NRC-89-0244, LER 89-024-00:on 891019,recognized That Secondary Containment Dampers Not Tested as Required by Tech Spec 3.6.5.2.Caused by Operations Personnel Error.Event Critique to Be Included in Required Reading program.W/891120 Ltr

LER 89-024-00:on 891019,recognized That Secondary Containment Dampers Not Tested as Required by Tech Spec 3.6.5.2.Caused by Operations Personnel Error.Event Critique to Be Included in Required Reading program.W/891120 Ltr

ML19332C284
Person / Time
Site:	Fermi
Issue date:	11/20/1989
From:	Orser W, Pendergast J DETROIT EDISON CO.
To:	NRC OFFICE OF INFORMATION RESOURCES MANAGEMENT (IRM)
References
CON-NRC-89-0244, CON-NRC-89-244 LER-89-024, LER-89-24, NUDOCS 8911270097
Download: ML19332C284 (5)

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                                , ' >     - 6400 North Dixie Highw 2y                                                 Nuclear lOO Newport. Mcrugan 481f4                                                   , Generation sOV         (3'3s 586 6 * -
                                                                                    . November 20, 1989 NRC-89-0244-                                .,

j s U . - S '. Nuclear Regulatory Commission

                                        . Attention:              Document Contro; Desk Washington. D.C. 20555

Reference:

Fetmi 2 W ,

                                                                  .NRC Docket No. 50-341                                               ,

Facility Operating' License No. NPF-43

Subject:

Licensee Event Report (LER) No. 89-024-00 P' l ease find enclosed LER No.. 89-024-00, dated November'

                                        ~20, 1989              for a: reportable event that occurred on October 19, 1989.              A copy of thi's LER is also be3nt sent to the                         4 Regional.Adminictrator, USNRC-Region III.

If you-have any questions, please contact Joseph Pendergast at (313) 586-1682. j .. ( X  ; 1 Sincerely, )

Enclosure:

NRC Forms 366' 366A

                                                                                                                                     '[

cc: A. B. Davis J. R. Eckert R.-W. Defayette/W. L.'Axelson

• W. G. Rogers J .- F. Stang Wayne County Emergency

 /f                                                    Manegement Division
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• t PPROVED OMB NO 3160 4104 s LICENSEE EVENT REPORT (LER) **"'6 ewee F ACILITV NAM 4 H) ' DOCKET NUMBER (2) PAGE( f Fernd 2 o is ; o ;o I o 131411 1 IOFl014

        " ' ' ' ' ' '-                  Surveillance of Secondary C W ainment Damper Was not Completed Due to Personnel Error EVENT DAth (6)                       LER NUM8tR 461                       REPORY OAff (71                         OTHER F AceLITIES INVOLVED 166 YEAR         $0       AL                  f*DNTH      DAY    YEAR                8 ACILIT v e= AMts               DOCKET NUMBtRts:

D A**-{ VEAR MONT H UMe N/A o gsjo g olo; i i

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        ~1l.0 1l 9 8                  9  8l 9          r .' 2l 4          0l0          1l 1 2 l0      8J9                          N/A                      o isto to i o,         i i THIS REPORT . )USMITTED PUR8UANT TO THE REQUIREMErkTS OF 10 CFR $. (Check one or mom of the followmpi (11)

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                 **'               5       a mi.i                                  n 4o.m                             60nm:2Hm                               muni 20.406(s10 Ha)                          60.364sh1) .                       60.73teH2Hvl                           73.?ual nOS         oi Oi o            n. 06NinHin                             60 x .n2,                          60.73..H H )

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           <                                  20 4066s)OH6vi                          60.73mH2Hn)                        50.73 tem 27tv4HHS) 20.406(all1Hel                          60.73teH2Hii0                      to.73teHPHal LICENSEE CONT ACT FOR THIS LER d2l NAME                                                                                                                                               TELEPHONE NVM94R Joseph Pendergast, Licensing Engineer 3il i3       5 , 8,6    i  i 1,6 8i 1 2 COMPLETE ONE LINE FOR E ACH COMPONINT F AILURE Of 5CRl8ED IN THis RHOF 71131 M                   "                                                                    MA               PORTA E CAU$t SYSTE              COMPONENT                  [      "f0    PH S k

CAUSE SY ST E M COMPONENT pp Mi l l l l l l l 1 l l l l l l l I l I l l l 1 1 I I I l f I SUPPLEMENTAL REPORT EXPECTED lie: MONTH DAY Y

                                                                                                                                                  $UBM'*siON YES (If res. remplete EXPECTED SU64913SION CATEl                                   NO                                                                   l      l      l A957 XACT ILimer to E*00 spaces. t e , eneronsmetery Mreen sme's wece typewntren Ioness 068 On October 19, 1500 hours, it was recognized that Secon'dary Containment Danpers had not been tested as required by Technical Specification 3.6.5.2.                                    At 1608 hours that same day, the Secondary                                                             ;

Containment Dampers were successfully tested, placing the plant in compliance with.the Technical Specification.

                       .The root cause of this event wss personnel error.                                                                      Operations personnel. both Control Room and the Surveillance Group, had not closely reviewed the Situational Surveillanco List.

A critique of this event will be included in the required reading program for Operations and Surv=111ance Group personnel. The Licensed Operator Requalification Training Program will include a discussion of this event as it relates to Technical Specification implenentation. This will enhance the awareness of Operations personnel concerning the circumstances of this event. j*5**"

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• LICENSEE EVENT REPORT (LER) TEXT CONTINUATION. neRovio ovs =o nso-cio.  ; '

EXPmES. 8 731/08 PaCMY haa#& H) DOCKET NUMBER CD LER NUMSER 161 Pa06 (3) me em:r w:en  ; m 2; 38R1 IW mene one., h !*Joholf. vee edannonel NMC form 3NA*29 (1h o Slo o o 31411 8l9 - 012l 41 - 0l0 012 OF 0 l4 I '

                           )                                                                                                                                            !
                                   -Initial Plant Conditionst Operational condition: 5~ (Refueling)
                                   ~ Reactor-Power:

O Percent , Reactor Temperaturet 100 degrees 7ahrenheit Reactor Pressure: O psig description of the Event On September 13, 1989, it-was decided that procedure NPP l 124.'404.002 "Divisionct SGTS: Filter and. Secondary Containment. Isolation _ Damper;0perability Test", sections 5.1 and 5.2 would be , performed s'eparately. This decision was made to support a_ rework

                                   .of.the Secondary Containment Automatic Isolation Dampers (DMP) as part"of an, upcoming' Standby Gas Treatment, System.(SGTS) (BF)
                                             ~
                                   -divisional outage.                        Section 5.1, " Division 1 Standby Gas Treatment System-Filter. Operability Test". was performed in its specified
                                   ; time interval.- Section 5.2, " Division 1 Secondary Containment Isolation Damper and SGTS Filter Operability' Test", was-4           anticipatedLtonbe completed as a post-maintenance test _following.

planned maintenance activities. i Section 3.22had a critical completion date of October 17, at 0540 houru. The'aurveillance exceeded its critical completion date on October.17, placing the-plant in an eight hour Limiting Condition ofL0peration (LCO).to-complete the damper surveillance or suspend core alterations which were in progress. Since it was not known

                                   ..that an LCO had been entered, the required' actions were-not performed. . This was a violation of Technical-Specification
                                    - 3 '. 6 . 5 . 2 . Core Alterations-were suspended to resolve an "Over the Core" limit: switch problem on October 19, at 1440 hours, a                                                                        '
                                   -situation not related to this event. ~This did however place the
                                   , plant intcompliance with the above described Technical
                                   ~ Specification. 'It'was recognized on October 19                                   at 1500 hours.

l 'that Technical l Specification 3.6.5.2 had been violated. At 1608 hours on October 19th the-Secondarv. containment Dampers were _successfully tested and Section 5.2 of 24.404.002 was completed. j Cause of the Event: ' I The? root cause of'this event wes personnel error. Operations-(Utility Licensed and Non-Licensed) personnel, both Control Room C4 l_ end'the Surveillance Group.-were not closely reviewing the LSituational Surveillance List for " Core Alteration" and " Handling g s

                        *          . Irradiated Fuel'in Secondary Centainment" during the described E                                    -event.
         ) t N3C FOTQ 3esA .                                                                                                            *U.6, CPos 1988 120-589,00M0

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   -. ,                 ;---.-                            ,. n Offic page 3BSA                                                                                       U.8 huCLEA3 EEIULAT03Y C0amilSSION
                , .:               - LICENSEE EVENT REPORT (LE.N TEXT CONTINUATION                              A*PRovto ove No. aiso-oio4
    .;f4                                                                                                        EXPIRES: 8/31/08 9 ACILtTY leAtti it!                                       DOCetti NV.4 DER (2)              LtH NUM98R tel              l     PA06 (3) viaa    -
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3*?: Femi 2 rm u 4. = w me i , monm 015 0 0 I o i 314 l 1 8 l9 - 0l2l4 - 0 10 013 0FIC,14 Analysis of'the Eventt j On October 19th, at 1608 hours, the Secondary Containment Dampers ware successfully tested. Successful completion of this , surveillance proves that the dampers were functional during the time frame over which they had not ~been. proven operable. Had an event occurred requiring their use, they would have functioned , properly, fulfilling their designed safety basis for secondary. containment isolation. Had this occurred at power, the dampets would still have performed their function. Therefore, this event did not affect the health and safety of the public, safety of the plant or result in any adverse safety consequences. Corrective Actions: A critique of this event vill be included in the required reading Program for Operations and Surveillance Group personnel. This required reading will increase the awareness of these personnel to the_ circumstances leading tc the missed rurveillance. The required reading is expected to be issued by November 30, 1989. i Additional training will be given to Operations Personnel. It will be designed to reinforce their understanding and awareness of the Situational Surveillance Program. This,will be completed ty

                 - December 20.-1989.

The Licensed Operator.Requalification Training Program will include a discussion of this event. The importance of a questioning attitude towards staying: on top of plant conditions and requirements as it relates to this event will be stressed. This will be complete by December 20.=1989.

                  .The surveillance engineer has been spending additional time with operations personnel, reviewing daily schedules and specisi condition reportn.                In addition. Operations Persornel heve been instructed by operations management to focus attention on the
                   " schedule" due dates for completing surveillances to reduce the need-to rely on the " critical"'due dates.

P N%C FORM 366A , 'U.S. CPoe 198d-5M-Sit t 00010

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4' f*5 ... UCENSEE EVENT REPORT (LER) TEXT CONTINUATION -. mnovto ous so. mo-oim EXPIRES: 8/31/s0 PACl617Y ! AM4 til DOCKET NVnenta (2) (gn gouagn gg) PAog (3) . , n " M P,',' vtan s ': *,'Jf,70 Fermi 2 o is l o j o l o'l 314 l 1 8l9 0 l 2l 4 - 0l0 0l4 0F 0 l4  ! s' rexT ta mi= m ..e=w. =. w unc 7.,= assa siit7) 7 t l

                        ' Previous Similar Events:                                          ,

i

LicenseeiEvent Reports (LER) 88-018 and LER;88-011.." Failure to ,

Perform:Shiftly Surveillances Within the Required Time" .LER , m 187-021, " Reactor Coolant System Leakage Limit. Surveillance

• Interval Exceeded Due to Personnel: Error". LER 87-048.." Inadequacies in Technical Specification Surveillances i f oundl during . Surveillanc e Reviewi' (which-lead to the Tech. Spec. .

L Improvements: Program)'.and LER 85-062, " Missed IRM Surveillance" E all describe-events-where'surveillances were missed due to personnel-error, g !f _.')" p L u r 1' {. l M b o k e FOLM 3esA ' ev.s. croe 1988 320 589,00070 I}}