnessed by
the inspector to ascertain procedural and performance adequacy.
The completed test procedures examined were analyzed for embodiment of the
necessary test prerequisites, preparations, instructions, acceptance criteria,
and sufficiency to technical content.
The selected tests witnessed were examined to ascertain that current written
approved procedures were available and in use, that test equipment in use
was calibrated, that test prerequisites were met, system restoration completed
and test results were adequate.
The selected procedures persued attested conformance with applicable TS and
procedural requirements, they appeared to have received the required adminis-
trative review and they apparently were performed within the surveillance
frequency specified.
PT/2/A/4252/02
M/D CA Pump 2A Performance Test
PT/2/A/4209/01A
NV Pump 2A Performance Test
PT/1/A/4252/02P
CA Valve Stroke Timing Quarterly
PT/1/A/4204/018
RHR Pump 1B Performance Test
PT/0/A/4250/04G
Turbine Trip Reactor Trip Functional Test
PT/1/A/4208/02
Containment Spray Stroke Timing Test
PT/1/A/4209/01B
Centrifugal Charging Pump Performance Test
PT/1/A/4204/018
Residual Heat Removal Pump Performance Test
13. Maintenance Observations
The maintenance activities categorizej below were analyzed and/or witnessed
by the resident inspection staff to ascertain procedural and performance
adequacy.
The completed procedures examined were analyzed for embodiment of the
necessary prerequisites, preparation, instructions, acceptance criteria and
sufficiency of technical detail.
The selected activities witnessed were examined to ascertain that where
applicable, current written approved procedures were available and in use,
that prerequisites were met.
Equipment restoration completed and maintenance
results were adequate.
The selected work requests / maintenance packages persued attested conformance
with applicable TS and procedural requirements and appeared to have received
the required administrative review.
-
.
.
.
8
WORK REQUEST
EQUIPMENT
113095
Repair INC-18
106134
Repair / Plug Leak on 1NV-239
950479
1 CA-22 Check Valve Installation and Hydro
036677
PM/PT on Limitorque Operator
14. Licensee Event Reports
The following licensee event reports (LER) were reviewed inorder to deter-
mine the adequacy of corrective actions the implications as they pertain to
safety of operations, the applicable reporting requirements, and licensee
review of the event.
Based on the results of this review, the items are closed.
Unit 1, LER's
83-03
83-42
83-62
83-71
83-04
83-45
83-63
84-05
83-26
83-49
83-64
84-04
83-28
83-52
83-66
84-20
83-33
83-59
83-68
84-21
83-40
83-60
83-69
84-24
83-41
83-61
83-70
Unit 2, LER 85-15
,
J