Text

ISI Rept 3-3
	ML20237E030
Person / Time
Site:	Palisades
Issue date:	07/31/1998
From:	Jennifer Ford, Fouty T; CONSUMERS ENERGY CO. (FORMERLY CONSUMERS POWER CO.)
To:	;
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ML18066A286	List: ML20237E030;
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O PALISADES NUCLEAR PLANT ENGINEERING PROGRAMS DEPARTMENT Review and Approval Summa.y TITLE: ISI REPORT 3-3 AM 'T

~7/5c>/9g ISI Senior Technical Knalyst / THFouty Date

% o rt Y3/h7 Engincejing Programs Manager / JKFord Date 9908280188 980825 PDR ADOCK 05000255 O

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g Pg ISADES NUCLEAR FLANT 1943 INSERVICE INSPECTION REPORT Submitted in accordance with 'the ASME Boiler and Pressure Vessel Code Section X1, Article IWA-6000, 1989 Edition.

1.

Date:

July 29, 1998 2.

Corporate Headquarters:

Consumers Energy 212 West Michigan Avenue Jackson, Michigan 49201 3.

Plant:

Palisades Nuclear Plant 27780 Blue Star Memorial Highway Covert, Michigan 49043 4.

Unit No:

1 5.

Commercial Service Date:

December 31, 1971 6.

Major Components Inspected:

i Manufacturer National 1

Comoonent Manufacturer

- Serial No.

State No.

Board No.

Stm Gen.E-50B Combustion Eng.

CE-70277-2 M358177M NB22865 7.

Completion Date for Inspections: June 7, 1998 8.

Code Inspector:

Kenneth L Blake 9.

Authorized Inspection Agency:

Protection Mutual, Norwood MA 10.

Abstract See ISI Report

1996 INSERVICE INSPECTION 3 3 3-PALISADES NUCLEAR PLANT Sumary Inservice Inspection No.' 3-3 was conducted during the period of April 21, 1998 through June 7, 1998 in accordance with Section 6.5.7 of the Palisades Nuclear Plant Technical. Specifications. ~ The ASME Boiler and Pressure Vessel (B&PV)

Code,Section XI 1989 controlled the inspections and provided the acceptance criteria for these examinations.

. Included in this submittal are three separate sections. The first section details the examinations which were performed and the final inspection results.

The second section provides the results summary to determine compliance with ASME Section XI for category and item numbers. The third section provides a listing of the repairs and replacements which have been performed over the last refueling cycle and the required NIS-2 Forms to document these repairs and replacements.

Inspection Activities This was the last examination of the first period of the third inspection interval.

Areas examined during this inspection included the steam generator and various components of the Primary Coolant System. Engineered Safeguards System, Main Steam System and various support systems as identified in the attached NDE Results Summary Report.

The examinations were performed using Radiographic (RT). Ultrasonic (UT)(Automated and Manual), Liquid Penetrant (PT), Magnetic Particle (MT) and Visual (VT) techniques. The examinations were conducted with Consumers Energy Engineering and Technical Services Department (E&TS) nondestructive examination personnel using site approved procedures.

Examinations were performed by personnel qualified. in the NDT process utilized in accordance with the requirements of ASME Section XI IWA-2300,1989 Edition.

Verification of ASME Section XI Compliance To document the results total after the completion of this first period of the third inspection interval a Verification of Section XI Compliance" report is attached. This report provides a category summary for all categories, followed by a detailed category and item number breakdown for inspection activities.

i i

9 FORM NIS 1 OWNER'S REPORT FOR INSERVICE INSPECTIONS l

As required by the Provisions of the ASME Code Rules

1. Owner Consumers Energy, 212 West Michigan Ave., Jackson MI 49.201 (Name and Address of Owner)

2. Plant Palisades Nuclear Plant, 27780 Blue Star Memorial Hwy, Covert MI (Name and Address of Plant) 49043 3 Plant Unit 1

4. Owrer Certificate of Authorization (if required)

N/A

5. Commercial Service Date 12/31/71 6. N ttior.at Board Number for Unit NB20827

7. Components inspected Manufacturer Component or Manufacturer or installer State or National Appurtenance or Installer Serial No.

Province No.

Board No.

Steam Generator Combustion Enc.

CE-70277-2 M358177M MR77AA9 SEE "NDE RESULTS

SUMMARY

REPORT (ATTACHED) i, i

I I

l Note: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% 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.

(12/s2)

This Form (E00029) may be obtained from the Order Dept., ASME,345 E. 47th St., New York, N.Y.10017 l

l i

?

FORM NIS 1 (llack) 4/21/90 0/7/90

9. Inspection Interval from 5/12/94o5/11/05 l

8. Examination Dates to

10. Abstract of Examinations. Include a list of examination

and a statement concerning status of work required for current interval. See " Verification of Compliance After Completion of Outage 3-3" ll. Abstract of Conditions Noted See ISI Report "NDE Results Summary".

12. Abstract of Corrective Measures Recommended and Taken See ISI Report "NDE Results Summary".

I i

We certify that the statements made in this rerort are correct and the ruminations and corrective mea-sures taken conform to the rules of the ASME Code, Sectic n XI.

Certificate of Authorization No. (if applicable)

Expiration Date N/A N/A N

)

19 SignedConsumer s Energy By Date

/

owner CERTIFICATE OF INS ERVICE INSPECTION 1, the undersigned, holding lid commission issued by tie N itional Board of Boder and Preksure Vessel inspectors Protect on Mut. Ing chlgan

,nd employed by and the State or Prounce of Norwood, MA have inspected the components described in this Owner's Report during the penod l

Y-U - 98 0"7"98

. and sta:e that t^ the best of my knowledge and belief, the Owner to has performed examinations and taken corrective measures descriced in this Owner's Report in accordance with the requirements of the ASME Code,Section XI, 1

By signing this certificate neither the Inspector nor tis employer makes any warranty, expressed or implied.

l 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 personalinjury or property damage or a loss of any kind arising from or con eted with this inspection.

Commissions t

Mutual Engineering Assoc Inspector's Signature National Board, State, Provmee, and Endorsements Date 7.80 19 [d M2/82) l

4 e

Palisades NDE RESULTS

SUMMARY

NIS 1 CATEGORY SYSTEM REFERENCE ID DISPOSITION EXAM COMMENTS Aug ESS ESS 24-SIS-SHi-207 Acceptable UT PT ESS-24 SIS-SH2 207 Acceptable UT t'T FWS FWS-18-FWL-ISI-241 Acceptable (IT PT FWS-18-FWL-ISI-242 Acceptable UT PT FWS-18-FWL 151-244 Acceptable UT PT FWS 18-FWL-2SI 244 Acceptable UT PT B-D SG2 2102-351 A Acceptable UT 2102 351 A IRS Acceptable UT 2-102-351B Acceptable UT I

2-102-351B-IRS Acceptable UT I

2-104-351 Acceptable UT 2-104 351 IRS Acceptable UT B-F CVC CVC-2-CHL-1 Al-17 Acceptable UT YT PCS PCS-12-SCS 2H1 1 Acceptable UT-A PCS-12-SCS 2H1-2 Acceptable UT-A PCS-12-SIS-1 Al l'.

Acceptable PT UT-A PCS-12-SIS-1 Al-12 Acceptable PT UT-A PCS-3-PSS-1B1-1 Acceptable UT PT l

Report: rptNDEResulteSummery Page 1 of 7 Sorted: Cet/ System / Reference 4D t____________..___.___

?

CATEGORY SYSTEM REFERENCE ID DISPOSITION EXAM COMMENTS PCS 3-PSS-2Al-1 Acceptable UT PT PCS-30-RCL-1 A ll/2 Acceptable PT PCS-30-RCL 1B 10/3 Acceptable PT PCS-30-RCL-2A ll/3 Acceptable PT PCS-30-RCL-2B 5/2 Acceptable PT PCS-4-PSS-lPI 20 Acceptable UT PT PCS-4-PSS-IPI-21 Acceptable UT PT B-G-2 ESS CK3101-BT Acceptable VT 1 CK3102-BT Acceptable VT-1 B-H SG2 2-110-351 Acceptable MT B-J CVC CVC-2-LDL 2B1-29 Acceptable PT CVC-2-LDL-2B1-30 Acceptable PT CVC-2-LDL-2B1-31 Acceptable PT ESS ESS-12-SIS 1 Al-10 Acceptable UT PT ESS 12-SIS-1 Al-9 Acceptable

.UT PT ESS-2 SIS-lB1-ll Acceptable PT ESS-2-SIS-181-12 Acceptable PT ESS-2-SIS-2BI-5 Acceptable PT PCS PCS-2 LDL-2B1-15 Acceptable PT PCS-2-LDL-2B1-17 Acceptable PT li PCS 2-PSS-IPl-54 Acceptable PT PCS-2-PSS-IPI-55 Acceptable UT PT PCS-3-PSS-2Al-13 Acceptable PT PCS-3-PSS-2 Al-14 Acceptable PT Report: rptNDEResulteSummary Page 2 of 7 Sorted: Cet/ System /ReferencelD

.______-_L__-________.

t

- CATEGORY SYSTEM REFERENCE ID DISPOSITION EXAM COMMENTS PCS-3-PSS-2Al-19 Acceptable PT PCS-3-PSS-2Al 20 Acceptable PT PCS 3 PSS 2Al-22 Acceptable UT PT PCS-4-PSS-IPl-1 Acceptable UT

)

PT PCS-4-PSS-lPI-17 Acceptable UT PT PCS-4-PSS-lPI-19 Acceptable UT PT PCS-42-RCL-lH 3/12 Acceptable UT PT B-N-1 RPV RPV-VESSEL INTERIOR Acceptable VT-3 C-B SCB E-60B-03 Acceptable UT PT E-60B Acceptable -

UT l'T SGI l 103 221 Acceptable UT PT l-103 221 IRS Acceptable UT C-C ESS ESS-12 SIS-2B1-9PLI Acceptable FT ESS 12-SIS-2BI-9PL2 Acceptable PT ESS-12-SIS-2B1-9PL3 Acceptable PT ESS-12 SIS-2BI 9PL4 Acceptable PT C-F-1 ESS ESS-10-SIS-LPB 220/3 Acceptable PT ESS-12-SIS-1 Al-8 Acceptable UT PT ESS-2-SIS HRA-208 Acceptable PT ESS-2 SIS HRA-208A -

Acceptable PT Report: rptNDEResultsaummary Page 3 of 7 Sorted: Cet/ System /ReferenceiO

t CATEGORY SYSTEM REFERENCE ID DISPOSITION EXAM COMMENTS ESS-2 SIS-HRA 208B Acceptable PT ESS-2 SIS-HRA 208C

- Acceptable PT ESS-2-SIS-HRA-208D Acceptable PT ESS-2 SIS-HRA-209 Acceptable PT ESS-3-SIS-3HP-203 Acceptable UT PT ESS 3 SIS-HPA-223 Acceptable UT PT ESS-3 SIS-HPA 224 Acceptable UT PT ESS-3-SIS-HPA 224A Acceptable UT PT ESS-3-SIS-HPA-224B Acceptable UT PT ESS-3-SIS-HPA-224C.

Acceptable UT ESS-3-SIS-HPA-230 Acceptable UT PT ESS-3-SIS HPA 233 Acceptable UT PT ESS-3-SIS-HPA-234 Acceptable UT PT ESS-3 SIS-HPA-239

. Acceptable UT PT ESS-6-LTC-1B-208 Acceptable UT PT ESS-6-LTC 1B 209 Acceptable UT PT ESS-6-LTC-1B 210 Acceptable UT PT ESS-6-LTC-1B-211 Acceptable UT PT ESS-6-LTC-1B-212 Acceptable UT PT ESS-6-SIS-lHP-209 Acceptable UT PT ESS-6-SIS-lHP 210 Acceptable UT PT

' Report: rptNDER ult. Summary Page 4 of 7 l-seriod: cet/ system / Refer nc.io 1

CATEGORY SYSTEM REFERENCE ID DISPOSITION EXAM COMMENTS ESS-6-SIS-lHP-216 Acceptable UT i

PT ESS-6-SIS lHP-217 Acceptable UT PT ESS-6-SIS-lHP-218 Acceptable UT PT j

l ESS-6-SIS-lHP-219 Acceptable UT PT ESS 4-SIS-lHP-220 Acceptable UT I

YT ESS-6-SIS-lHP-221 Acceptable UT l

PT ESS-6-SIS-lHP-224 Acceptable UT i

Irr l

1 ESS-6 SIS-lHP-225A Acceptable UT i

PT ESS-6-Sis-2HP-227 Acceptable UT PT ESS-6-SIS-2HP-228 Acceptable UT PT ESS4-SIS-2HP-232A Acceptable UT PT ESS-6-SIS-2HP-232B Acceptable UT Irr ESS-6-SIS-2HP-232C Acceptable UT PT ESS-6-SIS-2HP-232D Acceptable UT PT ESS-6-SIS-2HP 234B Acceptable UT PT ESS-6-SIS-2HP 235 Acceptable UT YT ESS-8-SIS-LPA-217/3 Acceptable Irr i

C-F-2 FWS FWS-18-FWL-2SI-245 Acceptable UT PT FWS-18-FWL-2SI-247/6 Acceptable PT l

Report: rptNDERestdteSummary Page 5 of 7 Sorted: Cet/ System / Reference 4D

i CATEGORY SYSTEM REFERENCE ID DISPOSITION EXAM COMMENTS FWS 18-FWL-2Sl-262 Acceptable UT MSS MSS-36-MSL-2SI-210/8A Acceptable MT MSS-36-MSL-2SI 210/8B Acceptable MT

)

D-B CCS j

CCS-18-RHC-lPI PR3 DB Acceptable VT-3 I

l CCS-20-CHX-RL.B PS Acceptable VT 3 l

SWS SWS-10-CRS-RL3-PS4 Acceptable VT-3 SWS-10-CRS-SL1 PS Acceptable VT-3 SWS-10-CRS-SL4-PR4-DB Acceptable VT-3 SWS-24-CCS-RLH-PRI-DB Acceptable VT-3 SWS-6-CRS-4R2-PSI Acceptable VT-3 SWS-6-CRS-4R2-PS2 Acceptable VT-3 SWS-6-EPS-SLA-PS Acceptable VT-3 F-A CCS l

CCS-18-RHC-lPI-PRI A Acceptable VT-3 CCS-18 RHC-IPI PR3 Acceptable VT-3 CCS-20-CHX-RLB-PSS Acceptable VT-3 CCS-20-CPU-IPA-PSS Acceptable VT-3 CCS-20-CPU-IPB-PSS Acceptable VT-3 CCS-20-CPU lPC-APR Acceptable VT-3 CCS-20-CPU-lPC-PR Acceptable VT3

)

CCS-24-CPU-IPA-PR Acceptable VT3 CCS-24-CPU-IPA-PRA Acceptable VT-3 CVC i

CVC-2-CHL-1 Al 13PR Acceptable VT-3 CVC-2-CHL-1 Al-3PRA Acceptable VT-3 CVC-2-CHL-2Al-15PR Acceptable VT-3 CVC-2-CHL-2Al-23PRC Acceptable VT-3 CVC-2-LDL-2B2-IIPR Acceptable VT-3 CVC-2-LDL-2B2-31PR Acceptable VT3 ESS ESS-12-SIS-ILP-233PR Acceptable VT-3 ESS-12-SIS-ILP-241PR Acceptable VT-3

{

Report: rptNDEResultsSummary Page 8 of 7 Sorted: Cet/ System /ReferenceID

CATEGORY SYSTEM REFERENCE ID DISPOSITION EXAM COMMENTS ESS-14 SDC-LPD-213PRA Acceptable VT-3 ESS-2-LTC-1B-20PR Acceptable VT-3 ESS-2-LTC-1B 24PS Acceptable VT-3 ESS-2-LTC-1B-26PR Acceptable VT-3 ESS-2 SIS-2Al 7 PSI Acceptable VT-3 ESS-2-SIS-HRA-213PRB Acceptable VT-3 ESS-2-SIS-HRB-209PR Acceptable VT-3 ESS-6-SIS-l Al SPR Acceptable VT-3 ESS-6-SIS-lB1 IPRI Acceptable VT-3 ESS-6-SIS-1Bl-IPSS Acceptable VT-3 ESS-6-SIS-1BI-7PR Acceptable VT-3 ESS-6-SIS-2Al 5PR Acceptable VT-3 ESS-6-SIS-2HP-232PR Acceptable VT-3 FWS FWS-18-FWL-ISI 248PR Acceptable VT-3 FWS 18-FWL-2SI-252PR Acceptable VT-3 PCS IB-SS Acceptable VT-3 PCS-2 DRL-1 Al 10PR Acceptable VT-3 PCS-2-LDL-2BI-14PRB Acceptable VT-3 PCS-3-PSS-1BI-14BPR Acceptable VT-3 PCS-3 PSS-1B1-14PRB Acceptable VT3 RGB E-56B S-01 Acceptable VT-3 SWS SWS-10-CRS-RL3-PSS4 Acceptable VT-3 SWS 10-CRS-SL1 PSS Acceptable VT-3 SWS-24-CCS-RLH PRI Acceptable VT-3 SWS-6-CRS-3RI-PR Acceptable VT-3

.N/A ESS HGR/BCB3 H730 Acceptable VT-3 HGR/BCB3-H731 Acceptabic VT-3 i

Report: rptNDEResulteSummary Page 7 of 7

-i Sorted: Cat / System /ReferencelD I

s

8 VERIFICATION OF SECTION XI COMPLIANCE AFTER THE COMPLETION OF l

OUTAGE 3 3 J

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Palicades Nuclear Power Plant Third Inservice Insnection Interval ASME Section XI Catenorv and Item Number Designation Legend 1..

An "R" after the Section XI item number for a particular examination category identifies that there is an associated Request for Relief.

2.

_ If exempt due to component thickness per Category C-F-1, Item No. C5.10 or Category C-F-2, Item No. C5.50 then; Examination Category is followed by an asterisk (*), (e.g., C-F-l*, C-F-2*). Also, the Code Item No. is identified as CFl*-N/A or CF2*-N/A as applicable.

3.

If excluded by Table IWC-2500-1 per note (2)(b) for Examination Category C-F-1 or C-F-2 pipe to pipe and associated longitudinal weld, the Examination Category is followed by a pound (#), (e.g., C-F-l#, C-F-2#). Also, the Code Item No. is identified as CFl#-N/A or CF2#-N/A as applicable.

4.

For pipe restraints on lines that are exempt per IWC-1220 in accordance with Code Case N-491, the Examination Category is the applicable Category (i.e., F-A). Also, the applicable Code item No. is used followed by an asterisk (*). (e.g., Fl.20A*).

5.

For Examination Category C-C, Integral Attachments where the line is exempt by Table IWC-2500-1 per notes (1)(c) and note (4) the Examination Category is followed by an asterisk (*) (e.g., C-C*). Also, the Code Item No. is identified as CC*-N/A.

For Examination Category C-C, Integral Attachments where the line is not exempt

. based on line thickness per note (4), but is exempt based on material design thickness per note (1)(c) then the Examination Category is followed by a pound (#) (e.g., C-C#). Also, the Code Item No. is identified as CC#-N/A.

6.

' Class 1,2, and 3 Component support letter designation after the Section XI Item No. as required by Code Case N-491.

"A" Designates one directional "B" Designates multi-directional "C" Designates thermal movement

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ASME S:ction XI R: pairs and R: placements The following is a list of repairs or replacements which have been performed through the end of the 1998 refueling outage for which NIS-2 Forms are attached:

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l l

Work Order Description of Work 1.

24002261 Replaced bolting on manual valve MV-SFP132.

2.

24510530 Replaced studs and nuts on manual valve MV-SFP131.

3.

24511866 Replaced manual valve MV-SW138 and associated piping.

4.

24611172 Replaced manual valve MV-MS152A.

l 5.

24611174 Replaced nuts on manual valve MV-MS153A.

6.

24611771 Replaced manual valve MV-SW256.

7.

24612911 Rebuilt Charging Pump, P-55A.

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8.

24613239 Replaced valve stem. 2 studs and 4 nuts on valve MV-ES3194.

9.

24613586 Replaced piping associated with relief valve RV-2234.

10. 24710052 Replaced fasteners on Containment Hatch, MZ-51.

11. 24710113 Replaced packing plug on control valve CV-0501.

12. 24710114 Replaced packing plug on control valve CV-0510.

13. 24710126 Rebuilt Servicewater Pump, P-7A.

14 24710562 Replaced stud on Steam Generator, E-50A primary manway.

15. 24711257 Replaced manual valve bonnet studs.

16. 24711347 Replaced studs, nuts and disc on control valve CV-0501.

17. 24711682 Replaced piping snubber SNB-80.

18. 24711684 Replaced piping snubber SNB-37.

19. 24711817 Modified piping support HGR/ hcl-H52.

20. 24712035 Rebuilt control rod drive seal housing CRD-45.

4

21. 24712952 Replaced studs on Component Cooling Water Heat Exchanger.

22. 24713048 Repaired leaks on room cooler VHX-278.

23. 24713150 Modified pipe support HGR/CC3-H1.20.

24. 24713283 Replaced flanges, studs and nuts on boric acid feed line.

25. 24714440 Replaced pipe plug on manual valve MV-MS152.

26. 24714835 Modified pipe support HGR/CC3-H1.18.

27. 24714836 Modified pipe support HGR/CC3-H1.19.

28. 24714838 Modified pipe support HGR/CC3-H1.22.

29. 24714839 Modified pipe support HGR/EC2-H1.3.

30. 24714848 Modified pipe support HGR-CC3-H1.10.

31. 24714849 Modified pipe support HGR/CC3-H1.7.

32. 24714854 Modified pipe support HGR/HC23-H8.

33. 24714856 Modified pipe support HGR/HC2-R168.2.

34. 24714879 Modified pipe support HGR/HC2-R165.1.

35, 24810272 Modified pipe support HGR/F"'-H1A.

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36. 24810275 Modified pipe support HGR/l.

H20.

37. 24810281 Added new pipe support HGR/HB30-H8.

38. 24810282 Added new pipe support HGR/HB30-H10.

39. 24811348 Replaced manual valve MV-CA122 and piping.

40. 24811350 Replaced manual valve MV-CA728 and piping.

41. 24811472 Repaired leaks on room cooler VHX-27A.

42, 24811475 Replaced studs and nuts on flow element FE-0882.

i

m, Work Order Description of Work

43. 24811478 Replaced handhole studs and nuts on Steam Generator. E-50A.

44. 24811479 Replaced handhole studs and nuts on Steam Generator. E-50B.

45. 24811702 Repaired leaks on room cooler VHX-278.

46. 24811757 Repaired leaks on room cooler VHX-27A.

All records of procedures, personnel certifications. equipment certifications, examination data and work order packages are on file at the Palisades Nuclear Plant.

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

1. Owner _ Co n s ume r s Enercy Company y /gg /g o.

~ ern.

27780 Blue Star Hwy. Covert, MI

snee, 1

I ot Address

2. Pfent Palisades Nuclear Plant

uni, 1

Name 27780 Blue Star Hwy. Covert, M1 W.O.

d'/ co ggg (

Address nopear Orsenization P.O. No., Joe No., e.g.

3. Work Performed by Consumers Ener0V Type Code symbo: stamp N/A Authoritetlon No.

N/A 27780 Blue Star Hwy. Covert, MI Empiretion oste N/A

4. Identification of System.,

d bi O

NM NM

5. (e) Applicable Construction Code 19

Edition, Addende.

code ce,e (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 6 9

' 6. Identification of Components Repaired or Replaced and Replacement Componente ASME Code National

Repaired, Stemped Nome of Name of Manufacturer Board Other Year

Replaced, (Yes Component Manufacturer Serial No.

No, identifiestion Built or Replacement or No) doi-f 5

$svA P6 **

f)

Alsa 87

('hchile ed /4 "

4/A G a si99 7 11 % AfP/ ace) MO ds!-tS

$cNI)

Nod A ;9 3 67 MAthsot 41A A f /9 6 & Wr % O 1997 (f.) Mo 7, Description of work AG G$~f!

9 ou A Uk M V ~ S / Oc) v

8. Tests Conducted: Hydroetetic 0 Paoumetie 0 Nominal Operating Proesure Othe O Pressure pel Test Temp.

'P l

l NOTE: Supplemental shoose in fann of flees, sketches, or drowings may be used, prodded (1) sies le 8% in. x 11 te., (2) Informe.

tion in items 1 throuWi e on thle report is included on each sheet, and (3) each sheet le numbered and the number of shoose le recorded et the top of this form.

(12/82) -

This Porm (E00030) may be obtained from the Order Dept., ASME,345 E. 47th St., New York, N.Y.10017 I

e L_______________.-_____.-._

{

FORM NIS 2 (Back)

9. Asmarks 04 Applicable Manufacturer's cots mooorts to be ettnehed CERTIFICATE OF COMPl. LANCE We certify that the statements made in the report are correct and this M W" conforms to the rules of the ASME Code,Section XI.'

Type Code Symbol Stamp N/A Certificate of Authorization No.

N/A N/A Expiration Date Signed Sen. Technical Analyst, M Date 19 Owner or owner's Desience. Title y

CERTIFICATE OF INSERVICE INSPECTION

' f, the undersigne,d gan hol ing a valid commission issued by the National Board of Boiler and Pressure Vessel inspectors and the State M

and erNployed by Protection Mutual or Province of og Norwood, MA have inspected the components described in this Owner's Report during the period 12/27/96 6/7/98 o

. and etete that to the best of my knowledge and belief, the Owner has performed examination 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 worrenty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector nor his employer theit be fiable in any menner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.

FACTORY MUTUAL ENGINEERING MI-762 NBI Commissions anseestire sienecure ustions sones, siete. Province, one snoor-ents Cate 19 (12/821

1 l

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

t. owner Con s u me r s Enercy Company eel 8 oete nome 27780 Blue Star Hwy. Covert, MI

$3,,,

1

[

Address

2. Plant Palisades Nuclear Plant

uni, 1

nome 27780 Blue Star Hwy. Covert, MI w.O. #

C2'/ 6 / 0 63C Adorese neoeir orsenseeuen p.o. No., seo me., etc.

3. Work Performed by consumers EneroV Type Code Symbol Stemp N/ A Authoriastion No.

N/A 27780 Blue Star Hwy. Covert, MI Empiration oste M/A

4. Identification of System 6 4~+'

5. (el Appilcable Construction Code b'

19

_ Edition, Addende-Code Case (b) Applicable Edition of Section XI Utilised for Repairs or Replacements 19 0,.3

' 6. Identification of Components Repaired or Replaced and Replacement Componente ASME Code National

Repelred, Stamped Name of Name of Manufacturer Board Other Year

Replaced, (Yes Component Manufacturer Serial No.

No.

Identification Built or Replacement or No) n n

8 - a u +5 yf ff A f 9 84 cD H CRAct \\fA(ut-MIT Mld G.c, J /3 7 11 %

O 9 - S-/t.r d S.

de>u A No d i

_1 A s93 B '1 mach rae N/A 9th G9499a5 s %~1 Aa6 N6 4' 5

ds

%4 kW M

AA3 B '7 mneh ras DIN

/alA GaSt994 1%8 F-tPkcN A]o WhCE1 0 **ES A

'fS M lW ~ OYb /A I

7. Oeecription of work

8. Tests Conducted: Hydrostatic 0 Pneumatic Nomines Operating Proesure Other Pressure poi Test Temp.

'F NOTE: Supplemental sheste in form of liste, sketches, or drowings may be used, prodded (1) eine le SM in. e 11 in., (2) Informe-tion in items 1 through 4 on this report le included on each sheet, and (3) seeh ehest is numbered and the number of sheete le recorded at the top of this form, t

(12/821'-

Thie Form (E00030) may be obtelned from the Order Dept., ASME,348 E.47th St., New York, N.Y.10017 e

o

rm FORM NIS 2 (Beck)

9. Romerns Aooticeole Manufacturers cate Reports to be etteched CERTIFICATE OF COMPl. LANCE 4

We certify that the statements made in the report are correct and this MMM conforms to the ruits of the ASME Code,Section XI.

receir or reciecomens Type Code Symbol Stamp N/A Certificate of Authorization No.

N/A N/A Expiration Oete Signed Sen. Technical Analyst,4 M d

~7h3

'If o,,,

owner or owner's Designee. Title j

CERTIFICATE OF INSERVICE INSPECTION 1, the undersigned holqing a valid commission issued by the National Board of Soiler and Pressure Vessel inspectors and the State or Province o, M i,ch i g a n

,,,,,,,oy eo ey Protection Mutual Norwood, MA heve inspected the components described in this Owner's Report during the period 12/27/96 6/7/98 and itete that j

to the best of my knowledge end belief, the Owner has performed exerninetions and taken corrective measures described in this Owner's Report in accordance w.cn the requirements of the ASME Code,Section XI.

By signing this certificate neither the inspector nor his employer maked any worrenty, expressed or implied, concerning the eneminations and corrective measures described in this Owner's Report. Furthermore, neither the Inspector not his employer shall be liable in any menner for any personal injury or property damage or a loss of any kind arising from or connected with this iaSection.

FACTORY MUTUAL ENGINEERING MI-762 NBI

_ Commissions sawesters sienwre sesions seere, stete. Provia... ene sneeroements Date

~d V S

19 (12/82) e 4

9 e

l I

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

1, owner _ Con sume rs Energy Company

'7 /dd hf Dete l

N.m.

l 27780 Blue Star Hwy. Covert, MI Sheet 1

/

of l

Aaareas

2. Plant Palisades Nuclear Plant yn;,

1 Nome 27780 Blue Star Hwy. Covert, MI w.o. #

c9'/ S/ / %(o Adorses Mooeir oreenine son P.o. No.. Joo No., etc.

3. Work Per*ormed by Consumers EnerQY Type Code symbos stamp N/A N'**

Authortastion No.

N/A 27780 Blue Star Hwy. Covert, MI Empiretion Dete M/A Adareas

4. Identification of System EM8 C AM

5. (a) Applicable Construction Code b 3 I*I Ib 19

Edition, MM Mb Addende.

_ Code case (b) AppliceOle Edition of Section XI Utilized for Repairs or Replacements 19 8 9

'6. Identification of Components Repaired or Replaced and Replacement Componente ASME Code National

Repaired, Stamped Name of Name of Manufacturer Board Other Year

Replaced, (Yes Component Manufacturer Serfel No.

No.

Identification Built or Replacement orNo) be.86 Alut btV6SCo MIS 4/A 6Vd8 /

l%T f/AcF) k rM9 se usu w

SA tolo AL la plA dlA G ooIID31 IMI lA66 NO v

i

7. Description of Work 8!4Cf I!A lVI~ d V

S uJ/3 8 A

/95Se CI4 #

h v'

8. Tests Conducted: Hydrostatic 0 Pneumatic Nominal Operating Pressure Other Pressure pel Test Temp.

'F NOTE: Supplemental eheste le form of lines, ekstehen, or drowings may be used, provided (1) else is 8% in. x 11 in., (2) Informe.

{

tion in items 1 through 8 on thle report is included on each shee;, sa4 (3) eesh ehest le numbered and the number of sheets le i

recorded et the top of this form.

(12/82f -

Thle Form (E00030) may be obtelned from the Order Dept., ASME,348 E. 47th St., New York, N.Y.10017 S

t FORM Nis 2 (Seck) bod

9. Remarks Appucente Manufacturers Deze Moorts to se ettsched t

CERTIFICATE OF COMPT. LANCE we certify that the statements made in the report are correct and this M* conforms to tne rufes of the ASME Code, Section Xl.

'***i'**'*****"'

Type Code Symbol Stamp N/A-Certificate of Authorization No.

N/A N/A Empiretion oote Signed Sen. Technical Analyst, 7h3 os,e owner or ownere Des.enee, Title y

/

CERTIFICATE OF INSERVICE INSPECTION f, the undersigned. holding a valid commission issued by the National Board of Soiler and Pressure Vessel insectors and the State Michigan

,,,d er#ptoyed by Protection Mutual or province of Norwood, MA-have inspected the components described in this Owner's Report during the period 12/27/96 6/7/98

. and state that to the best of my knowledge Spd belief, the Owner has performed eneminatione and taken corrective measures described in this Owner's Report in accordenes with the requirements of the ASME Code,Section XI, By signing this certificate neither the inspector nor his employer mekse any vuortenty, empressed or lenglied concerning the eneminatione and sorrectie measures described in this Owner's Report. Furthermore, neither the inspector nor his employer shall be liable in any menner for any pereenal injury or property damage or a lose of any kind arising from or connected with this ineeetion.

FACTORY MUTUAL ENGINEERING MI-762 NBI Commissions

nesstore sienmure -

Netiones soere, steio, prov% ene sneersement.

Dete'

'O is 98 (12/82) -

I l

I o.

FORM Nis 2 OWNER'S REPORT FOR REPAlRS OR REPt.ACEMENTS As Required by the Provisions of the ASME Code Section XI

1. Owner Consumers Energy Company 7bf 98 l

o,,,

Nome 27780 Blue Star Hwy. Covert, MI Sheet 1

I of Address i

2. Plant Palisades Nuclear Plant

uni, 1

[

Nome l

27780 Blue Star Hwy. Covert, MI W.O.

e> V(o /// 7cP Addre n= air oceans Mien P.O. No., Joe No., Me,

3. Work Performed by Consumers Eneray Type Code symbol Stamp N/A Authorization No.

N/A 27780 Blue Star Hwy. Covert, MI Empiretion oste N/A Addrese

~

4. Identification of System E

5. (a) Appilcable Construction Code 19 Edition.

Addende; Code Case (b) Applicable Edition of Section XI Utillaed for Receirs or Replacements 19 8 9

'6. Identification of Components Repelred or Replaced and Replacement Components ASME Code National

Repaired, Stamped Name of Name of Manufacturer Board Other Yeer

Replaced, (Yes Component Manufacturer Serial No.

No.

Identification Built or Replacement or No) t y

c.m

p h volve oWa+A 4 /4,.

ma c, nyse w

/s/ad l

i ReslAced menbAl yAlvt mV m5 \\SAA

{

7 Description of Wo,.

I

8. Tests Conducted: Hydrostatic 0 Pneumaine O Nominal Operating Pressure L

. Other O Pr*==ur.

-poi To t Teme.

NOTE: Supplemental sheets la form of lioso, sketches, or drawings may be used, provided (1) eine is 8% in. m 11 in., (2) Inferrre-tion in items 1 throws 6 on this report le included on each sheet, and (3) each ehest is numbered and the nurnber of sheets le recorded et the top of this form.

(12/82) -

This Form (E00030) may be obtained from the Order Dept., ASME,345 E. 47th St., New York, N.Y.10017 l

l l

_j

s l

l l

FORM N18 2 (Beck)

9. Romerks soon ai. u.novatur.~~4l.~~

~~(o of 19 4 - ad~~
~~Lhuskoa l A5 ) A" aIA G nom I*AS kPlAc&~~
O l
A!V6 M \\/ - M.S /S3 A
~~7. Descriptier:of Work 8 ff Y~~
'4 "f5 C4 S. Tests Conducted: Hydrostatic Pneumstic 0 Nominst Operating Proteure Other Pressure poi Test Temp.
'F NOTE: Supplemental sheets in form of liess, sketehen, or drowings may be used, provided (1) eine is SM in. u 11 in., (2) Informe.
tion in items 1 thr@ 4 on this report le included on each sheet, and (3) seeh sheet le numbered and the number of sheets la recorded et the top of this form.
(12/82) -
This Form (E00030) may be otteined from the Order Dept., ASME,345 E. 47th St., New York, N.Y.10017 l
9
~*9 L
sur FORM Nis 2 (Beck)
~~9. Romerks Acoliceole Manufacturer's cete mooorts to be atteened I~~
P CERTIFICATE OF COMPLIANCE We certify that the ststements made in the report are correct and this conforms to the rules of the ASME Code,Section XI.
Type Code Symbol Stamp N/A Certificeto of Authorization No.
N/A N/A Empiration oste Signed Sen. Technical Analyst, M M
igN o,,,
Owner or Owner's Des +enee, Title g7
/
CERTIFICATE OF INSERVICE INSPECTION f, the undersion, hol ing e valid commiwion issued by the National Board of Boiler and Pressure Vessel inspectors and the State or Province ofM d gan and ernpioved by Protection Mutual Norwood, MA have inspected the componente described in this Owner's Report during the period 12/27/96 6/7/98
. and etsee that to the best of my knowledge and belief, the Owner hee performed eneminatione end 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 worrenty, empressed or implied, concerning the eneminatione and corrective measures desoribed in this Owner's Report. Furthermore, neither the inspector not his employer shall be lieble in any menner for arvy personal injury or proper'ty damage or e loss of any kind erleing from or connected with this inspection.
FACTORY MUTUAL ENGINEERING MI-762 NBI A
comminione snesat.]]
(
~~8. Tests Conducted: _ Hydrostatic 0 Pneumette Nominal Operating Proesure h Other Proesure pel Test Temp.~~
'F NOTE: Supplemental sheste la form of lists, sketches, or drowings mey be used, provided (1) else le 84 in. x 11 in., (2) Informe.
tion in items 1 through S on this report is instuded on each sheet, and (3) eesh sheet is numbered and the number of sheets is recorded et the top of this form.
(12/82) -
This Form (E00030) may be obtained from the Order Dept., ASME,345 E. 47th St., New York, N.Y.10017 l
l j
w__-____-___-______--
FORM NIS 2 (Beck) 9, Remark:
OMb Applicable Manufacturer's Data Reports to be ettsched CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this D "' M conforms to the rules of the ASME Code,Section XI.
Type Code symbol Stamp N/A Certificate of Authorization No.
N/A O
Empiration oste S;gneo Sen. Technical A n a l y s t, --Q 7
M o,,,
ig Owner or Owner's Desiones, Title g
/
CERTIFICATE OF INSERVICE INSPECTION I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel inspectors and the State or Province ofMichigan and ernatoyed by Protection Mutual Norwood, MA hm inspected the components described 12/27/96 6/7/98 in this Owner's Roport during the period
. and stste 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 meine any wortanty, expressed or implied, concerning the examina!ione and corrective measures described in this Owner's Report. Furthermore, neither the inspector not 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 intpection.
FACTORY MUTUAL ENGINEERING MI-762 NBI commissions a neoester's slenature Nat6onal Boere, State, Province, one Encoreernents O
Date 19 (12/82) 4
y a
i I
FORM NIS 2 OWNER'S REPORT FOR REPAlRS OR REPLACEMENTS l
As Required by the Provisions of the ASME Code Section XI
~~1. Own.c Consumers Energy Company 7b@~~
o,,,
Name 27780 Blue Star Hwy. Covert, MI Sheet I
I of Address
~~2. Plant Palisades Nuclear Plant unit 1~~
Name 27780 Blue Star Hwy. Covert, MI W.O. # M lo? S //
Addreso nopear Oreenleetion P.0, No., Joo No., ste.
~~3. Work Performed by Consumers Eneray Type Code symbol stamp N/A Authorization No.~~
N/A 27780 Blue Star Hwy. Covert, MI Expirecion oe+:,_
M/A Address
4. Identification of System tMecA An Ofu,57E ok S. (e) Applicable Construction Code bM*l 1936. Edition, Ml4 Addende-A b Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 8 9___
~~'6. Identification of Components Repelred or Replaced and Replacement Components ASME Code National~~
~~Repaired, Stemped Name of Name of Manufacturer soord Other Year~~
~~Replaced, (Yes Component Manufacturer Serial No.~~
No.
Identification Sullt or Reptocement or No) kPlAtEb 0\\P UPPVR 0,ssk 6,,
D /A plA o 7 - De&R I?sto o
~
w o
CSL. Bloc.
Co s s.*m %
atA PlA 3l410 fi86 RP/A ct-a, ko I
l I
i
~~7. Description of Work M o*u e N~~
~~"6SA teu aa~~
~~8. Tests Conducted:, Hydrostotle O Pneumatic Nominal Operating Pressure h OtherO Pressure pai Test rema.~~
~~F NOTE: Supplemental sheets in form of lises, sketehen, or drawings may be used, provided (1) eine is 8% in. x 11 in., (2) Informs.~~
tion in items 1 through 4 on thle report le locluded on seeh sheet, and (3) eseh sheet is numbered and the number of sheets is recorded at the top of this form.
(12/82)' -
Thle Form (E00030) may be obtained from the Order Dept., ASME,348 E. 47th St., New York, N.Y.10017
(
i i
FORM NIS 2 (Back) -
bed
~~9. Remarks Apolkeblo Manufacturer's Date Reports to be ettsched 6~~
=
?
CERTIFICATE OF COMPLIANCE We certify that the statements inade in the report are correct and this A NMM conforms to the rules of the ASME Code,Section XI.
Type code Symbol Stamp N/A N/A N/A Expiration Dete Certificate of Authorization No.
Signed Sen. Technical Analyst,4#id d$
ggW o.,,
Owner or Owner's Desiones Title g
/
CERTIFICATE OF INSERVICE INSPECTION f, the undersigned holding a valid commission issued by the National Board of Boiler and Pressure Vessel inspectors and the State or Province o, Mi, chi g a n
-od erh' ployed by Protection Mutual Norwood, MA have inspected the components described in this Owner's Report during the period 12/27/96 6/7/98
. and state that to the best of my knowledge and belief, the Owner has performed examinations and taken correcttwo 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 worrenty, expressed or implied, conostning the examination and corrective measures described in this Owner's Report. Furthermore, neither the inspector not his employer shall be liable in any menner for any personal Injury or property damage or a loss of any kind arising from or connected with this
- inspection.
FACTORY MUTUAL ENGINEERING MI-762 NBI Commluions sneestere sieneture Netiones e ore, stete, Province, one snoor ments Y~EV 8
oste 1B (12/82) 8 9
e G
4
i
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FORM NIS 2 OWNER'S REPORT FOR REPAIRS OR REPt.ACEMENTS As Required by the Provisions of the ASME Code Section XI
~~1. Owner Consumers Enercy Company 7f3gh?~~
o,,,
Name 27780 Blue Stsr Hwy. Covert, MI Sheet 1
I of Ad dreae
~~2. Pient Palisades Nuclear Plant yn;,~~
1 Name 27780 Blue Star Hwy. Covert, M1 W.O.
o'?We 13 c? 39 Addreas nopear Creentration P.O. No., Joe No., etc.
~~3. Work Performed by Consumers Ener0y Type Code symbol stamp N/A Authorization No.~~
~~N/A 27780 Blue Star Hwy. Covert, MI Empiration oste N/A Address~~
~~4. Identification of System 9 fb 6EA.~~
A 69(A A A v
~
~~5. (e) Applicable Construction Code b 3I*$~~
19 5 5 soition, aI6 4aoeno,
4(d Code Case (b) Applicable Edition of Section x1 Utilized for Repairs or Reple;ements 19.3,9
' 6. Identification of Components Repaired or Replaced and Replacement Componente ASME Code National
~~Receired, Stemped Name of Name of Manufacturer Board Other Year~~
~~Replaced, (Yes Component Manufacturer Serlei No.~~
No.
Identification Built or Replacement or No) 3 *
~~doo 88 pe F a~~
VAlVt SM Auc$.AMAl<h M ld "
As //l G 13 7de I
/79 4 (Noc6)
Mo a swJs V
rNr*'
A 193 8 7 Aw: lea bAl
~~41A 4sA aces V39V lif fe P[4ce2 MO y a~e 194G H AaeleA2WLlelo A1IS ~~~
Ad a
4 16 deed-V39Y 11S(.o N//d(b2 MO V
~~1. Description of work SEPlAct YA $Vk S 4tm _ d 5%)$ Aub~~
~~'] k u *ts 0AIVt PlV=653194 oa~~
~~8. Tests Conducted:. Hydrostatic 0 Pneumatic Nominal Operating Pressure OtherO Pressure Poi Test Toma.~~
~~r NOTE: Supplemental sheets in form of lists, sketehen, or drewings may be used, provided (1) eine is SM in. x 11 in., (2) Informe.~~
tion in items 1 thnsup 6 on this report is ineluded on each sheet, e.'HI (3) eesh ehest is nuenbered and the number of sheets is recorded at the top of this form.
(12/821' -
This Form (E00030) may be obtained from the Order Dept., ASME,348 E.47th St., New York, N.Y.10017 a
c______________________
..,s i
1 l
- )I FORM NIS.2 (Beck) b MN
~~9. Romerks Apolicable Manufacturer's Oste mooorts to be attached i~~
e i
CERTIFICATE OF COMPLIANCE N### conforms to the rules of the We certify that the statements made in the report are correct and this ASME Code,Section XI.
Type Code Symbol Stemp N/A N/A Certificeto of Authorization No.
N/A Empiretion Oete 3
gg @
Signed Sen. Technical Analyst,
~~get, owner or owner's Devenee. Title f~~
CERTIFICATE OF INSERVICE INSPECTION f, the undersignest, holding a valid commission issued by the National Board of Boiler and Pressure Vessel inspectors and the State Michigan and erh' ployed by Proteetion Mutua1 or Province of Norwood, MA neve in,pec:ea gne component, oe,cribed 12/27/96 6/7/98
. and state thst in this Owner's Report during the period to the best of my knowledge end belief, the Owner hee 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 worrenty, expressed or implied, concorr.ing the examinations and corrective measures described in this Owner's Report. Furthermore, neither the inspector not his employer shall be liable in any rnenner for any personal injury or property damage or a loss of any kind erlsing from or connected with this inspection.
FACTORY MUTUAL ENGINEERING MI-762 NBI Commissions nopector e sieneture National Soord, State, Province, and Endorsements he2V 19 $
Oste (12/82) 9
~
FORM NIS 2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
~~1. Owner Consumers Enercy Company 7[oM b ?~~
o,,,
8.mo 27780 Blue Star Hwy. Covert, MI Sheet I
I of Address
~~2. Plant Palisades Nuclear Plant~~
~~uni, 1~~
Nome 27780 Blue Star Hwy. Covert, MI w O.
cQW, / 3 58G Ad dress neo ir orseniserion e.o. No., see ue., e,c.
~~3. Work Performedby Consumers EnerGV Type Code Symbol Stamp N/A Authorirstlon No.~~
N/A 27780 Blue Star Hwy. Covert, MI Empiration oete.
N/A Ad dress
~~4. Identification of Svstem _.~~
~~kGmcAk AuA o b m t-AOf O~~
~~5. (e) Applicable Construction Code b3I I 5 6_ eai, ion, 4IA 19~~
_Addende:
M!A Code Cese 1
(b) Applicable Edition of Section XI utilized for Repairs or Replacements 19 8 9
' 8. Identification of Components Repaired or Replaced and Replacement Components ASME Code National
~~Repaired, Stemped Name of Name of Manufacturer Board Other Yeer Roolaced.~~
(Yes Component Manufacturer Serial No.
No.
Identification Built or Replacement or No) c) " f*V* * **
7" Icy hfb M
s*
n r po 3o SeM,r 4 lo" dl4 G &cV50
/TS MA/,4ce J
^3e u
'V ef4 < b b D b, f
~~7. Description of Wort Af0t M Y -ddM 4 AS ScCI A Wi~~
~~8. Tests Conducted:,, "~~
Pneumatic 0 Nominal Operating PressureM Other Prosauro pel Test Temp.
'F
OTE

Supplemental shoose in form of lines, ekstehee, or drewings may be used,provided (Il else is 8% in. x 11 in (2) Informe.
tion in items 1 through 8 on thle report le included on each sheet, and (3) eseh sheet le numhered and the stumber of sheets is recorded et the top of thle form.
(12/82f -
This Form (E00030) may be obtained from the Order Dept., ASME,348 E. 47th St., Near York, N.Y.10017
FORM NIS 2 (Back)
W
~~9. Reenerks Acoliceele Manufacturer's Data mooorte se de etteemed i~~
CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this M
b conforms to the rules of the ASME Code,Section XI.
Type Code Symbol Stamp N/A Certificate of Authorization No.
N/A N/A Expiration Date Signed Sen. Technical Analyst, M M N3 T8 o,,,
gg Owner or Owner 6 Desiones, Title y
CERTIFICATE Of INSERVICE INSPECTION I, the undersigned, hol ng a valid commission issued by the Nata,esi Board of Boiler and Pressure Vesset inspectors and the State or Province of h gan and er6*pioved by Protischion Mutual Norwood, MA
__ have inspected the components described in this Owner's Report during the period 12/27/96 6/7/98
,,,,,,,,, in,,
to the best of my knowledge and belief, the Owner hee performed examinoilons 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 warrenty, empressed 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 menner for any personal injury or property damage or a loss of any kind arising from or connected with this inmeetion.
FACTORY MUTUAL ENGINEERING MI-762 NBI Commiseson.
sneestere sieneture NotWas Seere,8tmo, Province, one Endorsernente Date
'M tab 02/82)
G e
9 9
g o.
FORM N18 2 OWNER'S REPORT FOR REPAIRS OR REPt.ACEMENTS As Rgired by the Provisions of the ASME Code Section Xi 1.Ownw Consumers Enercy Company 7/df[T8 n,,
Nome 27780 Blue St r Hwy. Covert, MI Sheet I
l of.
Address
~~2. Plant Palisades Nuclear Plant uni, -~~
1 Nome 27780 Blue Star Hwy. Covert, M1 W.O.
@ 7/doSo?
Addrese neeeir oreensemien P.o. No., Jet No., ne.
~~3. Work Pwformed by Consumers Eneray Type Code symbol stem, N/A~~
~
Authorisetton No..
N/A
_27780 Blue Star Hwy. Covert, MI Empiration Dme M/A Ad
~~4. Identification of System est4t$1 mea SolA /as b~~
M
~~5. (a) Applicable Construction Code N I*!~~
19 5 S Edition, 4 IA Addende 41A Code een (b) Apolicable Edition of Section XI Utilised for Repairs or Replacements 19 8 9...
~ 8. Identification of Components Repaired or Replesed and Replacement Componente ASME Code National
~~Repaired, Stemped Name of Name of Manufacturer Board Other-Year~~
~~Replaced, (Yes Component Manufacturer Serial No.~~
No.
Identifiestion Sullt or Replesoment or No) ett-s t y
f)
Vassms 74ahc.
N (A "
+31A G asysa 1997 F#fAcsd No l-L l
kPlseth 1asuegs oa mf so %;omsfda.e(Cadh,hmstJAx],)
~~7. Deaription of work U~~
~~s. Tate conducted:, Hydroswde Pneummie Nomind Operming Preews O O*= O Pr*=-o~~
_ Pd Tat rema.
'P NOTE: Supplemental sheets in form of lises, skesehen, or d. swings eney to used, presided (1) eine is 84 in. x 11 in. (2) Informs.
tion in items 1 throuWe 8 on this report is included on oosh ehest, and (3) eesh sheet is numbered and the number of shesis is recorded et the top of this fenn.
a i
(12/82)' ~
This Form (E000308 may he eineined from the Order Dept., ASME lf 4 E. 47th St., New York, N.Y.10017 I
I l
J
FORM Nis 2 (Back)
~~9. Remarks k~~
Applicsele Manufacturer's Date Repotts to De attaches a
CERTIFICATE OF COMPLIANCE b4*
conforms to the rules of the We certify that the statements made in the report are correct and this
'***I'**'***"'
ASME Code,Section XI.
N/A Type Code Symbol Stamp N/A N/A En ration Date Certificate of Authorization No.
Signed Sen. Technical Analyst,M N 7
l ig Y Owner or Owner's Dessense. Title y
/
CERTIFICATE OF INSERVICE INSPECTION 1, the undersigned, holding a valid commission issued by the National Board o' Boiter and Pressure Vessel inspectors and the State Michigan and er# ployed by Protection Mutual or Province of Norwood, MA have inspected the components described 12/27/96 6/7/98
.no,,,,, in,,
in this Owner's Roport during the period to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in tnis 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 worrenty, expressed or implied, concerning the
- eneminations 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 erlsing from or connected with this insection.
FACTORY MUTUAL ENGINEERING MI-762 NBI
/
commioi.n,
.n.neirters sienature Nat6enes Seere State, Province, one Sneerewnents M to k8 cate ous2 e
4 4
e
~
~ ~ - ~ - - - - - - - - - - - - - - - - - -
i FORM NIS 2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
~~1. Owner EnURINFR 9 POLTFR CO*fPANY Date OI OS 7~~
Name Address
[
27780 Blue Star Mem. Hwy., Covert MI Sheet i
of t
l
~~2. Plant Dm14cadae Mnelant P1nnt Unit 1~~
l Name 277An n1no C e n t-Mam. Huv.
Cnvert. MT U_n_ # 07Y 7/ O//3 Ad dress Repair Organization P.O. No, Job No., etc.
j
~~3. Work Performed by r%nenmore Dnuar rnmnnny Type Code Symbol Stamp V A_~~
Authorization No.
NA
~~m... o n n1.meem mm r% rove, MT Expiration Date NA~~
~~4. Identification of System A/~~
~
A l
S. (a) Applicable Construction Code 19
~~Edition, Addenda, Code Case j~~
~~(b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 RQ l~~
~~6. Identification of Components Repaired or Replaced and Replacement Components l.~~
~~ASME Code National~~
~~Repaired, Stamped t~~
(
Name of Name of Manufacturer Board Other Year
~~Replaced, (Yes Component Manufacturer Serial No.~~
No.
Identification Built or Replacement or No)
I A
l
/[bCN f6 N bum, Sml AIA MA G aatTW 1%
EPl&N L'o i
Plu nu 9
9 ou Es
$7,tsl/e 8cfK ed A!tJ 6 C V-o Sc(
~~7. Description of Work 4C AC M c~~
V V
WV Q
l
~~8. Tests C snducted: Hydrostatic Pneumatic Nominal Operating Pressure h l~~
Other Pressure psi Test Temp.
'F L
NOTE: Supplemental sheets in form of lists, sketches, or drowings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion 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 reco ded et the top of this form.
l (12/82)
This Form (E00030) may be obtained f rom the Order Dept., ASME,345 E. 47th St., New York, N.Y.10017 l
t i
l
e-FORM NIS 2 (Back)
O
~~9.. Remarks Applicable Manufacturer's Data Aeports to be ettsched CERTIFICATE CF COMPLlANCE -~~
Nd conforms to the rules of the We certify that the statements made in the report are correct and this
' replacement ASME Code,Section XI.
Type Code Symbol Stamp NA Certificate of Authorization No, MA Expiration Dat, NA 5' 8
Ok"IC#
~
Date 19 Signed Owner or' Owner'posignee. T6t!e CERTIFICATE OF INSERVICE INSPECTION i, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel inspectors and the State or Province of MichiE2" and employed by Pmrueim Murum1 of hmnnA MA tuve inspected the components described
/*
/**N E and state that in this Owner's Report during the period to 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 makr any warranty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Repor.. 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.
FACTORY MUTUAL ENGINEERING ASSO.
2 Commissions Inspector's Signature National Board, State Province, and Endorsements
/ o2 7 39 9 Oste 0 2/82)
i FORM NIS 2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI l
1, Owner COM AINFR 9 ' DOtJFR COMPANY Date OI 3
7 Name 27780 Blue Star Mem. Hwy., Covert MI Sheet 1
of I'
I Addrene
~~2. Plant pn14andam Welonr P1nnt Unit 1_~~
Name m an nino mr nom. um_
cnvere. Mt un a c2^/7 /o //V Address '
Repair Organization P.O. No., Job No., etc.
~~3. Work Performed by-enn_ c uma r e pn;go r r'n mn n n u Type Code Symbot Stamp VA Authorization No.~~
~~[A 9 7 7..a n.~~
n i n a c e a,-
hr enuove. MT Expiration Data NA
~~4. Identification of System~~
~~/9/d NAM 1955 edition. MM~~
~~6. (s) Applicable Construction Code~~
~~Addenda, Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 R4~~
~~6. Identification of Components Repaired or Replaced and Replacement Components l~~
ASME
-Code National
~~Repaired, Stamped Name of Name of Mariufacturer Board Other Year~~
~~Replaced, (Yes Component Manufacturer Serial No.~~
No.
Identification Built or Replacement or No)
\\
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~~7. Description of Work A~~
la8 9 49 oAl l&SI b*d/ loc & on b6 CY*08/D V
V Wd
~~8. Tests Conducted: Hydrostatic Pneumatic 0 Nominal Operating Pressure Other] Pressure psi Test Temp.~~
'F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) Informa-tion in items 1 through 6 on this report is included on each sheet, and (3) er,ch sheet is numbered and the number of sheets is recorded at the top of this form.
f
(
(12/82)
This Form (E00030) may be obtained from the Order Dept., ASME,345 E. 47th St., New York, N.Y.10017 i
l
FORM NIS 2 (Back)
~~9. Remarks Applicable Manufacturer's Data Reports to be attached f~~
CERTIFICATE OF COMPLIANCE I NYA' conforms to the rules of the We certify that the statements made in the report are correct and this
~ '"A'*****"'
ASME Code, Section Xl.
Type Code Symbol Stamp NA Certificate of Authorization No.
MA Expiration Date NA 9MR C,hcM AM64g Date
~
19 Signe Owner rr 06fer's Designee. Title
/
CERTIFICATE OF INSERVICE INSPECTION 1, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vesset inspectors and the State
. or Province of ' M4 ch 4 gan and empicyed by Proenctinn Mutual
'of MneunnA MA have inspected the components described in this bwner's Report during the period
/*
'N
/~N'N and state that to 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 injury or property damage or a loss of any kind arising from or con.,ccted with this inspection.
FACTORY MUTUAL ENGINEERING ASSO.
Commissions M[*
Inspector's Signature
- National Board, State, Province, and E endorsements
/-d E hE 19 Date
- (12/82)
l
~
FORM NIS 2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI 1, Owner _. Co n s u me r s Energy Company N S/%
o,1, N on,.
27780 Blue Star Hwy. Covert, MI sn,
1 c9 Address
~~2. Ptent Palisades Nuclear Plant~~
~~uni, 1~~
~~Nome 27780 Blue Star Hwy. Covert, M1 W.O. # d47/o / Slo Adorses nopeir Creenitetton P.O. No., Job No., etc.~~
~~3. Work Performed by Consumers Energy Type Code symboi stemp N/A i~~
Authorization No.
N/A 27780 Blue Star Hwy. Covert, MI Empiration Dete N/A Address
~~4. Identification of System M Vf 6 4NA~~
~~5. (e) Applicabie Construction Code 19~~
~~Edition, Adende.~~
Code Case (b) Applicable Edition of Section XI Utilised for Repairs or Replacements 19 3 9
' 6. Identification of Components Repaired or Replaced and Replacement Componetits ASME Code Natione;
~~Repelred, Stemped Name of Name of Manufacturer Board Other~~
~~Yes, Repi m d, (Yes Component Manufacturer Serial No.~~
No.
Identification Built or Replacement or No)
OVA b#
S-tu h 5 Mach sa t AIA MtA 0013869
((flo Phrk No CAR.hikA {, f W
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No AoA Po d kpt' c U'tS Mach gu t Ald ylA G al3 SW l
A o
y MN FA u t/t AIA Glh S S=9150 1989 fflAr b
~~7. Description of Work Adr e- /4 6-ME rvt ) 8 '7 A dui S. Tests Conducted: Hydrostatic Pneumetle Nominal Operating Pressure Other Pressure pel Test Temp.~~
'F l
NOTE: Supplemental sheets in form of lists, sketches, or drewings troy be used, provided (1) else is 8% in. x 11 in., (2) Informe-tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and the number of sheets le recorded et the top of this form.
(12/82) ~
This Form (E00030) may be obtained from the Order Dept., ASME,346 E. 47th St., New York, N.Y.10017 I
l
,b i
O -
I 1
FORM N18 2 (Beck)
~~9. Remarks dM Aecilcease Manufacturer's Dets Mooorts to be stisched m..~~
tP/M/M/-A[s
' CERTIFICATE OF COMPLIANCE
. We certify that the statements made in the report are correct and this conforms to the rules of the ASME Code,Section XI,
~~dN'***'"*"'~~
Type Code Symbol Stamp N/A Certificate of Authorization No, N/A NA Empiration Dete Signed Sen. Technical Analyst,d 19 @
y Dete Owner er Owner's Dessense, Title
/
CERTIFICATE OF INSERVICE INSPECTION
.1, the undersigned, holding a valid sommission issued by the National Board of Seeler and Pressure Vessel inspectors and the State or Province o, Mi ch i g a n and employed by Protection Mutua1 Norwood, MA have inspected the componen's described in this Owner's Report during the period 12/27/96 6/7/98 to
. and state that to the heet of my knowiedyt and belief, the Owner hee performed eneminatione end taken corrective measures described in this
. Owner's Report in acct,relance with the requirements of the ASME Code,Section XI,
. By signing this certificate neither the inspector nor his employer makes any userrency, empressed or implied, concerning the eneminatione and corrective measures described in this Owner's Report. Furthermore, neither the inspessor nor his employer shall be flable in any menner for any pereenal injury or property damage or a loss of any kind arising from or connected with this insection.
FACTORY MUTUAL ENGINEERING MI-762 NBI Commineione
~~ne sor's m enenvee neuensi scene, stees, provinee, one snoorsemente Date N~~
d te i
U2/821 i
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9
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Asus Coos National
~~Capelred, Stamped Name of Name of Manufeower goerd OWW Year~~
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Identafloseten Sviig or RWasement or Not AlavA.
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- - - - - - - - - - - - ~ - - - - - - - - -
FORM NIS 2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisiorts of the ASME Code Section XI
~~1. Owner _ Co n s u m e r s Energy Company 7/3.3[gg o,,,~~
Nome 27780 Blue Star Hwy. Covert, MI Sn,,,_
1
/
Address 2, Plant Palisades Nuclear Plant Unit 1
Nem.
27780 Blue Star Hwy. Covert, MI W.O.
oF/7/OSbo7 Accreen Repelf Orsenisetlen P.O. No., Joe No., etc.
~~3. Work Performed by Consumers EnerQV Type code symbol stamp N/A Authorization No.-~~
~~N/A 27780 B1ue Star Hwy. Coyert, MI Enoiretion Date-N/A Ad 4rees~~
~~4. Identification of System WOI 00 v~~
~~5. (a) Applicable Construction Code 5dT'en 1 _19'77_ Edition. Noe Wf#~~
Addend,.
cooe C.,e (b) Apolicecle Edition of Section XI Utilized for Repairs or Roolecoments 19 8 9
'6. Identification of Components Repaired or Replaced and Replacement Componente I
l ASME -
Coce National
~~Repaired, Stemoed Name of Name of Manufacturer Board Other Y es, Roolaced.~~
(Yes Component Manufacturer Serial No.
No.
Identification Built or Replacement or No)
A00 foW S4MN dmAa$O km MIA MIA Gact.c6 31 l'l9L kN&
W
~~7. Description of Worte MSc S-fta c4~~
/- So A
<E44v M4mAq
)
~~8. Tests Conducted:~~
Hydrostatic 0 Paeu-stie O Nomiaal Operating Proesure[
Other Pressure pel Test Temp.
'F NOTE: Supplemental sheses la form of lises, ekstehen, oc drawings may be used, provided (1) else is SM in, a 11 in., (2) Informe-tion in items 1 through 4 on this report is included on esen sneet, and (3) each sheet is numbered and the number of sheets s recortled et the top of this form.
(12/821 '"
This Form (E00030) may be obtained from tne Order Dept., ASME,345 E.47th St., New York, N.Y.10017 l
l L__---------------
~
FORM NIS 2 (Back) g, Remarks ON
...s i..oi..._,. u,.... p.. n..o r,s,.e.
n ea CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this O!M W^8 conforms to the rules of the ASME Code,Section XI.
Type Code Symbol Stamp N/A Certificate of Authorization No.
N/A N/A Expiration Dete Signed Sen. Technical Analyst J d 7
~/
[l2 o,,,
own.r er owners o.en, ritie
/
CERTIFICATE OF INSE AVICE INSPECTION I, the undersigned or Province o, Mi holding a valid commission issued by the Nationel Board of Boiler end Pressure Vessel inspe chigan Protection Mutual and employed by Norwood, MA have inspected the components described in this Owner's Report during the period 12/27/96 6/7/98
,no,,,,,in,,
to the best of my knowledge end belief, the Owner has performed examinations and teken corroetive measures described in this Owner's Report in accordence with the requirements cf the ASME Code,Section XI.
By signing this certificate neither the Inspector nor his employer makes any worrenty, expressed or implied, concerning the examination and corrective " measures described in this Owner's Report. Furthermore, neither the inspector not 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 insection.
FACTORY MUTUAL ENGINEERING MI-762 NBI Commissioner no es.c.sien.sure ueti.ne see,e, steie, crowinee ena aneer men,s E86 se k8 care 02/82)
S 9
O.
o.
l FORM NIS 2 OWNER'S REPORT FOR REPAlRS 03 REPLACEMENTS As Required by the Provisions of the ASME Code Section XI l
t, Owner _ Co n s u m e r s Energy Company 7 /90 hp o,,,
Name 27780 Blue Star Hwy. Covert, MI sn,
1 f
Address
~~2. P:ent Palisades Nuclear Plant Unit 1~~
~~Name 27780 Blue Star Hwy. Covert, M1 W.O. # d'i7 //9 57 Ad dress neselr Creenleetion P.O. No., Joe No., etc,~~
~~3. Work Performed by Consumers EnerCV Type Code Symbol Stamp N/A Authortretion No.-~~
~~N/A 27780 Blue Star Hwy. Covert, MI Exoiration cate M/A Accrees~~
~~4. Identification of System~~
& /rf f A( A ad $
f oa M (*
ok r--
Ik Edition.
~~5. (a) Applicable Construction Code Addende:-~~
N Code Case (b) Appilcable Edition of Section XI Utilized for Repeirs or Replectmente 191
'6. Identification of Components Repeired or Replaced end Reple* ment Componente ASME Code National
~~Repelrod, Stamped Name of Name of Manufacturer Board Other Year~~
~~Replaced, (Yes Component Manufacturer Serial No.~~
No.
Identification Built or Replacement or No)
SRl*l3 8 7 CA Ad icA (,
ps (
p e
SNAs (A 12ush4 I ceA"
,c It9 5a9 7%a IMo AEB/4*)
Mo
~~1. Description of work Dl4ch A lus-S-h-, A 5~~
~~8. Tests Conductsd: Hydrostsele C Pneumatic 0 Nominst Operating Presouro~~
. OtherO Pre'eure poi Teit rema-
'r NOTE: Supplemental sheets in form of lists, ekstehee, or droswings may be used, provided (1) sies is 8% in. m 11 in., (2) Informa-tion in items 1 through e on thle report le included on each sheet, ent? (3) each ehest le numbered and the number of sheets le recorded et the top of thle form.
(12/82) -
Thle Form (E00C30) may be obtained from the Order Dept., ASME,346 E. 47th St., Neve York, N.Y.10017
FORM Nis.2 (Beck)
~~9. Remarks Applicable Manufacturer's cate Reports to be attacned CERTIFICATE OF COMPLIANCE O~~
We certify that the statements made in the report are correct and this conforms to the rules of the ASME Code,Section XI.
1 N/A Type Code Symbol Stamp N/A Certificate of Authorization No.
N/A Expiration Oete s;oned Sen. Technical Analyst, M 7
3 ggk o,,,
o.n.r e, o.n. e o.s,en rit,e f
CERTIFICATE OF INSERVICE int'.PECTION f, the undersigned holding a welid commission issued by the National Board of Boiler and Pressure Vessel inspectors and the State or Province o, Mi, chi g a n and erk'pioved by Protection Mutual Norwood, MA n,
in,pected the components described 12/27/96 6/7/98 in this Owner's Report during the period
. no,,,,,in,,
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 werfenty, expressed of irnplied, concerning the examinations and corrective measures described in thie Owner's Report. Furthermore, neither the inspector nor his employer shall be liable in any manner for any personal tr4ury or property damage or a lose of any kind arising from or connected with this insection.
FACTORY MUTUAL ENGINEERING MI-762 NBI Commissions inoestore sieneture untions soare, state, crowines, one snoorsements baW o V8 Oate t
02/B2) 9
- ~ ~ -
~
~
e.
e.
FORM NIS 2 OWNER'S REPORT FOR REPAlRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
~~1. Owner Consumers Enercy Company~~
~7[d@[9g o,g, nome 27780 Blue Star Hwy. Covert, MI sheet I
I of Addreas
~~2. Plant Palisades Nuclear Plant unit 1~~
~~nome 27780 Blue Star Hwy. Covert, MI w.O. # c9 A/7/ / 3 '/ '7 Ad areas nopear Orseniserion P.O. No., J00 No., etc.~~
~~3. work eerformed by Consumers Enercy Type Code Symbol Stemp_ N/ A Authorization No.~~
~~M/A 27780 Blue Star Hwr. Covert, MI Empiration cete N/A Address~~
~~4. Identification of System.~~
A/
AM
$5 &
~~5. (e) Applicable Construction Code b8I I 19M Edition, M lb~~
~~Addende, Mld Code Case (b) Applicable Edition of Section XI Utilized for Receirs or Replacements 19 8 9~~
'6. Identification of Components Repeired or Replaced and Replacement Componente A$ME Code National Repelred.
Stemped Name of Nome of Manufacturer Board Other Year
~~Replaced, (Yes Component Manufacturst Serial No.~~
No, identification Built or Replacement or No) hPd$436. f M
o
/G - Alu rs
'fduse.r4 A)/r4 "
4 //)
ScM '/937 I93 9 NP/4cd MO A#
A lo-S wds Accursch 4td a t4 G o00touS
/997 /GB/Med J/o c)-S d s Cathal l
A#
A LaswA Aln atA sera -4tSu
/99 ']
>@p/Ac&b do A kaah M
bisc kLs tess futMe RR. n ll MIA AIA G CaQY03 199 7 PlGcN hC I
~~7. Description of wort 4<~~
~~/ 07 Mut 3 5 % 25 Ass eerd tb 4[U t CV-C50l Alag s.ar-fh bes c tisswd(3~~
8. Tests Conducted:, Hydroetetle Pneumatic C Nomines Operating Pressure OtherO Pree ure pai T+'t rema-NOTE: Supplemental shoots in form of liens, sketehes, or dremngs may be used, p.ovided (1) else le SM in, a 11 in (2) Informe-tion In items 1 through 8 on thle report le ineluded og each sheet, and (3) eseh shoot is cuenbered and the number of sheets is recorded et the top of this form. -
112/821 -
This Form (E00030) may be obtained from the Order Dept., ASME,345 E. 47th St., New York, N.Y.10017
.o FORM NIS 2 (Back)
Y
~~9. Romerks Acoilceblo Manufacturer's Dets mecorts to be ettsched CERTIFICATE OF COMPLIANCE We certify that the statements mode in the report are correct and this U~~
conforms to the rules of the ASME Code, Section X1.
'*****'*****a' Type Code Symbol Stamp N/A Certificeto of Authorization No, N/A N/A Empiretion Oete Signed Sen. Technical Analyst, M 3
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Owner or Owner's cessense, Title y
/
CERTIFICATE OF INSERVICE INSPECTION
.1, the undersigne,d ganhol ing a valid commission issued by the National Board of Soiler and Pressure Vessel inspec M
and erKptoyed by Protection Mutual or Province of Norwood, MA have inspected the components described in this Owner's Report during the period 12/27/96 6/'7/98
, no,,,,, in,,
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 certificeto neither the Inspector nor his employer makes any worrenty, enspressed or irnplied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the inspector not his employer shall be liable in any menner for any personal Injury or property derr:ege of a foes of any kind arising from or connected with this insoection.
FACTORY MUTUAL ENGINEERING MI-762 NBI Commissions snesessere seneture metense s. ore, steis, provinee, ena sneer ements b Y o' fd Oete t
02/82) 4 0
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FORM NIS.2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
!~
~~1. Owner (n'MINFR 9 POIJFR CO3fP M W Date Name~~
_ ?l 23 0 Bhte Star Mem. Hwy., Covert MI Sheet i
of I
Address
~~2. Plant pn14cndne %cionr P 1 n n f-Unit t~~
Narne
~
277pn n1no 9enr M$m.
Huv._
Cnvert. MI (J. n _ #
W Address Repaar Organization P,0. No., Joo No., etc.
~~3. Work Performed by ennenmore pnuar Enmnnne Type Code Symbol Stamp vA Authorization No.~~
~~[A m..an. n 1,, m_ : *, r~~
~~tttn, emin r e MT Expiration Date NA~~
~~4. Identification of System NN 8E5S(/04 C7 Y 1AlRR.'LM bb'IlW6~~
~~5. (a) Applicable Construction Code /tMSI h>31, i 19 M Edition,~~
~~Addenda, Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 RQ~~
~~6. Identification of Components Repaired or Replaced and Replacement Components ASME Cooe National~~
~~Repaired, Stamped Name of Name of Manufacturer Board Other Year~~
~~Replaced, (Yes Cnmponent Manufacturer Serial No.~~
No.
Identification Built or Replacement or Nol 9vd8c4 pcip7c 95A -l y!b f0$Q26ll&S 1102-SNA-tblH-73(c SCICiCmfiC-2iH9 I' &M NO A
WMhrCA A+0 T%70) EXIWod SAUBSGl) AC AALGQ M9 NW.
~~7. Description ot work E~~
~~8. Tests Conducted: Hydrostatic 0 Pneumatic Nominal Operating Pressure Otherh Pressure psi Test Temp.~~
'F
$NU$.AC.1,64/C 7. gutt.1CV73 dA4 W5LM M NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 84 in. x 11 in., (2) informa.
tion 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.
(12/82)
This Form (E00030) may be obtained from the Order Dept., ASME,345 E. 47th St., New York, N.Y.10017
FORM NIS 2 (Back)
MM
~~9. S, marks Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this NbMM conforms to the rules of the~~
' ASME Code Section XI.
Type Code Symbol Stamp NA Certificate of Authorization No.
MA Expiration Date NA Nb b /' Yb 19 Signed Date Owner or Owner s Dessense. Title CERTIFICATE OF INSERVICE INSPECTION t, the undersigned, holding a valid commission issued by the National Board of Botter and Pressure Vessel inspectors and the State or Province of Mich4?An and omployed by Prnenerinn Mtt e tin 1 og W man A MA have inspected the components deseribed in this bwner's Report during the period to
. and state anat to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described an 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 i
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.
FACTORY MUTUAL ENGINEERING ASSO.
Commissions 048 - 7[# sI A/ b I inspector s Bieneture Nationee Board, State. Province, and Endorsements bN 19 Date 02/82) l l
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I FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI i
1, Owner ConstBfFR R PotJFR ConfPANY Date
$~
Nam.
27780 Blue Star Mem. Hwy., Covert MI Addreas
~
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~~2. Plant-Pa14cndaoJ ur1 mar P1nne Unit 5~~
Name 777Rn n1na gene M$m_ Huv.
Envert. MT tJ _ n _ #
~
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Address '
Repair Organisetton P.O. No., Job No., etc.
~~3. Work Performed by rw enmave pnuar f'nmn a n v Type Code Symbol Stamp MA Authorization No.~~
kik 9 7 7 0 ri n 1,, o c e e,-
TJtm r%ro e,. MT Expiretion Date NA
~~4. Identification of System OW DM bfLd D3U7MM~~
~~5. (a) Applicable Construction Code dGl O I 19 3 3 Edition,~~
~~Addendo, Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 RO j~~
~~6. Identification of t%onents Repaired or Reptoced and Replacement Components ASME Code National~~
~~Repaired, Stamped Name of Nome of Manufacturer Board Other Year~~
~~Replaced, (Yes Component Manufacturer Serial No.~~
No.
Identification Built or Replacement or No)
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SAIB-37 /5'wa t. t Coe'l Abel-ww 2Jtz b doEG2] dB Mcasw M
~~7. Description of Work~~
%#d A4 %57re LMnaid fwo%
CALAc-(# A//7s /t/cTo.
/
~~8. Tests Conducted: Hydrostatic Pneumatic Nominal Operating Pressure OtherM Prosauro psi Test Temp.~~
'F
%v88cf., &n71uvv% 9Lsf.S s4NA V1;3 CXAM NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 84 in. x 11 in., (2) Informe.
tion 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 et the top of this form.
(12/82)
This Form (E00030) may be obtained from the Order Dept., ASME,345 E. 47th St., New York, N.Y.10017
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Applicable Manufacturer's Data Reports to be attached 1 ;;2 b
' 'I
..w-CERTIFICATE OF COMPLIANCE We certify that the stetements made in the report are correct and this conforms to the rules of the ASME Code, Section Xl.
'4.
Type Code Symbol Stamp NA
,+.
Certificate of Authorization No, MA Empiretion Date h
s signed
/
h Date 19
" Owner or Owner e Dessense. Title
. CERTIFICATE OF INSERVICE INDECTION 1, the undersigned holding e valid sc M issued by the National Board of Soiler'and Pressure Vessel inspectors and the State
-2 or Province of M4 el'4 gan W employed by Prnt ar t 4 nn Mint nial og Mg mpmt MA howe'ingptted the componente deeCribed in this Owner's Report during the period OMM 5" 7"N to and state that to the bort of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in this Owner's Repart in accordance with the requirements of the ASME Code,Section XI, By signing this certificate neither the Inspector nor his employer rneke6 any warrenty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither *he inspeetor nor his employer ehall be liable in any menner for any personal Injury or property damage or a loss of any kind arleing from or connected with this tweetion.
i.. FACTORY MUTUAL ENGINEERING ASSO.
Comenissions M [.
E Mbf Inspectorfs E&gewture Nettonal Soard, State, Province, and Endorsement Date jg (12/8'4
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i FORM NIS 2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Ccde Section XI
~~1. Owner Consumers Energy comrany 7,~~
oate N.m.
27780 Blue Star Mem. Hwv.. covert. MT Sheet 1
of Address
~~2. Plant Palisades Nuclear Plant Unit 1~~
Name 27780 Blue Star Mem. Jyv. covert. MT W.O.
Nl l7 Ad dress Repair Organlaation P.O. NG, Job No., etc.
i Work Performed by NPS Energy Services Inc.
Type Code Symbol Stamp NA Authorization No.
NA Philadelphia, PA 19013-3672 Expiretion pote NA Ad dress
~~4. Identification of System~~
~~5. (a) Applicable Construction Code A b*!~~
~~O 19~~
~~Edition, Addenda _-~~
~~Cods Case (b) Applicable Edition of Section XI Utillred for Repairs or Replacements 19 09~~
~~6. Identification' of Components Repaired or Replaced and Replacement Components ASME Code National~~
~~Repaired, Stamped Name of Name of Manufacturer Board Other Year~~
~~Replaced, (Yes Component Manufacturer Serial No.~~
N o.
Identification Built or Replacement or No)
. bJ A N/A Nh hp0ct5 NC)
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~~7. Description of Wor I~~
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'OtherO Pressure -
psi Test Temp.
'F NOTE: Supplemental sheets in form of lists, sketches, or drewings may be used, provided (1) size is 8% in. x 11 in (2) Informe.
tion 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.
(12/82)
This Form (E00030) may be obtained from the Order Dept., ASME,345 E.47th St., New York, N.Y.10017 9
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FORM NIS 2 (Back) 9, Remarks _.
Appliceble Manufacturers Data Reports to be attached CERTIFICATE OF COMPLlANC nforms to the rules of the We certify that the statements made in the report are correct and this'***#'#*****"*
. ASME Code,Section XI.
b Type Code Symbol Stamp Expiration Date
~
, Certificate of Au' theorization No.
7 /(~
- N
..j Senior Technical Analyst,
o,,
' 39
/
~ Signed-Owner or owner's Desenes, Titte g
- 1 h
CERTIFICATE OF INSERVICE INSPECTION i
1, the undersigned, holding a valid commission issued by the National Board of Solfer and Pressure V Protection Mutual o,
Michigan and empiwed by or Province of have inspected the components described Norwood, MA 6/7/98
.ne,,,,,in.,
12/27/96 in this Owner's Report during the period i
to the best of my knowledge and belief, the Owner has performed examinativas and taken corrective measures
' Owner's Report !n accordance with the requirements of the ASME Code,Section XI,
, Sy signing this certificate neither the inspector nor his employer makes any worren examination end sorrective measures described in this Owner's Report, Furthermore, neither the inspector nor shall be liebte les any menner for any personal injury or property damage or a loss of any kind erlsing from or c Factory Mutual Engineering
" nspection; I i
a
~
MI-762 NBI ~
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Commissions National Beerd, State. Prmwines, and Endorsements
. Inspector's flSnesure
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FOR'M NIS 2 OWNER'S REPORT FOR REPAlRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
~~1. Owner Con s ume r s Energy Company 7[S7 b8 o,,,~~
Name 27780 Blue Star Hwy. Covert, MI sn,
1 l
Address
~~2. Plant Palisades Nuclear Plant~~
~~uni, 1~~
~~Name 27780 Blue Star Hwy. Covert, MI W.O. # cN7 /do35 Addreen nepair Orgendretton P.O. No., Job No., etc.~~
~~3. Work Performed by Consumers EneroV Type Code Symbol Stamp N/A Authoriastion No.-~~
N/A 27780 Blue Star Hwy. Covert, MI g,piration o.,,
N/A
~
Ad dress
~~4. identification of System e4 M V6~~
~~5. (e) Applicable Construction Code~~
~~O 19 Edition.~~
Addende:
Code Case (b) Applicablo Edition of Section XI Utilized for Repairs or Replacements 19 8 9
'6. Identification of Components Repaired or Replaced and Replacement Componente ASME Code National
~~Repaired, Stamped Name of Name of Manufacturer Board Other Year~~
~~Replaced, (Yes Compocent Manufseturer Serial No.~~
No, identification Built or Replacement or No)
N&yOf&
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~~7. Description of Work 8~~
%)
~~8. Tests conducted: Hydrostatic 0 Pneumatic Nominal Operating Pressurs OtherO Prosauro pel Test Temp.~~
'F NOTE: Supplert antel sheets in form of lists, sketches, or drowings eney be used, provided (1) ette le SM In. m 11 in., (2) Informe.
tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet le nurnbered and the number of sheets le recorded et the top of thle form.
(12/821'-
This Form (E00030) may be obtelned from the Order Dept., ASME,345 E. 47th St., New York, N.Y.10017
J
~
FORM NIS 2 (Seck) 9, Rernerks A
Aposicense Manufacturer's Data moports to me ettschee CERTIFICATE OF COMPLlANC M
We certify that the statements made in the report are correct and this onforms to the rules of the ASME Code,Section XI, repe'r or roolecoment Type Code Symbol Stamp N/A Certificate of Authorization No.
N/A N/A Empiretion Oete signed Sen. Technical' Analyst, M 9
~7 I
ig N Owner or owner's Desges, Title o,,e
/
CERTIFICATE OP INSERVICE INSPECTION 1, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vesset inspectors and the State or Province ofMichigan Protection Mutual
.,c ompi,yso ny e,
Norwood, MA he,e inspected the components describes in this owner's Msport during the period 12/27/ %
6/7/98
. and state th'er to the best of my knowledge and belief, the Owner has performed eneminatione 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 empioyer makes any werfenty, empressed or implied, conostning the eneminations and corrective measures described in this Owner's Report. Furthermore, neither the inspector nor his employer shall be liable in any manner for any poresnel injury or property damage or a less of any kind arising from or connected with this inspection.
FACTORY MUTUAL ENGINEERING
[I MI-762 NBI Commissions ineoessor's Signature National Seere, Stese, Prov6 nee, one Eneeroemente Date YO V a 8 1
(12/82) 4 4

~~w- _ _ _ _ - - -~~

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FORM Nis 2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI l
t, Owner Consumers Energy Company 7Mb o,,,
nem.
27780 Blue Star Hwy. Covert, MI sheet I
I of Adorses
~~2. Plant Palisades Nuclear Plant unit I~~
nome 27780 Blue Star Hwy. Covert, M1 W.O. # o)Y7/o77607 1
Adoreen Regeir Or$6nitetten P.O. No., Job No., etc.
~~3. Work Performedby Consumers Eneray Type Code symbol stamp N/A Authorization No.~~
~~N/A 27780 Blue Star Hwy. Covert, MI Empiretion oste N/A Addreas~~
~~4. Identification of System 6M hem f 9 N d.~~
~~5. (e) ApplicatAs Construction Code l'"~~
19
~~Edition, Addende; CodeCeee Ib) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 89~~
'6. Identification of Components Repaired of Replaced and Replacement Componente ASME Code l
Natione:
Repaired.
Stemped
)
Name of Name of Manufacturer Board Other Yeer
~~Replaced, (Yes Component Manufacturer Serial No.~~
N o.
Identification Sullt or Replacement or No)
Ou6 cst r'h il i
3%d 5 dA fi, A l 4/d M/f1 G ae 8He
/77L P/4Gd M6 i
~~7. Description of Work 08!4c S */t< 25 o4~~
[-Syd h,yf [ychg.e4 l
v
~~8. Tests Conducted: Hydrostatic 0 Paeumati O Nominal Operating Pressure OtherO Presser~~
~~asi To't Toma-~~
~~F I~~
NOTE: Sup%emental sheets in form of Ilmes, sketehes, or drowings may be used, provided (1) else is 8% in, a 11 in., (2) Informe-tion in items 1 throu$ 8 on this report is included on each sheet, and (3) eesh shoot is numbered and the teamber of sheets is f,
recorded et the top of thle form.
(12/82f "
This Form (E00030) may be obtelned from the Order Dept., ASME,346 E. 47th St., New York, N,Y.10017
FORM NIS 2 (Back)
~~9. Remarks Apolicable Manufacturer's Date Reports to be ettsched CERTIFICATE OF COMPLIANCE g~~
We certify that the statements made in the raport are correct and this conforms to the rules of the ASME Code,Section XI, Type Code Symbol Stamp N/A Certificate of Authorization No.
N/A N/A E piration Date Signed Sen. Technical Analyst, M b N
o,,,
39 Owner or Owner's Designee, Title
[/
d CERTIFICATE OF INSERVICE INSPECTION 1, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vesses inspectors and the State Michigan Protection Mut9al or Province of nd employed by Norwood, MA have insoseted the components described 12/27/96 6/7/98 in this Owner's Report during the period
. ne,,,,,in,,
to the best of my knowledge and belief, the Owner has performed exambetions and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code,Section XI.
By sQning tNs certificate neither the inspector nor his employer makes any worrenty, expressed or implied, concerning the examinations and corrective moseures described in this Owner's Report. Furthermore, neither the inspector nor his employer shall be lieble in any menner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
FACTORY MUTUAL ENGINEERING j
MI-762 NBI Commissions inesctore signetw.
National Board, state Province, and Indorsement Date 19_
(12/82) 9 e
---~_----------- - - - -- - -
--~
i FORM Nis 2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
=
~~1. Owner _ Con s u me r s Energy Company~~
~~7 /cPd /98 o,,,~~
Name 27780 Blue Star Hwy. Covert, MI sheet 1
I of Addreet
~~2. Plant Palisades Nuclear Plant Unit 1~~
Nome 27780 Blue Star Hwy. Covert, MI w.o. #
SV7/30 TE Adorses Rooser Organisetton P,0. No., Job No., etc.
~~3. Work Performed by Consumers Eneray Type code symbos stamp N/A Authorization No._~~
~~N/A 27780 Blue Star Hwy. Covert, MI Empiration oete N/A Addrese 4b8 Io.a s.Uq~~
~~4. Identification of Systerb N "f' 4~~
~~B 31 1 1955 4-V~~
~~5. (a) Applicable Construction Code O 31 k~~
~~19dEdmon, MIb Addende:~~
OIb Code Case (b) Applicable Edition of Section XI Utilized for Repelrs or Replacements 19 8 9
' 6. Identification of Components Repaired or Replaced and Replacement Componente ASME Code National
~~Repelred, Stemped Nome of Name of Manufacturer Board Other V ser Replaced.~~
(Yes Component Manufacturer Serial No, No.
Identification Sullt or Replacement or No) d'riCAic Ash VHV 9'78 A.a. M I4ee.
as" nlA alA 1%g M/hend Mo
~~7. Description of work fAl &~~
~~A M~~
)
~~8. Testa Conducted:. Hydrostatic 0 Pneumatic Nominal Operating Pressure Other O Pres==ro Pei Test remo.~~
NOTE: Supplemental sheets ln form of lines, sketches. or drowings may be used, provided (1) eine le SM in. x 11 in., (2) Infornw.
~
tion in items 1 through 8 on this report le included on each sheet, and (3) eseh ehest le numbered and the number of sheets le recorded et the top of this form.
(12/821 -
This Form (E00030) may be obtained from the Order Dept., ASME,348 E. 47th St.,New York, N.Y.10017 1
9 FORM NIS.2 (Back)
~~9. Remarks Odt Applicable Manufacturer's Date Reports te De Ottached n~~
/
CERTIFICATE OF COMPLlANCE We certify that the stetements made in the report are correct and this conforms to the rules of the ASME Code,Section XI.
Type Code Symbol Stamp --
N/A N/A NM Certificate of Awthoritetion No.
Empiration Dete s;gned Sen. Technical Analyst, M d e-IM 3, M o,,,
Owner or owner's Desience, Title
/
CERTIFICATE OF INSERVICE INSPECTION f, the undersigned holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province o, M i,ch i g a n and ern*piov ed by_ P r o t e c t i o n Mu t u a l Norwood, MA heve inspected the components described 12/27/96 6/7/98 in this Owner's Report during the period sp
. and stste that to the best of my knowledge and belief, the Owner has performed examinettons and taken corrective meneures 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 worrenty, expressed of irnplied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the inspector not his employer shall be liable In any menner for any personal injury or property damage of a loss of any kind erlsing from or connected with this inspection.
FACTORY MUTUAL ENGINEERING MI-762 NBI
_ Commissions
~~nepector's sieneture Nationes soare, state, r:Svince, one Endorsements N~~
b Date 19 (12/82) e G
mm FORM NIS.2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
'7!c)3.b[I
~~1. Owner Consu drs Enerry Cognmr oete Name 27780 Blue Star Mem. Hvv.. Covert. v7 Sheet 1~~
of I
Address
~~2. Plant Palisades Iluclear Plant Unit 1~~
Name 27780 Blue Star Mem. Hwv. Covert. M7 W.O.
c)47/3/SO Address Hepair Orgamretaon P.O. No-, Job No., etc.
~~3. Work Performed by IIPS Energy Services Inc.~~
Type Code Symbol Stamp
?IA Authorization No.
IIA Philadelphia, PA 19013-3072 E,pi,es;on oste IIA Addren
~~4. identification of System tMf A A~~
~~6 M6~~
~~5. (a) Applicable Construction Code Aa.s 5 b ). l cy e,dit,n.~~
gg
~~Addenda, f~~
~~ig Code Case (b) Applicable Edition of Section XI Utillied for Repairs or Replacements 19 09~~
~~6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National~~
~~Repaired, Stamped Name of Name of Manufacturer Board Other Year~~
~~Replaced, (Yes Component Manufacturer Serial No.~~
No.
Identification Built or Replacement or No) l t' D M
~~f* A'.~~
Gp a u r*tA$
t/GR/(c3 -#/.e?c dMy y 4M 4.0 A 4lA
/998' (Af44 C
~~7. Description of Work 8 V 1~~
~~f" 3Mh8cA + M6A bC~~
~~97 ~ O/ f yg~~
- s u -
r
~~8. Tests Conducted: Hydrostatic 0 eneumatic Nomiaai operatine roisure O e~~
Other O Pressure psi Test Temp.
'F NOTE: Supplemental sheets in form of lists, sketches, or drowings may be used, provided (1) size is 8% in. x 11 in., (2) Informa-tion 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.
(12/82)
This Form (E00030) may be obtained f rom the Order Dept., ASMS,345 E. 47th St., New York, N.Y.10017
_ - _ _ _ - - _ - - - -. - - _ - _ - _ _ - - - _ _ -_. _ - _ - - - -.. - - - - _ - _ _.. _ _ _ _ - - - _ - - _ _ _ - - - _ - - - = _ _,
l' l
FORM NIS 2 (Back)
OMb
~~9. Remarks Applicable Manufacturer s Data Reports to be attached~~
' CERTIFICATE OF COMPLIANCE We certify that the statements rnade in the report are correct and this Ubb nforms to the rulet c' the ASME Code,Section XI, Type Code Symbol Stamp Certificate of Authorization No.
Expiration Date Senior Technical Analyst M M
- 19 o.,g Signed owner or owner's Desiones. Title -
y
/
CERTIFICATE OF INSERVICE INSPECTION
. li the undersigned, ht,lding a valid commission issued by the National Board of Boiler and Pressure Vessel inspectors and the State or Province of Michigan Protection Mutual o,
and empioved by
'Norwood, MA have inspected the components described 12/27/96 6/7/98 in this Owner's Report during the period
.ne,,,,,in,,
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 injury or property damage or a loss of any kind arising from or connected with this
'"'d"-
Factory Mutual Engineering Comminions MI-762 NBI Inspeetor e sienetJre untion.i soero, state, province, ene s noorsements fd Date 3 19 H2/82)~
1 9
6
l
~
l FORM NIS-2 OWNER'S REPORT FOR REPAlRS OR REPLACEMENTS i
As Required by the Provisions of the ASME Code Section XI
~~1. owner Co n s u me r s Enercy Company~~
~l[S l[9 9 o,,,
~.m.
27780 Blue Star Hwy. Covert, MI sn,
1 J
Ad Jrees
~~2. Plant Palisades Nuclear Plant yn,,~~
1 Nome 27780 Blue Star Hwy. Covert, M1 w.O. # oP/ 7 / 343 Ac crees n ope #r organi,,ison p,o. No,, son u,,,,,,,
C
~~3. Work Performed by Consumers Eneray Type Code Symbos Stamp N/A Authorization No.~~
N/A 27780 Blue Star Hwy. Covert, MI Empiration Dete --
N/A Ad dress
~~4. Identification of System._ C kCAl A42 b LME 0 kJ~~
~
~~5. (e) Applicecle Construction Code 19~~
- Edition,
_ Addenda:
Code Case (b) Applicacio Edition of Section XI utilized for Repairs or Replacements 19 8 9
'6. Identification of Components Repelred or Replaced and Replacement Componente ASME Code National
~~Repelred, Stamped Name of Name of Manufacturer Board Other Year Replaced.~~
(Yes.
Component Manufacturer Serial No.
No.
Identifiestion Bullt or Replacement orNo) g s-tu J s Caadina i Po a sa si,4 - f. s o Lauswtd l 4 /eT N fA G it oa 79
/19y MP/Act)
Me lo H&K NvfL giovA hW Al44G8 MAChoufe Med MIA 6 eMa c? tt 1997 kPklcN k0
& //tg AufS ModA Pa &
f)
A 19 V G B Inachsar AIA DIA 6 939 8W 1997 RplA ct-No e
BL'2 F%G3%[
ifsews 1997 4/ud No gia ma
~~7. Description of Work fP/4c d e2 Un b~~
N, 8 SA25 4.,2
/d ^J u -f5 E
F)
?
Emrapcy Boare Acis feu ks.
~~8. Tests Conducted: Hydrostatic 0 Pneumatic Nommet Operating Preneuro OtherC Pressure poi Test Temp.~~
'F NOTE: Supplemental sheste la form of lists, ekstehen, or dromnge may be used, pewided (11 eine le 84 in. m 11 in., (2) Informe-tion in items 1 through 8 on thne report la included on each sheet. and (3) eseh sheet le numbered and the nummer of sheets le recorded et the top of thle form.
(12/82) ~
This Form (E00030) may be obtained f rom tee Order Dept., ASME,345 E. 47th St., Novv York, N.Y.10017 9
l
[
FORM NIS 2 (Beck) b C#t
~~9. Romerks Aooticense Manufacturer's Data mooorts to t>e ettecheo~~
\\
CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this W
conforms to the rules of the ASME Code,Section XI.
Type Code Symbol Stamp N/A N/A Certificate of Authorization No, N/A Empiration oete
$;gned Sen. Technical Analyst,75t N
N Date 19 Owner or Owner's Demones, Title V
CERTIFICATE OF INSERVICE INSPECTION 1, the undersignetil, holding a valid commission issued by the National Board of Soiler and Pressure Vessel inspectors and the State Michigan ond ernployed by Protection Mutual or Provmce of a,
Norwood, MA have inspected the components desvibed 12/27/96 6/7/98 in this Owner's Report during the period
. no,,,,, in,,
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 worrenty, exproceed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the inspector nor his employer shall be liabie in any menner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
FACTORY MUTUAL ENGINEERING MI-762 NBI Comminions ine entere sieneture Nationes soere, state, Province, one snoorsemems 7~a2 V b
19 Det.
0 2/82)
G g
4
FORM NIS 2 OWNER'S REPORT FOR REPAIR $ OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
~~1. Owner _ Con s ume r s Energy Company 7/63 hg Date Nome 27780 Blue Star Hwy. Covert, MI sheet 1~~
~~I of Ad dress~~
~~2. Plant Palisades Nuclear Plant yn;,~~
~~1 Nome 27780 Blue Star Hwy. Covert, MI W.O. # o)47/VWO Acoross neo or orsenizetton P.O. No., Joe No., etc.~~
3. Work Performed by Co n s time r s Ener0Y Type Code Symbos stamp __ N/A N"*
Authorization No.
N/A 27780 Blue Star Hwy. Covert, MI Empiration Dete M/A Ad oroes
~~4. Identification of System 41 1 N4 #1~~
~~5. (e) Applicable Construction Code 1~~
~~Edition, A~~
N/A Addende.
Code C (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19E
'6. Identification of Components Repaired or Replaced and Replacement Componente i
ASME Code l
National
~~Repelred, Stemped j~~
~~Nome of Name of Manufacturer Board Other Yeer~~
~~Replaced, (Yes Component Manufacturer Serlet No.~~
No, identification Built or Replacement or No) busae W
I Ah,3/v, cer wa I mg" a
cavsvv5 199, / r/w)
AJo
)
1 l
l l
i l
~~7. Description of Wort 6o/4 e4 d 9 ea A!VE /HV #75 / Sep a~~
~~8. Tests Conducted: Hydrostatic Pneumatic 0 Nominal Operating Pressure~~
, Other Pressure pel Test Temp.
'F i
NOTE: Suppiamental sheets la form of lisse, ekstehen, or drewinge may be used, prodded (1) sies le 8% in. x 11 in., (2) Informe.
tion in items 1 through 8 on this report le included on each sheet, and (3) eesh shoot le numbered and the number of sheste le recorded et the top of this form.
(12/82) ~
This Form (E00030) may be obtained from the Order Dept., ASME,345 E. 47th St., New York, N.Y.10017 4
C
FORM NIS 2 (Beck)
"t
9. Romerks AppliceDie Menuf acturer's Data Reports to be attacned CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct end this NO conforms to the rules of the ASME Code,Section XI.
N/A Type Code Symbol Stamp UA Certificate of Authorization No, N/A Expiration Oete s;gneo Sen. Technical Analyst, M O 3
ig N o,,,
/
owner or owner's Designee, Titie g
CERTIFICATE OF INSERVICE INSPECTION 1, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vesset inspectors and the State Michigan and em' ployed by Protection Mutual or Province of Norwood, MA hwe inspected the components described 12/27/96 6/7/98 in this Owner's Report during the period
. no,,,,, in,,
to the best of my knowledge end belief, the Owner has performed eneminatione and taken corrective measures described in this Owner's Report in accordance with the stoutrements of the ASME Code,Section XI.
By signing this certificate neither the inspector nor his employer makes any worrenty, espesesed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the inspector nor his employer shell be liable in any menner for any personal injury or property damage or a Mrs of any kind arising from or connected with this inspection.
FACTORY MUTUAL ENGINEERING MI-762 NBI Commissions s neseters sieneture Neuenas soare, siete, Provinee, one u ncereernents IN is 98 Oate 02/82) e 4
9 e
FORM NIS 2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI b
~~1. Owner Consume rs Energy dompany o te Name 27780 Blue Star Mem. Hvv.. Covert. MT Sheet 1~~
of.
Adoress 2, Plant Palisades Nuclear Plent unit 1
Nome 27780 Blue S_ tar Mem..Hwv. Covert. MT W.O.
)l Ad dress Roosir Organization P.O. No., Job No., etc.
~~3. Work "- tmed by NPS Energy Services Inc.~~
Type Code Symbol Stamp NA Authorization No.
NA Ph.1adelphia, PA 19013-3672 g,p;r, tion o,t, NA Address 4.16 notification of System 6
CA k
O
~~5. (a) Applicable Construction Code Aws M. I is90 edition, MM~~
~~Addenda, Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 09~~
~~6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National~~
~~Repaired, Stamped Name of Name of Manufacturer Board Other Year~~
~~Replaced, (Yes Component Ma.iufacturer Serial No.~~
No.
Identification Built or Replacement or No)
$$b.it MI W/A N/A N/A IHis Reeix42 No I
~~7. Description of Work y~~
s4 r
er Sc t-oM.
I 1\\
1
~~8. Tests Conducted: Hydrostatic Pneumatic 0 Nominal Operating Pressure O Other Pressure psi Test Temp.~~
'F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa, tion 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 recordet. at the top of this form.
(12/82)
This Form (E00030) may be obtained from the Order Dept., ASME,345 E,47th St., New York, N.Y.10017
I I
FORM NIS.2 (Back)
~~9. Remarks Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLI ANCE We certify that the statements made in the report are correct and this b conforms to the rules of the~~
P*d*'P'***'"*"'
ASME Code,Section XI.
Type Code Symbol Stamp Certificate of Authorization No.
Expiration Date Senior Technical Analysts M 6
o,te
,19 Signed Owner or Owner's Designee, Title y
CERTIFICATE OF INSERVICE INSPECTION 1, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel inspectors and the State
~
Protection Mutual or Province o, Michigan and employed by Norwood, MA have inspected the components described 12/27/96 6/7/98 to
.no,t,1,,n,t in this Owner's Report during the period 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 injury or property damage or a loss of any kind arising from or connected with this 3"5P**'i "-
Factory Mutual Engineering Commissions MI-762 NBI inspectoPr$ignature National Board, State, Province, and Endorsernents Date 19
. (12/82)
=
i FORM NIS 2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI j
~~1. Owner Consumers Enerray Connany i~~
Name
~
Date 27780 Blue Star Mem. Hvv.. Covert. MT sheet 1
of Address
~~2. Plant Palisades Nucienr Plant Unit 1~~
Name 27780 Blue Star Mem..Hwv. Covert. MT W.O. Ml!
b Address Repair Organization P.O. No., Job No., etc.
~~3. Work Performed by NPS Energy Services Inc.~~
Type Code Symbol Stamp NA Name Authorization No.
NA Philadelphia, PA 19013-3672 Expir tion Date NA Address
~~4. Identification of System b dbN~~
~~5. (a) Applicable Construction Code Atos b ( 1 189o Edition, NM Addenda.~~
~~A Codr Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 09 l~~
~~6. Identification of Components Repaired or Replaced and Replacement Components l~~
~~i ASME Code National~~
~~Repaired, Stamped Name of Name of Manufacturer Board Other Year~~
~~Replaced, (Yes Component Manufacturer Ser:st No.~~
No.
Identification Built or Replacement or No)
CC3
,19 O
I I
~~7. Description of Work M~~
b>[DC
$le WrT 4e r
$C 9 7-0 R.
l I
(
l j.
~~8. Tests Conducted: Hydrostatic 0 eneum. tic 0 Nominal Operating Pressure O Other O Pressure psi Test Temp.~~
'F l
NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) Informs-tion in items 1 through 6 on this rooort is included on each sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.
(12/82)
This Form (E00030) may be obtained from the Order Dept.. ASME,345 E. 47th St., New York, N.Y.10017 t
I i
o___________.__._____..____
FORM NIS 2 (Back).
~~9. Remarks O~~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are corrert and this W W
onforms to the rules of the
P * # * ' '* P ' ** *'"* "I ASME Code, Section Xt.
Type Code Symbol Stamp Certificate of Authorization No.
Expiration Date
$bd 98 Senior Technical Analysts M o,e 19 Signed
/
Owner or Owner's Designes, Title l
CERTIFICATE OF INSERVICE INSPECTION 1, the undersigned, holding a valid comrnission issued by the National Board of Boiler and Pressure Vessel inspectors and the State or Province of Michigan Proteetion Mutual og and employed by Norvood, MA have inspected the components described in this Owner's Report during' the period 12/2Y/9b b/7/9b to and state that to the best of my knowledge and belif f, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with the mouirements 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 descri,ed in this Owner's Report, Furthermore, neither the inspector nor his employer s5all be liable in any manner for any personal injury or property damage or a loss of any mind arising from or connected with this
'"'P'*'i "-
i Factory Mutual Engineering Commissions MI-762 NEI inspector's SynaVre National Board, State, Province, and Endorsements J
Date 19 L
(12/82)
L_-
FORM NIS-2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI h
~~1. Owner Consumers Enercy Company oate~~
~..
.27780 Blue Star Mem. Hw.. Covert - MT Sheet 1
of Address
~~2. Plant _ Palisades Nuclear Plent Unit 1~~
27780 Blue Star Mem. Hwv. Covert. MI W.O.
ll Address -
Repair Organization P.O. No,, Job No., etc.
~~3. Work Performed by NPS Energy Services Inc.~~
Type Code Symbol Stamp NA Name Authorization No.
NA Philadelphia, PA 19013-3672 Expiration oste NA Address
~~4. Identification of System CN C,~~
~~D WT~~
~~5. (a) Applicable Construction Code A d b~~
19
~~Edition, Addenda, Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 09~~
~~6. Identification of Components Repaired or Replaced and Replacement Components ASME~~
)
Code National
~~Repaired, Stamped Name of Name of Manufacturer Board Other Year~~
~~Replaced, (Yes Component Manufacture.~~
Serial No.
No.
Identification Built or Replacement or No)
I g cc - 121
.NM Nh N
@% Dfbd NO l
7, Description of Work M bh kJ b
~
\\l 8
j
~~8. Tests Conducted: Hydrostatic Pneumatic Nominal Operating Pressure l~~
Other Pressure psi Test Temp.
'F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) Informe.
j tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet !s numbered and the number of sheets is recorded at the top of this form.
(12/82)
This Farm (E00030) may be obtained from the Order Dept., ASME,345 E. 47th St., New York, N.Y.10017 4
r
~~8 FORM NIS 2 (Back)~~
~~9. Remarks Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and thisN M~~
conforms to the rules of the
"P'*****"'
ASME Code,Seetion Xl.
Type Code Symbol Stamp Certificate of Authorization No.'
Expiration Date Senior' Technical Analysts M b
Date 19 Signed owner or Owner's Designee, Title.
[/
~ CERTIFICATE OF INSERVICE INSPECTION 1, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel inspectors and the State Protection Mutual Michigan and empioved by or Province of Norvood, MA have ineected the components described
'12[2Y/9b
'b/I/9b and state that in this Owner's Report during the period to 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 personalinjury or property damage or a loss of any kind arising from or connected with this 3"S***3 "~
Factory Mutual Engineering MI-762 NBI
/
Commissions inspector's Signature National Board, State Province, and Endorsernents Date 19 (12/82) -
4 9
i II L.
a.
l-a l
FORM NIS 2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS l
As Required by the Provisions of the ASME Code Section XI l
f.
f
~~1. Owner. Consumers Enerry Comperv Date O/~~
'v u
Name l
27780 Blue Star Mem. Hw.. Covert. MT Sheet 1
of l
Address l
~~2. Plant Pali 3ades Nuclear Plant unit 1~~
27780 Blue Star Mem. Hw. Covert. MT LO.
b Ad dress Repair Organization P.O. No., Job No., etc.
- 3. Work Performed by NPS Energy Services Inc.
Type Code Symbol Stamp NA Authorization No.
NA Philadelphia, PA 19013-3672 E,piration oata NA Address
~~4. Identification of System Chm CA l 4 oh4 D~~
~~5. (a) Applicable Construction Code A 19~~
~~Edition, Addenda, Code Case (b) Applicable Edition of Section XI utilized for Repairs or Replacements 19 09~~
~~6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National~~
~~Repained, Starnped Name of Name of Manufacturer Board Other Year~~
~~Replaced, (Yes I~~
Component Manufacturer Serial No.
No.
Identification Built or Replacement or No) l
$/$Hg.3 Y$.
M/A N/A N/A
\\%f VQkb No a
l
~~7. Description of Work 54h0 he r~~
-ON -
\\1
~~8. Tests Conducted: Hydrostatic Pneumatic Nominal Operating Pressure i.~~
Other O Pressure psi Test Temp.
'F NOTE: Supplemental sheets in form of lists, sketches, or drewings may be used, provided (1) size is 8% in x 11 in., (2) Informa-tion 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.
(12/B2)
This Form (E00030) may be obtained from the Order Dept., ASME,3AS E. 47th St., New York, N.Y.10017 l
l-C___._____.___
o FORM NIS-2 (Back) b*
~~9.. Hemarks Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this N N~~
onforms to the rules of the
8*"P'*****"*
ASME Code,Section XI, Type Code Symbol Stamp Certificate of Authorization No.
Expiration Date Senior Technical Analyst 3M k
oate 19 Signed Owner or Owner's Designee, Title
(/
CERTIFICATE OF INSERVICE INSPECTION 1, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel inspectors and the State
~
Protection Mutual o,
or Province of Michigan
-and employed by Norwood, MA beve inspected the componehts described 12/27[9b b/I/90 and state that in this Owner's Report during the period
_to to the best of my knowled e and belief, the Owner has performed examinations and taken corrective measures described in this t
' 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 Ow'ner's Report. Furthermore, neither the inspector nor his employer shall be liable in any manner for any personal injury or property d6 mage or a loss of any kind arising from or connected with this.
'"'Pd Factory Mutual Engineering MI-7C2 NBI Commissions ins 5ector's signature National soord, state, Province, and Endorsements Date 19 02/82).
I 1L
l i
FORM NIS 2 OWNER'S REPORT FOR REPAli(S OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
~~1. Owner Consumers Enerry Company Date~~
.~ame l
27780 Blue Star Mem. Hw.. Covert. MI Sheet 1
of Address
~~2. Plant Palisades Nuclear Plant Unit 1~~
Name 27780 Blue Star Mem. Hw. Covert. MI W.O.
7 Address Repair Organization P.O. No., Job No., etc.
~~3. Work Performed by NPS Energy Services Inc.~~
Type Code Symbol Stamp NA Authorization No.
NA Philadelphia, PA 19013-3672 Expiration oate NA Address
~~4. Identification of System Na A A~~
0
~~5. (a) Applicable Construction Code Ab b~~
19
~~Edition, Addenda, Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 09~~
~~6. Identification of Components Repaired or Replaced and Replacement Components l~~
~~ASME Code National~~
~~Repaired, Stamped Name of Name of Manufacturer Board Other Year~~
~~Replaced, (Yes Component Manufacturer Serial No.~~
N o.
Identification Bullt or Replacement or No)
N A
0
/
j,jo g
t
[
I
~~7. Description of Work M~~
[
hk ho R A e.r 5C 97-o R.
\\i I
~~8. Tests Conducted: Hydrostatic 0 Pneumatic Nominal Operating Pressure Other O Pressure psi Test Temp.~~
'F.
NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size Is 8% in. x 11 in., (2) informa-tion 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.
(12/82)
This Form (E00030) may be obtained from the Order Dept., ASME,345 E. 47th St., New York, N.Y.10017 i
l.
FORM NIS 2 (Back) 9.' Remarks Applicable Manufacturer's Dets Reports to be attached CERTIFICATE OF COMPLlANCE We certify that the statemt'nts made lo the report are correct and this M UM onforms to the rules of the
P
d '"P'***'n en t ASME Code, Section Xl.
Type Code Symbol Stamp
' Certificate of Authorization No.
Expiration Date Senior Technical Analysts M d b,
cate 19 Signed Owner or Owner's Designe1, Title y
CERTIFICATE OF INSERVICE INSPECTION 1, the undersigned, holding a valid co nmission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State Protection Mutual Michigan
_and empioved by or Province of Norwood, MA have inspected the components described in this Owner's Report'during the g eriod 12/27/96 6/7/98 to and state that to the best of my knowledge end belief, the Owner has performed examinations and taken corrective measures described in this Owner's Report in accordance with ths requirements of the ASME Code,Section XI.
By signing this certificate neither he inspector nor his employer makes any warranty, expressed or implied, concerning the examinations and corrective measure. 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 erlsing from or connected with this
'"'P**'i "-
Factory Mutual Engineering Commissions MI-762 NBI inspec' tor's Signature Netional Board, State, Province, and Endorsements Date
~~/8 19 b (12/82) 4 T~~
l i
I FORM NIS 2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI 1, Owner ~ Consu[ners Energy b
Company oate N._.
27780 Blue Star Mem. Hyv.. Covert. MT Sheet 1
of Address 2, Plant Palisades Nuclear Plant Unit 1
Nome 27780 Blue Star Mem..Hvv. Covert. MT W.O. dhlN Address Repair Orgenleetion P.O. No., Job No., etc.
j
~~3. Work Performed by NPS Energy Services Inc.~~
Type Code Symbol Stamp NA Authorization No.
NA Philadelphia, PA 19013-3672 s,piration oate NA Address
~~4. Identification of System b%~~
~~Ob NM~~
~~5. (a) Applicable Construction Code AW5 bl.I 1990 edition,~~
~~Addenda, Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 09~~
~~6. Identification of Components Repaired or Replaced and Replacement Components I~~
l ASME l
Code National
~~Repaired, Stamped Name of Name of Manufacturer Board Other Year~~
~~Replaced, (Yes Component Manufacturer Serial No.~~
N o.
Identification Built or Replacement or No) y sqr i ss-s l
g w cc3-st.7 Emu bl/A N/A N/A 1%$ fQAad No i
'I j
l 7, Description of Work O
bkh I
b
~b
\\\\
8 Tests Conducted: Hydrostatic Pneumatic Nominal Operating Pressure Other O Pressure psi Test Temp.
'F NOT E: Supplemental sheets in form of lists, sketches, or drawings may' be used, provided (1) size is 8% in. x 11 in., (2) informa-tion 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 et the top of this form.
(12/82)
This Form (E00030) may be obtained from the Order oept., ASME,345 E. 47th St., New York, N.Y,10017 4
V U
N' FORM NIS 2 (Back)
~~9. Remarks Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF. COMPLIANCE We certify that the statements made in the report are correct and this conforms to the rules of the~~
*i'b***'"*"'
ASME Code,Section XI, Type Code Symbol Stamp
-NA NA-Certificate of Authorization No.
Expiration Date Senior Technical Analyst M b,lb i
_ pate 19 Signed
/
9 Owner or Owner's Designee Title
' CERTIFICATE OF INSERVICE INSPECTION
' I, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel inspectors and the State Protection Mutual Michigan and empioved by or Province of Norwood, MA have inspected the components described 12/27/96 6/7/98
, and state that in this Owner's Report during the period to the best t,f 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 injury or property damage or a loss of any kind arising from or connected with this
'3"'A'**' "-
Factory Mutual Engineering MI-762 NBI Commissions i'nspectorTSienature National Soerd, State, Province, and Endo cernents Y I 19 Date
~~g 0 2/82)~~
L
[.
9
l l
l l
i
+.
l l
l l
i FORM NIS 2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS l
As Required by the Provisions of the ASME Code Section XI
~~1. Owner Consumers Enerrr Connany~~
~..
Date r
27780 Blue Star Mem. Hvv.. Covert. MI Sheet 1
of Address
~~2. Plant Palisades Nuclear Plant Unit 1~~
Name Shhb 27780 Blue Star Mem..Hvv. Covert. MI W.O.
Ad dress Repair Organization P.O. No., Job No., etc.
~~3. Work Performed by NPS Energy Services Inc.~~
Type Code Symbot Stamp NA Authorization No.
NA Philadelphia, PA 19013-3672
. e,piration Date NA Address
~~4. Identification of System M~~
Ob b
M
'N
~~5. (a) Applicable Construction Code~~
'9
~~Edition, Addenda, Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 09~~
~~6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National~~
~~Repaired, Stamped Name of Name of Manufacturer Board Other Year~~
~~Replaced, (Yes Component Manufacturer Serial No.~~
No.
Identification Built or Replacement or No) f6fk
@ Tk W I Nar/Wot-HR Ewrw N/A F/A N/A hplece) h)O v,
~~7. Description of Work M~~
1b D8I
\\
l
~~8. Tests Conducted: Hydrostatic Pneumatic Nominal Operating Pressure Other Pressure psi Test Temp.~~
'F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion 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.
(12/82)
This Form (E00030) may be obtained from the Order Dept., ASME,345 E. 47th St., New York, N.Y,10017
,_v.
I-I.
l t
FORM NIS 2 (Back)
9. Remarks Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANC We certify that the statements made in the report are correct and this nforms to too rules of the ASME Code, Section'XI, Type Code Symbol Stamp Certificate of Authorization No.
Expiration Date Senior Technical Analyst - M b[I o,te
,39 Signed Owner or Owner's Desiones Title
(/
CERTIFICATE OF INSERVICE INSPECTION holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State 1, the undersigned, Michigan Protection Mutual a,
or Province of and employed by Norwood, MA have inspected the components described 12/27/9b b/I/9b to and state that in this Owner's Report during the period 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 personalinjury or property damage or a loss of any kind arising from or connected with this
' 3"'P'C'i "-
Factory Mutual Engineering MI-762 NBI commissions in w rs sien.ture National Board, State, Province, and Endorsements Date 19 (12/82) 4
FORM NIS.2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI E3 bT
~~1. Owner Cons r ers Energy Company cate N.m.~~
27780 Blue Star Meq. Hw.. Covert. MT Sheet 1
of
/
Address
~~2. Plant Palisades Nuclear Plant Unit 1~~
Nome 27780 Blue Star Mem. Hw. Covert. MT W.O.
c2 47 /'/ F%
Ad dress Repair Organization P.O. No., Job No., etc.
~~3. Work Performed by NPS Energy Services Inc.~~
Type Code Symbol Stamp NA N"'
Authorization No.
NA Philadelphia, PA 19013-3672 Expiration oste NA Address
~~4. Identification of System d~~
b
~~5. (a) Appilcable Construction Code AWS b I is90 Edition, M Id~~
~~Addenda, dfA Code Case (t-) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 09~~
~~6. Identification cf Components Repaired or Replaced and Replacement Components ASME Code National~~
~~Repaired, Stamped Name of Name of Manufacturer Board Other Year~~
~~Replaced, (Yes Component Manufacturer Serial No.~~
No.
Identification Built or Replacement or No)
% ll rit'E tlA" y 4
% surf +As NGRlHC a-A mt.a b sa9 u, Al1A A31 A lJ/A 1998 pl4 chb o
l l
l l
~~7. Description of Work NoE e fr-SvDod + [Ved 8C-S7-O/O r~~
U!
' i aI i
~~8. Tests Conducted: Hydrostatic 0 Pneumatic Nominal Operating Pressure~~
)
I Other Pressure psi Test Temp.
'F j
NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) informa-tion 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 et the top of this form.
(12/82)
This Form (E00020) may be obtained from the Order Dept., ASME,345 E. 47th St., New York, N.Y.10017 l
9
FORM NIS 2 (Back)
OMb
~~9. Remarks Applicable Manuf ai:turer's Date Reports to be attached CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this MM nforms to the rules c' the~~
*''*C#'"*"*
ASME Code, Section X1, Type Code Symbol Stamp Certificate of Authorization No.
Expiration Date Senior Technical Analyst J N M
39 N -
o,te Signed owner or owner's Desiones. Title
/
CERTIFICATE OF INSERVICE INSPECTION i, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vesset inspectors and the State Michigan Protection Mutual a,
or Province of and employed by Norwood, MA have inspected the components described 12/27/96 6/7/98 to
.no,,,,, in,
in this Owner's Report during the period 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, t
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 frorn or connected with this
'"'d"'
Factory Mutual Engineering MI-762 NBI Commissions inspector's Si{noture National goerd, State. Province, and Endorsements Date 19 (12/82)
l 1
i FORM NIS 2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI ConsubersEnerry
,M
~~1. Owner Compan-r o 1,~~
~._e 27780 Blue Star Mem. Hwv.. CovertI MT Sheet 1
of Address
~~2. Plant Pali.Sades Nuclear P1 ant Unit 1~~
~~Name 27780 Blue Star Mem..Hvv. Covert. Mr W.O. Sh Address Repelr Organization P.O. No., Job No., etc.~~
~~3. Work Performed by NPS Energy Servicc3 Inc.~~
Type Code Symbol Stamp NA Authorization No.
NA Philadelphia, PA 19013-3672 expiration oate NA Address
~~4. Identification of System 4Ah 6~~
~~5. (a) Applicable Construction Code blAlb 19~~
~~Edition, b~~
~~Addenda, A~~
~~Code Case (b) Applicable Edition of Section XI Utillred for Repairs or Replacements 19 09~~
~~6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National itspaired.~~
~~Stamped Name of Name of Manufacturer Board Other veer~~
~~Replaced, (Yes Component Manufacturer Serial No.~~
No.
Identification Built or Replacement or No)
W Y
&& w.L f*$
MC,t/HQ-tllS.\\ Mr au N
b N
lk We fl4CtYNd I
~~7. Description'of Work Mo la ww SuA M T ker SC O-M.~~
l
\\\\
f l
~~8. Tests Conducted: Hydrostatic~~
' Pneumatic 0 Nominal Operating Pressure Other O Pre==ure pii Test Tema.
'F I
NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in.x 11 in., (2) Informa-tion 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 I
recorded et the top of this form.
1 (12/82)
This Form (E00030) may be obtained from the Order Dept., ASME,345 E. 47th St., New York, N.Y.10017 I
l
FORM NIS 2 (Back) 9,' Remads 0%-
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE
- We certify that the statements made in the report are correct and thish UM onforms to the rules of the
S'*P'*****"'
ASME Code,Section XI.
Type Code Symbol Stamp Certificate of Authorization No.
Expiration Date Senior Technical Analyst Q d 3 M'
pase 19 Signed l
Owner or Owner's Designes, Title
[
CERTIFICATE OF INSERVICE INSPECTION 1, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State Protection Mutual og or Province of Michigan and employed by Norwood, MA have inspected the components described 12/27/9b 1 /7/90 to and state that in this Owner's Report during the period to the best of my knowledge and belief, the Owner has performed examinations and taken corrective rr,easures 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 injury or property damage or a loss of any kind arising f rom or connected with this 3"S'**i "-
Factory Mutual Engineering Commissions MI-762 NBI insiiifKor's Signature National Board, State, Province, and Endorsernents NY 19 Date (12/82) a
.o FORM NIS 2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI b
fb
~~1. Owner Consumers Enerry Company o i.~~
Name 27780 Blue Star Mem. Hw.. Covert. MT Sheet --
1 of Address
~~2. Plant Palisades Nuclear Plant Unit 1~~
~~Name W.O. E l OSM 27780 Blue Star Mem..Hw. Covert. MT Address Repalt Organization P.O. No., Job No., etc.~~
~~3. Work Performed by NPS Energy Services Inc.~~
Type code Symbol Stamp NA Name-Authorization No.
NA Philadelphia, PA 19013-3672 E,piration o,1, NA Address
~~4. Identification of System C O $O LJA5Tb~~
~~5. (a) Applicable Construction Code Aw5 M. I 19@ Edition, Nh~~
~~Addenda, Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 09~~
~~6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National~~
~~Repaired, Stamped Name of Name of Manufacturer Board Other Year~~
~~Replaced, (Yes Component.~~
Manufacturer Serial No.
No.
Identification Built or Replacement or No) lb f b
k O
l Hf / C
=
u i
I
~~7. Description of Work M~~
~~f G NC~~
'se I E
~Ob.
\\
n
~~8. Tests Conducted: Hydrostatic Pneumatic Nominal Operating Pressure Other O Pressure p:1 Test Temp.~~
'F i
NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 84 in. x 11 in., (2) Informa.
tion in items 1 through 6 on this report is included on sech sheet, and (3) each sheet is numbered and the number of sheets is recorded at the top of this form.
(12/82)
This Form (E00030) may be obtained from the Order Dept., ASME,345 E. 47th St., New York, N.Y.10017
I a
FORM NIS 2 (Back)
~~9. Remarki~~
~
Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLlANCE '
We certify that the statements made in the report are correct and this DWU conforms to the rules of the
'N *I' *' '*D' *C'"' * "*
- ASME Code,Section XI.
Type Code Symbol Stamp Certificate of Authorization No.
Expiration Date k
N Senior Technical' Analyst-73W o,,,___
,39
- Signed Owner or Owners Designee, Title V
CERTIFICATE OF INSERVICE INSPECTION 1, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel inspectors and the State Protection Mutual o,
Michigan and employed by i
or Province of Norwood, MA-have inspected the components described 12/27/96 6/7/98 and state that in this Owner's Report during the period to to the best of my knowledge and belief,- the Owner hts 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 injury or property damage or a loss of any kind arising from or connected with this 3"***i "-
Factory Mutual Engineering MI-762 NBI Commissions inspectoriSienature National Board, State, Province, and Endorsements
&/W,, 98 Os,e (12/82) l.
1 1
^
i i
FORM NIS 2 OWNER'S REPORT FOP. REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
~~1. Owner' Consumers Enerrnr Connany b~~
~em.
Date 27780 Blue Star Mem. Hvv.. Covert. Mr Sheet 1
of Address
~~2. Plant Palisades Nuclear Plant Unit 1~~
Name 27780 Blue Star Mem..Hwv. Covert. MI W.O. )
b Address Roomir Organization P.O. No., Job No., etc.
~~3. Work Performed by NPS Energy Services Inc.~~
Type Code Symbol Stamp NA Name Authorization No.
NA Philadelphia, PA 19013-3672 c,piration oate NA Address
~~4. Identification of System d~~
~~O IA)~~
~~6. (a) Applicable Construction Code 8 19 0 Edition, b~~
~~Addenda, Code Case '~~
~~(b) Applicable Edition of Section XI Utillied for Repairs or Replacements 19 09~~
~~6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National~~
~~Repaired, Stamped Name of Name of Manufacturer Board Other Year~~
~~Replaced, (Yes Component Manufacturer Serial No.~~
No.
Identification Built or Replacement or No)
Pip SpT ggs H t;,t/H51 - H30 Ewem MA 6%
bpuce)
<l l
l
~~7. Description of Work M e kith S(MI h>f F bb "O b.~~
~~s. i i~~
~~8. Tests Conducted: Hydrostatic Pneumatic Nominal Operating Pressure C Other Pressure psi Test Temp.~~
'F NOTE: Supplemental sheets in form of lists, sketches, or drawings may' be used, provided (1) size is 8% in. x 11 in., (2) Infortna-tion in items 1 through 8 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.
(12/82)
This Form (E00030) may be obtained from the Order Dept., ASME,345 E.47th St., New York, N.Y.10017
a.
FORM NIS.2 (Back) 9, Remarks O
~~cpilcoble rJanufacturer's Data Reports to be attached L~~
CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this N h onforms to the rules of the
P*iA******"'
ASME Code, Section'XI.
Type Code Symbol Stamp Certificate of Authorization No.
Expiration Date Senior Technical Analyst M S
A N
o,te
,19 Signed
- Owner or Owner's Designee, Title
(/
CERTIFICATE OF INSERVICE INSPECTION 1, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State Protection Mutual o, -
-Michigan and employed by or Province of Norwood, MA have inspected the components described 12/27/96 6/7/98 to
,no,t,t, (n t in this Owner's Report during the period to the best of my knowledge and belief, the Owner has performed examinations and taken corrective measures described in thi.
Owner's Report in accordance with the requirements of the ASM& Code, Section Xt, By signirq this certificate neither the inspector nor his employer makes any warranty, expressed or implied, concerning the
- examinations and corrective rnessures 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 3"'Ai Factory Mutual Engineering Commissions MI-762 NBI Inspect'5r7 Signature National Board, State, Province, and E endorsements
~/b 19 Date 02/82) 9 i
e.
2 FORM NIS.2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI b
7 b
~~1. Owner Consumers Enerry Company oste.~~
~..
27780 Blue Star Mem. Hw.. Covert. MT Sheet 1
of Address
~~2. Plant Palisades Nuclear Plant unit 1~~
Name 27780 Blue Star Mem..Hw. Covert. MI W.O.
O Address Repair Organization P.O. No., Job No., etc.
~~3. Work Performed by NPS Energy Services Inc.~~
Type Code Symbol Stamp NA Name Authorization No.
NA Philadelphia, PA 19013-3672 Expiration o.te NA Address
~~4. Identification of System 5.' (a) Applicable Construction Code Au;5 N.I wSQ edition, NM N/A~~
~~Addenda, Code case (b) Applicable Edition of ecction XI Utill ed for Repairs or Replacements 19 09~~
~~6. Identification of Components Repaired or Replaced and Replacement Components ASME Code National~~
~~Repaired, Stamped Name of Name of Manufacturer Board Other Year~~
~~Replaced, (Yes Component Manufacturer Serial No.~~
No.
Identification Built or Replacement or No)
YQ Sf A (eyf MV $
H6m/asu-HE 6nenw w/A N/A WA lM bple No si l
~~7. Description of Work MN bb I~~
b
,\\
\\
l' l
S. Tests Conducted: Hydrostatic 0 Pneumatic 0 Nominal Operating Presture O i
Other O Pressure psl Test Temp.
'F NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in x 11 in., (2) Informa.
tion 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 et the top of this form.
(12/82)
This Form (E00030) may be obtained f rom the Order Dept., ASME,345 E. 47th St., New York, N.Y.10017 t_.__________._
_j
e.
FORM NIS 2 (Back)
' 9. ' Remarks Ni Appilcable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLI ANCE W
- We certify that the statements made in the report are correct and this nforms to the rules of the ASME Code, Section Xl.
- Type Code Symbol Stamp Certificate of Authorization No.
Expiration Date 8,
7 Senior Technical Analyst
.~3d case
_19 Signed owner or owner's Designee, Title F
CERTIFICATE OF INSERVICE INSPECTION
' 1, the undersigned, holding a valid commission issued by the National Board of Boiler and Presr,ure Vessel inspectors and the State
!~
or Province of Michigan Protection Mutual.
- o, and empioved by Norwood, MA have inspected the componerits described in'this Owner's Report during the period 12/27/96 6/7/98 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 injury or property damage or a loss of any kind arising from or connected with this
'"'Pd Factory Mutual Engineering MI-762 NBI l
Commissions
. InspecMSlgnature National Board, State, Province, and E endorsements t.
Date 19 0 2/82) f $.
_______E_____.-____.___
.[m_,
i l
FORM NIS.2 OWNER'S REPORT FOR REPAlRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI b.
1.' Owner Consumers Fnercy Company Date
~am.
27780 Blue Star Mem. Hvv.. Covert. MT Sheet 1
of Address
~~2. Plant Palisades Nuclear Plant unit 1~~
j Name bO c1 27780 Blue Star Mem..Hvv. Covert. MI W.O.
Address Repair Organization P.0, No., Job No., etc.
~~3. Work Performed by NPS Energy Services Inc.~~
Type Code Symbol Stamp NA N'**
Authorization No.
NA
_ Philadelphia, PA 19013-3672 Expiration Date NA Address
~~4. Identification of System 1~~
~~5. (a) Applicable Construction Code A b~~
19
~~Edition, Addenda, Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 09 l~~
~~6. Identification of Components Repaired or Replaced and Replacement Components ASME I~~
~~Code National~~
~~Repaired, Stamped Name of Name of Manufacturer Board Other Year~~
~~Replaced, (Yes l~~
Component Manufacturer Serial No.
No.
Identification Built or Replacement or No) 1 I
$ $ lwo N(
N/A N/A Nlf9
\\%% MU"O No 7.' Description of Work AAMf FW) b OW hff Sb 7' b'46 *
\\ '
l
~~8. Tests Conducted: Hydrostatic 0 eneumatic 0 Nominai Operating Pressure O l~~
Other O Pressure psl Test Temp.
'F l.
t NOTE: Supplemental sheets in form of lists, sketches, or drawings may be used, provided (1) size is 8% in. x 11 in., (2) Informa+
tion in items 1 through 6 on this report is included on each sheet, and (3) each sheet is numbered and she number t'f sheets is f
recorded at the top of this form.
(12/82)
This Form (E00030) may be obtained from the Order Dept., ASME,345 E. 47th St., New York, N.Y.10017 L_
__-_____-____-____-___-__J
t 9./ Remarks 01-Applicable Manufacturer's Data Reports to be attached CERTIFICATE OF COMPLIANCE.
We certify that the statements made In the report are correct and this, conforms to the rules of the
'i*P"*"'
. ASME Code, Section'XI.
Type Code Symbol Stamp Certificate of Authorization No, Expiration Date b
b Senior Technical Analysts
~~pot,~~
_19 Signed V
Owner or Owner's Designee, Title CERTIFICATE OF INSERVICE INSPECTION 1, the undersigned, holding a valid commission issued by the National Board of Boiler and Pressure Vessel inspectors and the State
- Protection Mutual or Province of Michigan and empioved by Norwood, MA have inspected the components described 12/2Y/9b b/I/9O and state that in this Owner's Report during the period to 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 employP 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 irt any manner for any personal injury or property damage or a loss of any kind arising from or connected with this
'"$P"" "'
Factory Mutual Engineering MI-762 NBI Commissions inspector s sieneture National Board, State, Province, and E endorsements b'/b 19 W Date l
f (12/82) p
j e.
FORM NIS 2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
~~1. Owner Co n s u me r s Energy Company 7~~
[
o,,,
~...
27780 Blue Star Hwy. Covert, MI Sheet I
of Address
~~2. Pfent Palisadr's Nuclear Plant Unit i~~
nome 27780 Blue Star Hwy. Covert, M1 W.O. # )
Addrese nopelt Creenlastion P.0, No., Joo No., etc.
~~3. Work Performed try Consumers EnercY Type Code symbos stamp N/A Authorization No.~~
~~N/A 27780 Blue Star Hwy. Covert, MI Expiretion Dete N/A Ad dress~~
~~4. Identification of System-~~
~~5. (e) Applicable Construction Code 19~~
~~Edition, b~~
Addsnde CodeCese (b) Appliccole Edition of Section XI utilized for Repairs or Replacernents 19 0 9
'6.
Identification of Components Repaired or Replaced and Replacement Componente ASME Code National
~~Repelred, Stamped Name of Name of Manufacturer Board Other Year~~
~~Rooleced, (Yes Component Manufacturer serial No.~~
No.
Identification Built or Replacement or No) r%dnkAI YAlvf,
/$eA+5Ck mv-cA n comme b,'
NbA s w'*' t o s s P
nn Ro\\N No kep busse s-mi N/A N/A heo RehAudNo 9ses em l
7 Doestletion of Work 6
N N M' A
4 'N '
l L
\\
t
. Hydrostatic C Pneumetleh Nominal Operating Pressure C
~~8. Tests Conducted:~~
Other Proseure pel Test Temp.
'P NOTE: Supplemental sheets in form of liees, ekstehee, or drowinge may be used, provided til else le 8% in. x 11 in., (2) Informe.
tion in items 1 through 8 on this report le included on seeh sheet, and (3) eesh sheet le numbered and the rumber of sheete le recorded et the top of this form.
(12/82) -
This Form (E00030) may be obtained from the Order Dept., ASME,346 E. 47th St., New York, N.Y.10017 9
9
FORM NIS-2 (Beck)
. 9. Remarks
/
Appliccole Manufacturer's Date neporte to t>e etteched a
CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this MMA conforms to the rules of the ASME Code,Section XI.
'*Y'"'*****"'
Type Code Symbol Stamp N/A Certificate of Authorization No, N/A N/A Expiration Date Signed Sen. Technical Analyst, M
-Id3 3, @
o,,,
Owner or owner's Desiones. Title.
y
/
CERTIFICATE OF INSERVICE INSPECTION 1 the undersigned, holding a valid commission issued by the National Board of Soiler and Pressure Vesset inspectors and the State or Province o, M i ch i ga n y e,g,ioy,e n, Protection Mutual og Norwood, MA have inspected the components described in this Owner's Report during the period 12/27/96 6/7/98
,o
. and state thet to the boet of my knowledge and belief, the Owner has performed eneminatione and taken corrective measures described in this Owner's Report in accordance with the roovirements of the ASME Code,Section XI.
By signing this certificate noether the inspector nor his employer makes any warrenty, espressed or implied, concerning the eneminatione end correctiw mesaures descritped in this Owner's Report. Furthermore, neither the Inspector nor his employer shall be liable in any menner for any personal injury or property damage or a loss of any kind erleing from or connected with this inspection.
FACTORY MUTUAL ENGINEERING MI-762 NBI Commissioner sney.etoi e siensruro Net 6enal Seere, State Province, and Endorsements YN e$
Oese 1
overi G
8 4
~~4 4~~
l e.
I FOTIM NIS 2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
~~1. Owner Consumers EnerQy Company 7 /S3 fc)g o,1, name 27780 Blue Star Hwy. Covert, MI sheet-1 I~~
[
Address of
~~2. Plant Palisades Nuclear Plant~~
~~uni, 1~~
~~Name 27780 Blue Star Hwy. Covert, MI w o. # o W 8 // 3 5 0 Addrous nepair Organisetton P.O. No., Joe No., ete.~~
~~3. wor~~
~~Performed by Consumers EnerQV Type Code symboi stemp N/ A Authoritetion No.~~
~~N/A 27780 Blue Star Hwy. Covert, MI Expiration cate N/A Ad dress~~
~~4. Identification of System cdbM~~
~~5. (a) Applicacle Construction Code B 3 f. I is & Edition, N/A Addende;-~~
MIN Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 R 9
'6. Identification of Components Repaired or Replaced and Replacement Componente ASME Code National
~~Repaired, Stamped Name of Name of Manufacturer Board Other Year~~
~~Replaced, (Yes Component Manufacturer Serial No.~~
No.
Identification Built or Replacement or No) 9GA+t dWsek M
g Velvr b>A M A //9" 4I A G atmos s
/777
^& lac 42 de e
S6 to to Pe> ed
,ff-buBest SWM MM
,e g $
Sepe.95eg l$$$
p/d(M hh tPlAcb oi SA h A lv &
/Y)4 - C A 75 8 Assb c) ' hoY&
~~1. Description of worst Hydrostatic 0 Paeumeiio M Nominst Operating Pressure C~~
~~8. Tests Conducted:~~
OtherO Pressure pel Test Temp.
'F NOTE: Supplemental sheets in form of lines, sketches, or drewings mey be used, provided (1) else le 8% in. m 11 in., (2) Informe.
tion in items 1 through 8 on this report is included on each sheet, and (3) seeh ehest le numbered and the number of sheste le recorded et the tno of thle fons (12/32) ~
This Form (E00030) may be obtained from the Order Dept., ASME,345 E. 47th St., New York, N.Y.10017 l
i
FORM NIS 2 (Back) 9, Remarks
?
AcoliceDie Manufacturer's Cate Reports to oe attacNed I
l l
l CERTIFICATE OF COMPLIANCE O#p We certify that the statements made in the report are correct and this conforms to the rules of the A$ME Code,Section XI.
I Type Code Symbol Stamp N/A Certificate of Authoriastuan No.
N/A N/A Expiration Oate l
$;gned Sen. Technical Analyst M i
~7 3
3g(6 o,,,
Owner or Owner's Desiones. Title
[/
/
I t
CERTIFICATE OF INSERVICE INSPECTION f, the undersigned holding a valid commission issued by the National Board of Boiler and Pressure Vessel Inspectors and the State or Province o, Mi,ch i g a n and spioved by Protection Mutual Norwood,-MA have inspected the components described in this Owner's Report during the period 12/27/96 6/7/98 n,,,,,, in,,
to the best of my knowledge and belief, the Owner has performed esamirations 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 inepector nor his employer makes any worrenty, empressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the inspector not his employer j
shall be liable in any manner for any personal injury or property damage or a loss of any kind erloing from or connected with this insection.
FACTORY MUTUAL ENGINEERING MI-762 NBI Comminions ineester's stenature Natione seere, sta erovinee, one anaeroements Oate WY is 98 (12/82) 6
(
< a O
4 FORM NIS 2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI l
~~t. Owner Consumers Energy Company 7hf?S g,,,~~
name
_2,,7780 Blue' Star Hwy. Covert, MI Sheet 1
I of Ao dr es.
~~2. Pfent Palisades Nuclear Plant~~
~~uni, 1~~
Name 27780 Blue Star Hwy. Covert, MI w.O. # d48//Y79 As ores.
noseir oceaniaetion p.o. us., m us., m.
~~3. Work Performed by Consumers EneraV Type Code Symbol Stemo N/A Authoriaetion No.~~
N/A 27780 Blue Star Hwy. Covert, MI Empiretion Dete N/A A Orsee
~
~~4. Identification of System dT A "U 0"'b l c 4' 9~~
B St. l t? 55 (
V
~~5. (e) Applicable Construction Code O 3 b I 19_2,h Edition, M~~
Addends-M/l Code Ceae (b) Applicable Edition of Section XI Utillaed for Repeirs or Replacement 19. 8 9
'6. Identification of Components Repaired or Replaced and Replacement Componente ASME Coce Nationes
~~Repaired, Stemped l~~
~~Nome of Name of Manufacturer Board Other~~
~~Yes, Replaced, (Yes Component Manufacturer Serial No.~~
No.
Identification Built or Replacement or No) 8MAicAu D
VH1-57A Aok A Het plA "
d)A a(A Ing Kenseb do o
~~7. Description of Work Ar 64 5 a.a --/J&M V~~
l
~~8. Tests Conducted: Hydrostatic O Pneumette Nominst Operating Proesure k l~~
OtherO Press ro Poi Test Te=a.
'P I
NOTE: Supplemerited sheste in form of flees, sketehas, or drWngs nwy be used,provided (1) else le 84 in, a 11 in., (2) Informs.
tion in items 1 thW S on this report le ineluded on each sheet, and (3) seeh sheet is numtrated and the number of sheste le recorded et the top of thee form.
i (12/82) **
Thie Porm (E000301 may be obtained from the Order Dept., ASME,348 E. 47th St., New York, N.Y.10017 l
i
,e 4
FORM N18 2 (Back)
~~9. Remarks Mk Acolicenae Manufacturer's Date neerte to t>e etteches i~~
A CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this conforms to the rules of the ASME Code,Section XI.
'*e 8' 'se'esem*at Type Code Symbot Stamp N/A Certificate ' f Authoriastion No, N/A N
o Empiration Dete Signed Sen. Technical' Analyst' W
Date 19 Owner er Owner's Desense, Title y
CERTIFICATE OF INSERVICE INSPECTION 1, the undersigne, hol ing a valid commission issued by the National Board of Boiler and Pressure Vessel inspectors and the Stato ur Province o,M ch gan w orsioved by Protection Mutual av Norwood, MA h
inspected the components described in this Owner's Report during the pr* led 12/27/96 6/7/98
.ng g,,,, in,,
to the best of my knowledge end belief, the Owner has performed esaminatione end taken correettwo mesa,res described in this Owner's Report in accordenes with the requirements of the ASME Code,Section XI.
By signing this certificate neither the inspector nor his employer enekse any warrenty, empressed or implied, concerning the examinations and corrective mecanes described in this Owner's Report. Furthermore, neither the inspooner nor his employer shall be liable in any menner for any pereenal injury or property damage or a loss of any kind arising from or connected with this insection.
FACTORY MUTUAL ENGINEERING MI-762 NBI Comminione snesessere sigassure Necene soare, stese, Provinse, one sneer monte Date U
S 18
' (12/82) 4 0
g e
e i
's
FORM Nis 2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
~~1. Owner _ Co n s u me r s Er'e rc y Company N~~
~~Date~~
~~u. e 27780 Blue Star Hwy. Covert, MI Sheet 1~~
~~I or Address~~
~~2. Plant Palisades Nuclear Plant unit 1~~
Name 27780 Blue Star Hwy. Covert, Mt W.O.
@l81/975 Address nopeer Orsenisetion P.O. No.. Job No. etc.
3. Work Performed by Consumers Ener0V Type Code symbol stamp N/A N***
Authorization No.
N/A 27780 Blue Star Hwy. Cc rert, MI Expiration oste N/A Address
~~4. Identifiestion of System DRVIC E b~ EA 19~~
~~Editioe, N/A N/A~~
~~5. (a) Applicable Construction Code Addeo,;~~
code ca.
(b) Applicable Edition of Section x1 Utill ed for Repeirs or Roplacemente 19 3.9_
'6. Identification of Components Repaired or Repleesd and Replacement Componente I
ASME Code National
~~Repaired, Stamped Name of Name of Manufacturer Board Other Year~~
~~Rooleced, (Yes Component Manufse'urer Serial No.~~
No.
Identification Built or Replacement or No) whs Lna.hM l A **
\\
L Lsfu din asA S u,,8s41 199 s ftplac+)
do A n a s'T
/.b -t-5 0
/ 6vA Po #
194*SA
/Y1/\\Ch r t-MIA AIA G 9 SicOCC 1998 Alfici-b o
l l
~~1. Description ot work~~
? A C E*
S~Nb S A U 'f6 b5SoO ~>ic woh FE-ona
~~8. Tests Conducted: Hydrostatic Pneumstic 0 Nominel Operating Pressure Other Pressure pel Test Temp.~~
'P NOTE: Supplemental sheets in form of liste, ekstehes, or drewings may be used, prawided (Il else is 8% in, a 11 in., (2) Informe-tien in items 1 through 8 on this report is inetuded on each sheet, and (3) eseh sheet is numbered and the number of sheets le recorded at the top of this form.
(12/82) ~
~
This Form (E00030) may be obtained from the Order Dept., ASME,345 E. 47th St., New York, N.Y.10017 e
o
FORM NIS 2 (Bacl0 60
~~9. Romerks Applicable Menuf acturer's Dete mooorts to be etteched f~~
CERTIFICATE OF COMPLIANCE O#
onforms to the rules of tne We certify that the statements made in the report are correct end this ASME Coce,Section XI.
h N/A Type Code Symbol Stamp UA N/A Expiration Oete Certificate of Authorization No.
Signed Sen. Technical Analyst, M 3s 7
19 pate
/
Owner or owner s Designee, Titie y
CERTIFICATE OF INSERVICE INSPECTION j
f, the undersigned, hot ing a valid commission issued by the National Board of Soiler and Pressure Vessel inspectors and the State Ch gan and erNoloyed by Protection Mutual or Province of Norwood, MA have inspected tne components described 12/27/96 6/7/98 and state that in this Owner's Report during the period to the best of my knowledge and belief, the Owner has performee examinettone end taken correctivo meneures 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 worrenty, empressed or implied, concernias the examination and corrective measures described in this Owner's Report. Furthermore, neither the inspector not his employer shall be lieble in any menner for any personal injury or property damage or a loss of any kind erleing from of connected with this FACTORY MUTUAL ENGINEERING inspection.
MI-762 NBI i -,.<
.i.no.u,._,
Commissions
~ e,ie.,s.
e,...te f.,evir e,,...,.e, n.n.s l
Nu i,9a oste 02/82) 1 9
4
a e f
l l
.e 1
FORM NIS 2 OWNER'S REPORT FOR REPAlRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI 1, owner Con s ume rs Enercy Company N
b o,,,
N.m.
27780 Blue Star Hwy. Covert, MI sheet 1
l of Address
~~2. Plant Palisades Nuclear Plant l~~
unit 1
Name 27780 Blue Star Hwy. Covert, MI W.O. #h b
Address Repair Orgenfretten P.0, No., Joo No., etc.
~~3. Work Performed by Consumers Eneray Type Code symbos Stamp N/A Name Authorization No.~~
~~N/A 27780 Blue Star Hwy. Covert, MI Empiretion Dete N/A Addreee~~
~~4. Identification of System b~~
~~I I~~
~~5. (a) Applicable Construction Code b6CYM 7 7 Edition, i~~
19 AMende-Code Ceae (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 8 9.-
i
' 6. Identification of Components Repelred or Reptoced and Replacement Components ASME Code National
~~Repaired, Stamped Name of Name of Manufacturer Board Other Yeer~~
~~Replaced, (Yes Component Manufacturer Serlei No.~~
No.
Identification Built or Replacement or No)
Hard Mie NJS A Bts P. o -=
S A A't c)B G 4 6T/e Fa kN,,
N/A C,007Di~7 l@3 NWM No Harv>boie Sws Ac5 P.c.e 5A R$ f57 C, 4 s e 6x.
N/A N/A gg<g lqq3 m(gy (90 7, Description of Wo,t, eN4ce 5r4 AM NJS on 6SDA$eoA M4 Ale W5 I
~~8. Tests Conducted: Hydrostatic 0 Pneumatic Nominal Operating Proesure 8 Other O Pressure poi Test Tema.~~
r NOTE: Supplemental sheets in form of lists, sketehm, or drewings may be used, provided til else le 84 in. x 11 in (2) Informe-tion in items 1 throup 8 on this report is ineluded on each sheet, and (3) eseh sheet le numbered and the number of sheets le recorded at the top of this form.
(12/82) -
Thle Form (E00030) may be obtained from the Order Dept. ABME,345 E. 47th St., New York, N.Y.10017 I
e
. e l
l FORM Nis.2 (Back) b
~~9. Remarks Appliccole Manufacturers Data Reports to t>e attached I~~
A CERTIFICATE OF COMPLlANCE We certify that the statements made in the report are correct end this W N' ' conforms to the rules of the ASME Code,Section XI.
Type Code Symbol Stamp N/A Certificate of Authorization No.
N/A N/A Expiration Oste Signed Sen. Technical Analyst, Q Q Date is o no, or o.n.r. oes.enes, ntie y
CERTIFICATE OF INSERVICE INSPECTION f, the undersigned, holding a valid commission issued by the Nationel Scard of Boiler and Pressure Vesent inspectors and the State Michigan and er#pioved by Protection Mutual or Province of Norwood, MA hwe inspected the components described in this Owner's Report during the period 12/27/96 6/7/98 and itste that to the best of my knowledge end belief, the Owner hos performed eneminations 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 worrenty, empressed or implied, concerning the examinations and corrective f6eesures descr6 bed in this Owner's Report. Furthermore, neither the inspector nor his employer shall be liable in any menner for any personal injury or property damage or a loss of any kind arising from or connected with this inspection.
FACTORY MUTUAL ENGINEERING MI-762 NBI Commissions sneesters sieneture Natione seere, state. Province, one sneersements E-b 96 o.t.
i H2/82) e 4
e
]
[
. e
+
t' i
e a FORM Nis 2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provi:
2ons of the ASME Code Section XI
~~1. Owner Consumers Energy Company 7~~
[k o,,,
~...
27780 Blue Star Hwy. Covert, MI
$3,,,
1 Ad dress
~~2. Plant Palisades Nuclear Plant~~
~~uni, 1~~
~~Nome 27780 Blue Star Hwy. Covert, MI W.O. # cNf lN7 Ac erees mooser oreeniserien P.c. no., see No.. sie.~~
~~3. Work Performed by Consumers EneraV Type Code symbos stamp N/A Authorization No.~~
N/A
__27780 Blue Star Hwy. Covert, MI Empiretion Dete N/A Acarea.
~~4. Identification of System A~~
M M
I
~~5. (e) Applicele Construction Code $fC.Ti'^~~
19
~~Edition, N~~
Addende; Code Case (b) Applicento Edition of Section XI Utilised for Receirs or Replacements 19 0.9
' 6. Identification of Components Repaired or Replaced and Roolecement Componente ASME Code Nationel Repelred.
Stemped Name of Name of Manufacturer Board Other Year
~~Replaced, (Yes Component Manufacturer Serfel No.~~
No.
Identification Built or Replacement or No)
He,liCali N.T :W..
P. a. -w raen He\\b(\\
um-nas N/A mssu mE hekc~n No 5 s11ds o 64T rs sat 95 k1 wa,>4 H/A N/A SyggQ
\\98b fieptaed No
r.. *
.2 w Ts ceibe:<
sal % J8
%:e:m N/A N/A gg y gqq$ p.eplAad No v.a.+
s l
~~7. Description of worm TATA\\l b A hdiCoil !^StFT, retJ Aa 3 STJS ad > N3 on STum 1~~
t
\\
sr w,crev-E-sos.
B. Tests Conducted: Hydrostotle Pneumsele O Nommel Operating Prosours
. OtherO Pressero asi rest rema.
P NOTE: Supplemental sheets in fome of liens, sketehen, or drewings erwy be used, prodded til slee le 84 in.x 11 in (2) Infortre-tion in items 1 throuWi 4 on this report le included on each sheet, and (3) eesh sheet le numbemd and the numiser of sheste le recorded at the top of thle form.
(12/52) -
Thie Porm (E00030) may be ooteined from the Order Dept., ASME,348 E. 47th St., New York, N.Y.10017
i e e FORM NIS 2 (Seck)
9. Romerks ON-Applicense Manufacturer's Data moports to be attacneo CERTIFICATE OF COMPLIANCE We certify that the statements made in the report are correct and this4k8M^I conforms to the rules of the ASME Code,Section XI.
Type Code Symbol Stamp N/A Certificate of Authorization No, N/A N/A Empiretion Oete Signed Sen. Technical Analyst,
~7 gg N o,,,
owner or owner's Dee enee Title p
'/
CERTIFICATE OF INSERVICE INSPECTION 1, the undersignegi, holding a welid commission issued by the Nationet Board of Boiler and Pressure Vessel inspectors and the State or Province o, Mi ch i g a n and erneioved by Protection Mutual Norwood, MA have inspected the components described in this Owner's Report during the period 12/27/96 6/7/98
. and state inet to the best of my knowledge end beisef, the Owner has performed eneminatione 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, empressed or implied, concerning the examination and corrective measures descritied in this Owner's Report. Furthermore, neither the inspector nor his employer
. enoil be liebte in any manner for any personal injury or property damage or a lose of any kind arising from or connected with this insection.
FACTORY MUTUAL ENGINEERING MI-762 NBI Commi.. ion.
e noenere sienmuro mesi.nse e. ore, siese, provinee ene aneer.ement.
Ie30 is_f8 Oste (12/82)
S k-6 I
s
~~l l 9~~
~~l FORM N15 2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI~~
~~1. Owner Con sume rs Energy Company 7 fdl o,,,~~
Name 27780 Blue Star Hwy. Covert, MI Sheet 1
(
of Ad dress
~~2. P:ent Palisades Nuclear Plant~~
~~uni, 1~~
~~Name 27780 Blue Star Hwy. Covert, MI w o. # d 'f ? /l 76 0 Ad dress noselr Orsentastion P.O. No., Joe No., etc,~~
~~3. Work Performed by Consumers Eneray I~~
Type code symbol stamp - N/A Authoritetton No.
N/A 27780 Blue Star Hwy. Covert, MI Empiretion Dete N/A Ad dress
~~4. Identification of System-M AMb 0" bl 8~~
/c
' 9
/S E-#1 t5 3 (. I ASS &
V
~~5. -(e) Applicable Construction Code b bI* \\~~
~~73 19~~
~~Edition, M~~
M Addende Code Case (b) Applicable Edition of Section XI Utilized for Repairs or Replacements 19 8 9
' 6. Identification of Components Repaired or Replaced and Replacement Componente ASME Coce National
~~Repelred, Stemped Name of Name of Manufacturer Board Other~~
~~Yes, Reoleced, (Yes l~~
Component Manufacturer Serial No.
No.
Identification Built or Replacement or No) bM&idQ44 VHY. 37B Aia F.1+te aid a <a alA r, tor Aard
~~l l~~
l
~~7. Description of Work DA' A~~
ou 8'
\\
J
~~8. Tests Conducted: Hydrostatic Pneumatic 0 Nomine# Operating Pressure Other Prosauro pel Test Temp.~~
'F NOTE: Supplemental eheese in form of lines, ekstehen, or drowings may be used,prMded (1) eine le 8% in. x 11 in., (2) Informe.
tion in iteme 1 through 4 on this report le included on esce sheet, and (3) eseh sheet le numbered and the number of sheets le recorded at the top of this form.
(12/82) -
Thle Form (E00030) may be obtained from the Order Dept., ASME,345 E. 47th St., New York, N.Y.10017 I
l L-_
o o 1
FORM NIS 2 (Back)
~~9. Romerks 6AW Applicable Manutecturer's Data Mooorts to os attached 4~~
a CERTIFICATE OF COMPLIANCE We certify that the statements mode in the report are correct end this b
conforms to the rules of the ASME Code,Section XI.
repeer or replacement Type Code Symbol Stamp N/A Certificate of Authorizet' ion No.
N/A N/A Expiration Dete Signed Sen. Technical Analyst,355rI
~7 I
N oste 39 Owner or Owners Desegnee, Title f/
CERTIFICATE OF INSERVICE IN8PECTION l, the undersignegi, holding a valid commission issued by the National Board of Boiler and Pressure Vessel inspectors and the State or Province ofMichigan
,ng,,3pioved by Protection Mutual Norwood, MA have inspected the components described in this Owner's Report during the period 12/27/96 6/7/98 and state that to the best of my snowledge and belief, the Owner hos performed examinations and taken corrective measures described in this Owner's Report in accordance with the requirements of the ASME Code,Section XI, Sy signing this certificate neither the inspector nor his employer makes any worrenty, expressed or implied, concerning the examinations and corrective measures described in this Owner's Report. Furthermore, neither the inspector not his employer shall be liable in any menner for any personal injury or property damage or a lose of any kind arising from or connected with this inspection.
FACTORY MUTUAL ENGINEERING MI-762 NBI Comminions eneeeeter signeeur.
Notwaes seere, stete, Provinee, one sneersements I-d Y n[8 cate i
02/82)
G e
4 %
e
1 o.
. 6 l
9 w i
FORM NIS 2 OWNER'S REPORT FOR REPAIRS OR REPLACEMENTS As Required by the Provisions of the ASME Code Section XI
~~1. Owner __ Con s ume r s Ene rgy Company 7foh q n,1,~~
~eme 27780 Blue Star Hwy. Covert, MI Shm 1
I of Addreas
~~2. Plant Palisades Nuclear Plant~~
~~uni, 1~~
Name 27780 Blue Star Hwy. Covert, M1 W.O. # o)8/Sl/ 767
}
A.
..se,, o,sen....n,.. ~... o ~ e., e,s.
l
~~3. Work Performed by Consumers EneraV Type code Symbol stamp N/A Authorlastion No.~~
~~N/A 27780 Blue Star Hwy. Covert, MI Expiretion Date N/A Addreas~~
4. Identification of System Yu+ A "b b *
~~b * +tsa r 9~~
S&fF1 sJ
{
~~5. (e) Applicable construction Code b 3 k~~
~~19 73 Edition.~~
M Addende MIb Code Case (b) Applicable Edition of Section XI Utilized for Receirs or Replacements 19 89._
' 6. Identification of Components Repaired or Replaced and Replacement Componente ASME Code National
~~Repelred, Stemped Nome of Name of Manufacturer Board Other Yeer~~
~~Replaced, (Yes Component Manufacturer Serlei No.~~
No.
Identification Built or Replacement or No) dmeAICAA
. o W p enA A,r. Arde A/6 M14 alA 19 a Ohi M fjo
1. Description of worer M-Ab S ou fA 5 4*
~~Cb8~~
~~8. Tests Conducted:, Hydroetetic 0 Pneumatic Nominal Operating Pressure C,therC Pressure poi Test Temp.~~
'F l'
NOTE: Supplemental sheets in form of lists, sketehee, or drawings may be used, provided (1) else le 8% in. x 11 in., (2) Informe.
l tion in itorne 1 through 8 on this report le included on each sheet, and (3) each ehest le numberaal and the number of shoots is j
recorded et the top of thle form.
l l
(12/82) b This Form (E00030) may be obtained from the Order Dept., ASME,348 E. 47th St., New York, N.Y.10017 t
I l
l 9
l L_______________-.____
J
n}
e..
4-ad 9
l 6
FORM NIS 2 (Beck) j
9. Remarks Applicable Manufacturer's Data Meports to be attached CERTIFICATE OF COMPLIANCE We certify that the stetements made in the report are correct and this conforms to the rules of the ASME Code,Section XI.
resser or replacement Type Code Symbol Stamp N/A
. Certificate of Authorization No.
N/A N/A Expiretion Oete Signed Sen. Technical Analyst, M h 7_
3g M o,,,
Owner or Owner's Designee, Title
(/
/
CERTIFICATE OF INSERVICE INSPECTION f, the undersignegl, holding a valid commission issued by the National Board of Soiler and Pressure Vessel inspectors and the State or Province ofMichigan nd espioved by Protection Mutual a,
N,orwood, MA have inspected the components described in this Owner's Report during the period 12/27/96 6/7/98 end state that to the best of my knowledge and belief, the Owner hee 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 worrenty, expressed or implied, concerning the examinations and corrective measures doecribed in this Owner's Report. Furthermore, neither the inspector nor his om,Moyer shall be liable in any menner for any personal injury or property damage or e loss of any kind erlsing from or connected with tnis inspection.
FACTORY MUTUAL ENGINEERING MI-762 NBI Commissions inse.ctors signature Nedonal Boere, state, Province, and Endorsements M Ig b Date 02/82) e 9
_ _ _ _ _ _ - - - - - - _

ML20237E030

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ML20237E030

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