NRC-89-0258, LER 89-025-00:on 891115,low Level 2 Signal Unintentionally Induced During Reactor Pressure Vessel Hydrostatic Pressure Test.Caused by Personnel Error.Personnel Counseled on Notifying & Coordinating Instrument lineups.W/891215 Ltr

LER 89-025-00:on 891115,low Level 2 Signal Unintentionally Induced During Reactor Pressure Vessel Hydrostatic Pressure Test.Caused by Personnel Error.Personnel Counseled on Notifying & Coordinating Instrument lineups.W/891215 Ltr

ML19332F799
Person / Time
Site:	Fermi
Issue date:	12/15/1989
From:	Orser W, Pendergast J DETROIT EDISON CO.
To:	NRC OFFICE OF INFORMATION RESOURCES MANAGEMENT (IRM)
References
CON-NRC-89-0258, CON-NRC-89-258 LER-89-025, LER-89-25, NUDOCS 8912190061
Download: ML19332F799 (4)

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1. Cllliam S. orser Vece Prestaent Nuclear Oprations ' ,

10CFR50.73 pj; ,

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p-_ December 15, 1989 L NRC-89-0258 U. S'.[ Nuclear Regulatory Commission '

Attention: Document Control Desk Washington, D.C. 20555

Reference:

Fermi 2 NRC Docket No. 50-341 Facility Operating License No -NPF-43 Subj ect : Licensee _ Event _ Report (LER)_No. 89-025-00

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Please find enclosed LER No. 89-025-00, dated December

15. 1989. for a reportable event that. occurred on.

• November 15, 1989. A copy of this'LER is also being sent .

to the Regional Administrator, USNRC Region'III.

If you have any questions, please contact Joseph-Pendergast at (313)'586-1682.

Sincerely, 4

Enclosure:

NRC Forms 366, 366A cc A. B. Davis J. R. Eckert R. W. Defayette/W. L. Axelson W. G. Rogers 1 J. F. Stang Wayne County Emergency 1 Management Division l

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8912190061 891215 PDR ADOCK 05000341 N 2 2- l

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F ACILITV NAME 111 DOCKET NUMSER (2) FAGEi3i Fermi 2 o is I o 10 l o f 3l4 l 1 1 lor)03 1 Reactor Scram Signal was Generated During the Performance of Instrument Valve Lineups EVENT DATI (St LER NUMeER tel REPORT DATE 171 OTHER F ACILiYlES INVOLVED ($1 MONTH DAY YEAR YEAR 38{Uy ' A, L [tu n$ MONTH DAY YEAR F ActLITV NAMES DOC AE T NUMBE RISP N/A o is to loio, i l

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LICEN5f t CONTACT FOR THIS LIR H26 ,

NAMI TE LEPHONE NUMBER AH&A CODE Joseph Pendergast, Licensing Engineer 3 i li 3 5i 8161-l1161812 COMPLETE Oht LINE FOR E ACH COMPONENT F AILURE DESCRISED IN THIS REPOR* (13)

NI' M C- REP " L CAUSE SYSTEM COMPONENT "")N( AC' TO PR 5" CAUSE SYSTEM COMPONENT N O NPR S , 1 1 I I i I I I i i t I I I I I I l i 1 I l l I I i l 1 1 SUPPLEMENTAL REPORT EXPECTED 114) MONTH DAY YEAR

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On November 15, 1989, at 0853 hours0.00987 days <br />0.237 hours <br />0.00141 weeks <br />3.245665e-4 months <br />. during the performance of the Reactor Pressure Vessel (RPV) Hydrostatic Pressure Test an RPV low level 2 signal was unintentionally induced. Consequentially, a reactor scram signal was generated and all safety systems responded as designed.

L An Instrument & Controls Repairman had been performing a valve i lineup verification in accordance with plant procedures. He was attempting to manipulate an instrument rack isolation valve which q i.

E was stuck. This caused a hydraulic vibration in the associated Reactor Level Transmitter line. The cause of this event was I&C personnel performing the instrument lineups while the reactor was pressurized for the Hydrostatic Pressure Test.

I As corrective action. I&C personnel will be counselled on notifying and coordinating instrument valve lineups with the Shift j Supervisor. This event will be added to the I&C Continuing Training as a Lessons Learned.

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. Operational Condition:~:4 (Cold Shutdown) -

' Reactor Power: 'OL Percent Reactor Temperature: 180 degrees Fahrenheit Reactor' Pressure: 965 pois -

. Description oLthe Even,n On' November 13, 1989. Instrument _& Controls personnel were )

authorized to began performing NPP-23.237, " Nuclear Boiler-System", section 4.2.3 " Nuclear Boiler System Instrument Lineup". The procedure involves the lineup of 275 instruments and requires several days to complete. ,

Onl November 15, 1989, at 0854 hours0.00988 days <br />0.237 hours <br />0.00141 weeks <br />3.24947e-4 months <br />, an I&C repairman assigned to perform the procedure was checking the position of an instrument rack. isolation valve (ISV) as part of the required lineup. He attempted to close the valve to off its' backseat positio_n'and then '

rotate it b a ck', - a s is good practice to prevent valve hangup. This vorified the valve's open position as required by procedure.

However.-the valve was stuck..and.when it'was released rapidly it created afhydraulic vibration. This actuated reactor water low ,

level sensing. instrumentation transmitter B21-N081B (LT).

Consequently, the Division I Alternate Rod (ROD) Insertion.

actuated at RPV Low Level 2 which depressurized the scram pilot aircheader, resulting in'a Reactor scram signal on high Scram-

-Discharge Volume level. Also, the Division I Core Spray (BG)

L Pumps (P).and Emergency Diesel Generators (EK) 11, 12 and 13 automatically started. Division II Core-Spray would have auto-started at Level'1 but was in off-reset. EDG #14 would'have i . auto-started but was out-of-service. Reactor Core Isolation cooling-(RCIC) (BN) also auto-started at Level 2 but tripped approximately 0.3 seconds later when the Level 8 trip occurred. .j The control rods were already inserted in the core except for

' control rod 30-11 which was fully withdrawn for scram time testing. It inserted on the scram signal. The scram was reset at

( The affected systems wcre returned to normal 0859 hours0.00994 days <br />0.239 hours <br />0.00142 weeks <br />3.268495e-4 months <br />.

operation by 1212 hours0.014 days <br />0.337 hours <br />0.002 weeks <br />4.61166e-4 months <br />.

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Cause'of the Event:

The cause of this event was I&C personnel performing the instrument lineups while the reactor was pressurized for the _

Since the instrument lineups required 1 Hydrostatic Pressure Test.

several days to complete. I&C personnel should have been checking ,

with the Nuclear Shift Supervisor shiftly for changing plant conditions, t A pressure transient was induced in a level sensing line with common reference lege for transmitters B21-N091 A&C and B21-N081B' which caused the actuations associated with Low Reactor Vessel Levels 1 2 and High Level 8.

A' contributing factor was the valve was stuck. When it was freed "

it moved rapidly creating a hydraulic _ vibration. Instruments on L th" shared sensing line interpreted this as an RPV low level s i, Ans o. f the Event  ;

The instrument rack pressure transient had no effect on the actual reactor vessel water _ level. It did however, affect reactor water level-instrumentation. Had the actual reactor vessel water level required the operation of the Engineered Safety Features systems involved, their actuation and performance would have already been initiated and performing their designed safety functions. If this event'would have occurred during' reactor operation an unexpected

_ plant shutdown would have been the result. Therefore the health and safety of plant personnel and the general public was protected ,

at all times.

Corrective Actions: t I&C personnel will be counselled on notifying and coordinating instrument valve lineups with the Shift Supervisor.by January 30, 1990. This event will be added to the I&C Continuing Training ~ as a " Lessons. Learned" for these personnel by the end of the first Quarter 1990.

Previous Similar Events:

There have been several events where isolations occurred while I&C personnel were working with instruments on the common reference legs. These other events were reported in Licensee Event Reports85-005, 85-014 85-015.85-021. 85-030,85-067 85-073 86-033,87-016 and 87-025.

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