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| | issue date = 12/12/1997 | | | issue date = 12/12/1997 |
| | title = LER 97-009-01:on 971114,identified That CR Console Switch for 3B SG Feedwater Pump Was Not in Start Position.Caused by Inadequate Procedural Guidance.Procedures 3/4-OP-074,SGFP Were revised.W/971212 Ltr | | | title = LER 97-009-01:on 971114,identified That CR Console Switch for 3B SG Feedwater Pump Was Not in Start Position.Caused by Inadequate Procedural Guidance.Procedures 3/4-OP-074,SGFP Were revised.W/971212 Ltr |
| | author name = HOVEY R J, MIHALAKEA S | | | author name = Hovey R, Mihalakea S |
| | author affiliation = FLORIDA POWER & LIGHT CO. | | | author affiliation = FLORIDA POWER & LIGHT CO. |
| | addressee name = | | | addressee name = |
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| {{#Wiki_filter:~CATEGORY 3g REGULATORY INFORMATION DISTRIBUTION SYSTEM (RIDS)ACCESSION NBR:9712170281 DOC.DATE: 97/12/12 NOTARIZED: | | {{#Wiki_filter:CATEGORY 3g |
| NO DOCKET FACIL:50-250 Turkey Point Plant, Unit 3, Florida Power and Light C 05000250 AUTH.NAME AUTHOR AFFILIATION MIHALAKEA,S. | | ~ |
| Florida Power&, Light Co.HOVEY,R.J. | | REGULATORY INFORMATION DISTRIBUTION SYSTEM (RIDS) |
| Florida Power 6 Light Co.RECIP.NAME RECIPIENT AFFILIATION | | ACCESSION NBR:9712170281 DOC.DATE: 97/12/12 NOTARIZED: NO DOCKET FACIL:50-250 Turkey Point Plant, Unit 3, Florida Power and Light C 05000250 AUTH. NAME AUTHOR AFFILIATION MIHALAKEA,S. Florida Power &, Light Co. |
| | HOVEY,R.J. Florida Power 6 Light Co. |
| | RECIP.NAME RECIPIENT AFFILIATION |
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| ==SUBJECT:== | | ==SUBJECT:== |
| LER 97-009-01:on 971114,identified that CR console switch for 3B SG feedwater pump was not in start position.Caused by inadequate procedural guidance.Procedures 3/4-OP-074,SGFP | | LER 97-009-01:on 971114,identified that CR console switch for 3B SG feedwater pump was not in start position. Caused by inadequate procedural guidance. Procedures 3/4-OP-074,SGFP revised.W/971212 ltr. 'ere DISTRIBUTION CODE: IE22T COPIES RECEIVED:LTR ENCL SIZE: |
| 'ere revised.W/971212 ltr.DISTRIBUTION CODE: IE22T COPIES RECEIVED:LTR ENCL SIZE: TITLE: 50.73/50.9 Licensee Event Report (LER), Incident Rpt, etc.NOTES: RECIPIENT ID CODE/NAME PD2-3 PD INTERNAL: AEO~D~)gl/
| | TITLE: 50.73/50.9 Licensee Event Report (LER), Incident Rpt, etc. |
| E CENTE R EELB NRR/DRCH/HHFB NRR/DRCH/HOLB NRR/DRPM/PECB NRR/DSSA/SRXB RGN2 FILE 01 EXTERNAL: L ST LOBBY WARD NOAC POORE,W.NRC PDR COPIES LTTR ENCL 1 1.2 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 RECIPIENT ID CODE/NAME CROTEAU,R AEOD/S PD/RRAB NRR/DE/ECGB NRR/DE/EMEB NRR/DRCH/HICB NRR/DRCH/HQMB NRR/DSSA/SPLB RES/DET/EIB LITCO BRYCE,J H NOAC QUEENER,DS NUDOCS FULL TXT COPIES LTTR ENCL 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 D M E N NOTE TO ALL"RIDS" RECIPIENTS:
| | NOTES: |
| PLEASE HELP US TO REDUCE WASTE.TO HAVE YOUR NAME OR ORGANIZATION REMOVED FROM DISTRIBUTION LISTS OR REDUCE THE NUMBER OF COPIES RECEIVED BY YOU OR YOUR ORGANIZATION, CONTACT THE DOCUMENT CONTROL DESK (DCD)ON EXTENSION 415-2083 FULL TEXT CONVERSION REQUIRED TOTAL NUMBER OF COPIES REQUIRED: LTTR 24 ENCL 24 DEt.'j.21997 L-97-294 10 CFR 50.73 U.S.Nuclear Regulatory Commission Attn: Document Control Desk Washington, D.C.20555 Re: Turkey Point Unit 3 Docket No.50-250 Reportable Event: 97-009 Date of Event: November 14, 1997 Console Switch Position Disabled Auxilia Feedwater Auto Start Lo ic on 3B Steam Generator Feedwater Pum Tri The attached Licensee Event Report is being submitted pursuant to the requirements of 10 CFR 50.73 to provide notification of the subject event.Sincerely, R.J.Hovey Vice President Turkey Point Plant SM Attachment cc: Regional Administrator, USNRC Region II Senior Resident Inspector, USNRC, Turkey Point Plant I 97i2i7028i 97i2i2 PDR ADQCK 05000250 8 PDR lllllllf fill lllllllflllflllfll IIIfff f an FPL Group company LICENSEE EVENT REPORT{LER)fACILITY t(AME (1)TURKEY POINT UNIT 3 DOCKET NUMBER (2)05000250 PAGE (3)1 Of 6 TITLE (4)Console Switch Position Disabled Auxiliary Feedwater Auto Start Logic on 3B Steam Generator Feedwater Pump Trip MOH EVENT DATE (5)DAY YR YR SEQ (LER NUMBER(6)R(MON DAY RPT DATE (7)YR OTHER FACILITIES INV.(8)FACILITY NAMES DCCKET I (S)11 14 97 97 09 00 12 12 97 OPERATING MODE (91 POWDER LEVEL (10)100 10 CFR 50.73 (a)(2)(I)(B)LICENSEE CONTACT FOR THIS LER (12)S MIHALAKEAg LICENS ING ENGINEER Telephone Number (305)246-6454 COMPLETE ONE LINE FOR EACH COMPONENT FAILURE DESCRIBED IN THIS REPORT (13)CAUSE SYSTEM COMPONENT MANUfACTURER NPRDS?CAUSE SYSTEM COMPONENT MANUfACTURER NPRDS?SUPPLEMEHTAL REPORT EXPECTED (14)HO YES 0 (if yes, complete EXPECTED SUBMISSION DATE)EXPECTED SUBMISSION DATE (15)MOt(TH DAY ABSTRACT (16)On 11/14/97, the Reactor Control Operator identified that the Control Room (CR)console switch for the 3B Steam Generator Feedwater Pump (SGFW)pump was not in the start position.The 3B SGFW pump had been locally started on 7/30/97, while Unit 3 was in Mode 3.Technical Specification (TS)Table 3.3-2, Item 6.e, requires Auxiliary Feedwater (AFW)actuation on trip of all main feedwater pumps breakers during Modes 1 and 2.Item 6.e of TS Table 3.3-2, was not met from 7/31/97 (when Unit 3 entered Mode 2), until 11/14/97 because the minimum operating channels requirement includes having each pump switch semaphore in the operating position (red flag).This AFW auto-start feature is an anticipatory AFW actuation for a Steam Generator Low-Low level.The AFW auto-start on SGFW pump trip was disabled only when SGFW pump 3A was not running during Modes 1 and 2.The 3A SGFW pump was not running from 0413 until 1845 on 7/31/97, and again from 1044 on 8/14/97, until 1010 on 8/15/97., At 1820 on 11/14/97, the CR console switch for the 3B SGFW pump was momentarily placed in the start position, restoring the AFW automatic start actuation circuit for the 3B SGFW pump.Procedure revisions to add local start requirements for the SGFW pump in Modes 3, 4, and 5, were reviewed to ensure they contain all necessary guidance.Operations verified that all CR switch semaphores match component indicating lights.A training brief was issued describing the event and its significance. | | RECIPIENT COPIES RECIPIENT COPIES ID CODE/NAME LTTR ENCL ID CODE/NAME LTTR ENCL PD2-3 PD 1 1. CROTEAU,R 1 1 INTERNAL: AEO~D~)gl/ 2 2 AEOD/S PD/RRAB 1 1 E CENTE 1 1 NRR/DE/ECGB 1 1 R EELB 1 1 NRR/DE/EMEB 1 1 NRR/DRCH/HHFB 1 1 NRR/DRCH/HICB 1 1 NRR/DRCH/HOLB 1 1 NRR/DRCH/HQMB 1 1 NRR/DRPM/PECB 1 1 NRR/DSSA/SPLB 1 1 NRR/DSSA/SRXB 1 1 RES/DET/EIB 1 1 RGN2 FILE 01 1 1 D |
| | EXTERNAL: L ST LOBBY WARD 1 1 LITCO BRYCE,J H 1 1 NOAC POORE,W. 1 1 NOAC QUEENER,DS 1 1 NRC PDR 1 1 NUDOCS FULL TXT 1 1 M |
| | E N |
| | NOTE TO ALL "RIDS" RECIPIENTS: |
| | PLEASE HELP US TO REDUCE WASTE. TO HAVE YOUR NAME OR ORGANIZATION REMOVED FROM DISTRIBUTION LISTS OR REDUCE THE NUMBER OF COPIES RECEIVED BY YOU OR YOUR ORGANIZATION, CONTACT THE DOCUMENT CONTROL DESK (DCD) ON EXTENSION 415-2083 FULL TEXT CONVERSION REQUIRED TOTAL NUMBER OF COPIES REQUIRED: LTTR 24 ENCL 24 |
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| C LICENSEE EVENT REPORT (LER)TEXT CONTINUATION FACILITY NAME'URKEY POINT UNIT 3 DOCKET NUMBER 05000250 LER NUMBER 97-009-00 PAGE NO.2 OF 6 BACKGROUND The 3B Steam Generator Feedwater Pump(SGFW) pump[SJ:p]was started locally on July 30, 1997, while Unit 3 was in Mode 3.The associated SGFN pump Control Room (CR)console switch[SJ:js]was not placed in the start position.Operations personnel considered the decision to start the first SGFW pump locally as conservative, because the local start would prevent an inadvertent Auxiliary Feedwater (AFN)[BA]actuation if the SGFW pump breaker failed to close.On April 11, 1997, with Turkey Point Unit 3 in Mode 3, AFN was inadvertently actuated during an attempt to start the 3B SGFW pump, when the associated pump breaker failed to close.This event was reported in LER 250/97-004.
| | DEt. 'j. 21997 L-97-294 10 CFR 50.73 U. S. Nuclear Regulatory Commission Attn: Document Control Desk Washington, D. C. 20555 Re: Turkey Point Unit 3 Docket No. 50-250 Reportable Event: 97-009 Date of Event: November 14, 1997 Console Switch Position Disabled Auxilia Feedwater Auto Start Lo ic on 3B Steam Generator Feedwater Pum Tri The attached Licensee Event Report is being submitted pursuant to the requirements of 10 CFR 50.73 to provide notification of the subject event. |
| It was determined that an inadvertent AFW actuation may occur while attempting,to start the pump from the CR if the breaker were to fail to close while the other SGFN pump is not operating.
| | Sincerely, R. J. Hovey Vice President Turkey Point Plant SM Attachment cc: Regional Administrator, USNRC Region II Senior Resident Inspector, USNRC, Turkey Point Plant I |
| It was recommended that the first SGFW pump be started using the local push-button during Mode 3.Using the local push-button prevents an AFW automatic actuation if the associated pump breaker fails to close.Following the pump start using the local push-button, the CR console switch must be cycled to the start position in order to enable the AFW automatic start actuation circuit and provide evidence of this action by displaying the red flag.As a result, procedural changes were required to incorporate guidance for starting the first SGFW pump during Mode 3 using the local push-button.
| | 97i2i7028i 97i2i2 lllllllffill lllllllflllflllfll PDR ADQCK 05000250 IIIffff 8 PDR an FPL Group company |
| These procedural changes were initiated on July 22, 1997, and were not approved until August 25, 1997.Consequently, on July 30, 1997, when a reactor trip occurred as a result of an inadvertent closure of the 3B Main Steam Isolation Valve[SB:isv](LER 250 97-007), the procedures used to start the 3B pump had not been changed to address locally starting a SGFW pump.II.DESCRIPTION OF THE EVENT On November 14, 1997, Turkey Point Unit 3 was running at 100%power.At approximately 1800 hours, during the once per shift review of 3-OSP-201.1, Reactor Control Operator (RCO)Daily Logs Minimum Instrumentation and Equipment List, the RCO questioned why the 3B SGFW pump CR console switch had a green flag semaphore[SJ:js, zi]even though the pump was operating.
| | |
| The"green flagged" semaphore indicates that the last demand by the switch was to stop the pump.Technical Specification Table 3.3-2, Item 6.e, requires automatic actuation of AFW on the trip of all Main Feedwater pump breakers for Modes 1 and 2.It was determined that Technical Specification Table 3.3-2, Item 6.e had not been met since Unit 3 entered Mode 2 on July 31, 1997.Operations personnel determined that the as found condition would prevent an AFW automatic start actuation on SGFW pump trip if the 3B SGFW pump was the only feed pump running and the 3B SGFW pump motor breaker tripped.Although the Technical Specification requirements were not met from July 31, 1997 until November 14, 1997, the AFW automatic start actuation on SGFW pump trip was only disabled when the SGFN pump 3A was not running during Modes 1 and 2.Operator logs show that the 3A,SGFW pump was not running from July 31, 1997, at 0413 hours (when Unit 3 entered Mode 2), until July 31, 1997, at 1845 hours, and again from August 14, 1997, at 1044 hours until August 15, 1997, at 1010 hours.The entry into Mode 2 on July 31, 1997, also violated Technical Specification 3.0.4, which requires that,"Entry into an OPERATIONAL MODE...shall not be made when the conditions for the Limiting Condition for Operation are not met...".During the period in which the condition existed, Technical Specification 3.0.4 was violated twice more when mode changes took place;when Unit 3 entered Mode 1 later on July 31, 1997, and again when Unit 3 entered Mode 1, on August 15, 1997.
| | LICENSEE EVENT REPORT {LER) fACILITY t(AME (1) DOCKET NUMBER (2) PAGE (3) |
| I LICENSEE EVENT REPORT (LER)TEXT CONTINUATION FACILITY NAME TURKEY POINT UNIT 3 DOCKET NUMBER 05000250 LER NUMBER 97-009-00 PAGE NO.3 OF 6 The AFW automatic start actuation on SGFW pump trip for the 3B SGFW pump was restored on November 14, 1997, at 1820 hours by momentarily placing the CR console switch to the start position and returning the switch to the mid position.This action aligned the CR switch contacts to restore the interlock and changed the switch semaphore from green to red.III.SYSTEM DESCRIPTION The trip of all SGFW pumps is a non-safety related AFW actuation feature.AFW will automatically actuate on the loss of both feedwater pumps under normal operating conditions, as described in Section 9.11.2 of the Updated Final Safety Analysis Report (UFSAR).The AFW automatic start feature is an anticipatory AFW actuation for a Steam Generator (SJ:sg)Low-Low level condition associated with the Loss of Feedwater Flow event.This anticipatory Engineering Safety Feature (ESF)actuation is required in Technical Specification Table, 3.3-2, Item G.e.The Technical Specifications minimum channel operable requirement is one channel per breaker per operating pump, in Modes 1 and 2.The SGFW pump CR console switch is a three position, STOP/START and spring return to middle position switch.These CR console switches have a semaphore (small red/green flag)window which indicates if the switch was last in the open (green)or closed (red)position.The SGFW pump switches are part of the AFW initiation logic in order to avoid an AFW initiation when the SGFW pumps are manually stopped.With either of the two pump control switches in the middle position after having been in the start position and with both of the two pump breakers open, AFW will be initiated.
| | TURKEY POINT UNIT 3 05000250 1 Of 6 TITLE (4) Console Switch Position Disabled Auxiliary Feedwater Auto Start Logic on 3B Steam Generator Feedwater Pump Trip EVENT DATE (5) LER NUMBER(6) RPT DATE (7) OTHER FACILITIES INV. (8) |
| When only one pump is operating, the tripping of that pump will initiate AFW.Starting a SGFW pump locally does not enable the AFW automatic start logic.Using the local push-button, AFW automatic start would not be actuated if a pump breaker failed to close.Following the SGFW pump start using the local push-button, the CR console switch must be cycled to the start position in order to enable the AFW automatic actuation circuit as evidenced by the red flag.IV.ANALYSIS OF THE EVENT An event investigation was performed to determine the causes of the mismatched CR switch semaphore on the 3B SGFW pump that existed from July 30, 1997 to November 14, 1997.The results of the event investigation identified the following:
| | MOH DAY YR YR SEQ ( R( MON DAY YR FACILITY NAMES DCCKET I (S) 11 14 97 97 09 00 12 12 97 OPERATING MODE (91 10 CFR 50.73 (a) (2) (I) (B) |
| The 3B SGFW pump was started locally on July'30, 1997, at 1634 hours while Unit 3 was in Mode 3.Operator log reviews and personnel interviews show that historically the SGFW pumps have been started from the control room with the exception of tests, for example, bumping the motor for rotation, stroking the motor operated discharge valve.An information tag was placed over the 3B SGFW pump CR console switch semaphore indicator because of recent pump casing deficiencies.
| | POWDER LEVEL 100 (10) |
| The CR console switch semaphore was not considered as an indicator for the SGFW pump.Operations personnel did not zegard the tag as improperly placed over a SGFW pump indicator. | | LICENSEE CONTACT FOR THIS LER (12) |
| This tag hid the status of the switch from operators performing board walkdowns.
| | Telephone Number S MIHALAKEAg LICENS ING ENGINEER (305) 246-6454 COMPLETE ONE LINE FOR EACH COMPONENT FAILURE DESCRIBED IN THIS REPORT (13) |
| LICENSEE EVENT REPORT (LER)TEXT CONTINUATION FACILITY NAME TURKEY POINT UNIT 3 DOCKET NUMBER 05000250 LER NUMBER 97-009-00 PAGE NO.4 OF 6~The procedure utilized to start the 3B SGFW pump locally, Procedure 3-OP-74, Steam Generator Feedwater Pump, did not provide specific guidance to start the SGFW pump locally.Operations personnel were aware that Engineering had evaluated the use of the local start control switch as a method to prevent an inadvertent AFW actuation when attempting to start the first SGFW pump.The procedural changes to incorporate specific guidance to start a SGFW pump locally were initiated on July 22, 1997.These changes were approved on August 25, 1997.Previous start failures of the SGFW pumps led to a decision to perform local starts of the pumps when in Modes 3, 4, 5.This evolution creates the potential for not meeting Technical Specification Table 3.3-2, Item 6.e.requirements if the CR console switch is left in the stop (returned to middle)position (green flagged)when entering Modes 1, and 2.The 3B SGFW pump was started locally, but the CR console switch was not placed to start to actuate the AFW automatic start interlock after the pump was running.The Technical Specification Table 3.3-2, Item 6.e was not met from July 31, 1997, when Mode 2 was entered at approximately 0413 hours, until November 14, 1997, at approximately 1820 hours, when the AFW automatic start actuation on SGFW pump trip for the 3B SGFW pump was restored.However, the AFW automatic start actuation on SGFW pump trip was disabled only when 3A SGFW pump was not running during Modes 1 and 2, for approximately 14.5 hours on July 31, 1997, and for approximately 24 hours during August 14-15, 1997.CAUSE OF THE EVENT The root cause for this event is inadequate procedural guidance for starting the SGFW pump locally without enabling the AFW automatic start circuit by momentarily placing the CR console switch to start.This information needed to be provided to the CR Operators, that entry into Modes 1 and 2 without momentarily placing the CR console switch to start (as evidenced by the switch semaphore red flag)would not meet the requirements of Technical Specification Table 3.3-2, Item 6.e.There are several causal factors that contributed to the duration of time before the SGFW pump CR console switch was repositioned to restore the AFW actuation interlock.
| | CAUSE SYSTEM COMPONENT MANUfACTURER NPRDS? CAUSE SYSTEM COMPONENT MANUfACTURER NPRDS? |
| The CR console switch semaphore flag was covered by an information tag that prevented the discovery during operator board walkdowns. | | SUPPLEMEHTAL REPORT EXPECTED (14) HO YES 0 EXPECTED SUBMISSION MOt(TH DAY DATE (15) |
| Operations personnel were not aware of the significance associated with the SGFW pump CR console switch alignment and semaphore indication. | | (if yes, complete EXPECTED SUBMISSION DATE) |
| Operations personnel did not have an adequate knowledge level associated with the SGFW pump CR console switch alignment requirements and the significance of the semaphore indication.
| | ABSTRACT (16) |
| Operations personnel had been instructed not to reposition switches to align semaphores unless directed by procedure.-
| | On 11/14/97, the Reactor Control Operator identified that the Control Room (CR) console switch for the 3B Steam Generator Feedwater Pump (SGFW) pump was not in the start position. The 3B SGFW pump had been locally started on 7/30/97, while Unit 3 was in Mode 3. |
| General Operating Procedure, 3/4-GOP-301, Hot Standby to Power Operations, requires a CR console switch alignment check prior to a mode change, but this verification did not include the SGFW pump control switches or semaphores.
| | Technical Specification (TS) Table 3.3-2, Item 6.e, requires Auxiliary Feedwater (AFW) actuation on trip of all main feedwater pumps breakers during Modes 1 and 2. Item 6.e of TS Table 3.3-2, was not met from 7/31/97 (when Unit 3 entered Mode 2), until 11/14/97 because the minimum operating channels requirement includes having each pump switch semaphore in the operating position (red flag). This AFW auto-start feature is an anticipatory AFW actuation for a Steam Generator Low-Low level. The AFW auto-start on SGFW pump trip was disabled only when SGFW pump 3A was not running during Modes 1 and 2. The 3A SGFW pump was not running from 0413 until 1845 on 7/31/97, and again from 1044 on 8/14/97, until 1010 on 8/15/97., |
| -0 LICENSEE EVENT REPORT (LER)TEXT CONTINUATION FACILITY NAME TURKEY POINT UNIT 3 DOCKET NUMBER 05000250 LER NUMBER 97-009-00 PAGE NO.5 OF 6 VI.SAFETY SIGNIFICANCE The three turbine driven AFW pumps (shared by Turkey Point Units 3&4)aze started on any of the following signals: a)Low-Low water level in any steam generator, b)any Safety Injection signal, c)loss of offsite power d)loss of either A or B 4.16 kv bus on either unit, e)trip of all running Main Feedwater pumps on either unit f)ATWS Mitigating System Actuation Circuitry (AMSAC), g)manual actuation.
| | At 1820 on 11/14/97, the CR console switch for the 3B SGFW pump was momentarily placed in the start position, restoring the AFW automatic start actuation circuit for the 3B SGFW pump. Procedure revisions to add local start requirements for the SGFW pump in Modes 3, 4, and 5, were reviewed to ensure they contain all necessary guidance. |
| The UFSAR Chapter 14 accident analysis credits AFW for mitigation of several events.The following events which credit AFW were reviewed: 1)Loss of Normal Feedwater, 2)Loss of Non Emergency AC to plant auxiliaries, 3)Steam Generator Tube Rupture, 4)Main Steam Line Break, and 5)Small Break Loss of Coolant Accident.The loss of Normal Feedwater Flow transient is analyzed in Section 14.1.11 of the UFSAR.The event assumes that AFW is initiated conservatively 120 seconds following the start of the signal on the Low-Low Steam Generator level signal.The loss of Non Emergency AC Power to plant auxiliaries is analyzed in Section 14.1.12 of the UFSAR.The analysis assumes that AFW is initiated on the Low-Low Steam Generator level signal.The Steam Generator Tube Rupture transient is analyzed in Section 14.2.4 of the UFSAR.For this event AFW i's initiated on the Safety Injection signal.The Main Steam Line Break transient is analyzed in Section 14.2.5 of the UFSAR.AFW is initiated on the Safety Injection signal.The Small Break LOCA is analyzed in Section 14.3.2.2 of the UFSAR~AFW is initiated on the Safety Injection signal.Based on the review of these events, it is concluded that the AFW automatic start initiation credited in the analyses is based on Safety Injection or Low-Low Steam Generator Water Level signals.There are no analyses which credit the AFW automatic initiation on the trip of all running Main Feedwater pumps.The actuation of AFW due to loss of the running SGFW pump is anticipatory. | | Operations verified that all CR switch semaphores match component indicating lights. |
| Additionally, all risk dominant scenarios requiring the operation of AFW are associated with Low-Low steam generator levels.Since Low-Low steam generator level would have provided actuation of the AFW, the risk impact of the Main Feedwater related AFW actuation failure is not significant.
| | A training brief was issued describing the event and its significance. |
| Therefore, it is concluded that there is no safety significance associated with the as found condition.
| | |
| VII.'ORRECTIVE ACTIONS 1)Procedures 3/4-OP-074, Steam Generator Feed Pump, were revised to incorporate the requirements to locally start the first SGFW pump in Modes 3,4, and 5.These revisions were reviewed to ensure they contain all necessary guidance for local SGFW pump starts.2)An Operations Department Night Order has been issued informing personnel of the event.Emphasis was placed on the SGFW pump CR console switch alignment requirements and the placement of information tags.3)The control room was walked down to ensure other information tags were not obscuring control board indication.
| | C LICENSEE EVENT REPORT (LER) TEXT CONTINUATION FACILITY DOCKET NUMBER LER NUMBER PAGE NO. |
| LICENSEE EVENT REPORT (LER)TEXT CONTINUATION FACILITY NAME TURKEY POINT UNIT 3 DOCKET NUMBER 05000250 LER NUMBER 97-009-00 PAGE NO.6 OF 6 4)Training Brief 703, AFW pump Automatic-Start Logic, has been issued describing the event and the logic of the AFW automatic actuation on loss of all running SGFW pumps.5)General Operating Procedure, 3/4-GOP-301, Hot Standby to Power Operations, has been revised to incorporate switch alignment checks for the SGFW pump CR console switches including verification of the semaphore indication.
| | POINT UNIT 3 NAME'URKEY 05000250 97-009-00 2 OF 6 BACKGROUND The 3B Steam Generator Feedwater Pump(SGFW) pump [SJ:p] was started locally on July 30, 1997, while Unit 3 was in Mode 3. The associated SGFN pump Control Room (CR) console switch [SJ:js] was not placed in the start position. Operations personnel considered the decision to start the first SGFW pump locally as conservative, because the local start would prevent an inadvertent Auxiliary Feedwater (AFN) [BA] |
| 6)Operations performed a control board walkdown and verified that CR switch semaphores match associated component indicating lights.7)Engineering will perform a review to determine if other CR switches with semaphore indication have a control function that is inhibited if the semaphore does not match the component indicating light.8)FPL is pursuing an enhanced information tag or method of controlling tag installation to ensure control board indication is not obscured from view.9)The SGFW pump CR console switch semaphore alignment and AFW actuation logic has been verified on the plant simulator.
| | actuation if the SGFW pump breaker failed to close. |
| The Training Department will demonstrate this event during licensed operator simulator training.VIII.ADDITIONAL INFORMATION There have been two other events reported related to the AFW Actuation Automatic Start logic.These events were LERs 250/96-004, and 250/97-004. | | On April 11, 1997, with Turkey Point Unit 3 in Mode 3, AFN was inadvertently actuated during an attempt to start the 3B SGFW pump, when the associated pump breaker failed to close. This event was reported in LER 250/97-004. |
| LER 250/96-004 pertained to the inadequate surveillance testing of the AFW actuation circuitry.
| | determined that an inadvertent AFW actuation may occur while attempting,to start It was the pump from the CR if the breaker were to fail to close while the other SGFN pump is not operating. It was recommended that the first SGFW pump be started using the local push-button during Mode 3. Using the local push-button prevents an AFW automatic actuation if the associated pump breaker fails to close. Following the pump start using the local push-button, the CR console switch must be cycled to the start position in order to enable the AFW automatic start actuation circuit and provide evidence of this action by displaying the red flag. As a result, procedural changes were required to incorporate guidance for starting the first SGFW pump during Mode 3 using the local push-button. These procedural changes were initiated on July 22, 1997, and were not approved until August 25, 1997. |
| LER 250/97-004 is directly related to this event.The local start of the SGFW pump was an approved corrective action for preventing an inadvertent AFW initiation when the breaker for the first pump fails to close while attempting to start the first SGFW pump from the CR console switch.The AFW Initiation logic diagram for the loss of SGFW pumps is attached.EIIS Codes are shown in the format[EIIS SYSTEM: IEEE component function identifier, second component identifier
| | Consequently, on July 30, 1997, when a reactor trip occurred as a result of an inadvertent closure of the 3B Main Steam Isolation Valve [SB:isv](LER 250 97-007), |
| {if appropriate)).}} | | the procedures used to start the 3B pump had not been changed to address locally starting a SGFW pump. |
| | II. DESCRIPTION OF THE EVENT On November 14, 1997, Turkey Point Unit 3 was running at 100% power. At approximately 1800 hours, during the once per shift review of 3-OSP-201.1, Reactor Control Operator (RCO) Daily Logs Minimum Instrumentation and Equipment List, the RCO questioned why the 3B SGFW pump CR console switch had a green flag semaphore |
| | [SJ:js, zi] even though the pump was operating. The "green flagged" semaphore indicates that the last demand by the switch was to stop the pump. |
| | Technical Specification Table 3.3-2, Item 6.e, requires automatic actuation of AFW on the trip of all Main Feedwater pump breakers for Modes 1 and 2. It was determined that Technical Specification Table 3.3-2, Item 6.e had not been met since Unit 3 entered Mode 2 on July 31, 1997. Operations personnel determined that the as found condition would prevent an AFW automatic start actuation on SGFW pump if trip the 3B SGFW pump was the only feed pump running and the 3B SGFW pump motor breaker tripped. Although the Technical Specification requirements were not met from July 31, 1997 until November 14, 1997, the AFW automatic start actuation on SGFW pump trip was only disabled when the SGFN pump 3A was not running during Modes 1 and 2. Operator logs show that the 3A,SGFW pump was not running from July 31, 1997, at 0413 hours (when Unit 3 entered Mode 2), until July 31, 1997, at 1845 hours, and again from August 14, 1997, at 1044 hours until August 15, 1997, at 1010 hours. |
| | The entry into Mode 2 on July 31, 1997, also violated Technical Specification 3.0.4, which requires that, "Entry into an OPERATIONAL MODE...shall not be made when the conditions for the Limiting Condition for Operation are not met...". |
| | During the period in which the condition existed, Technical Specification 3.0.4 was violated twice more when mode changes took place; when Unit 3 entered Mode 1 later on July 31, 1997, and again when Unit 3 entered Mode 1, on August 15, 1997. |
| | |
| | I LICENSEE EVENT REPORT (LER) TEXT CONTINUATION FACILITY NAME DOCKET NUMBER LER NUMBER PAGE NO. |
| | TURKEY POINT UNIT 3 05000250 97-009-00 3 OF 6 The AFW automatic start actuation on SGFW pump trip for the 3B SGFW pump was restored on November 14, 1997, at 1820 hours by momentarily placing the CR console switch to the start position and returning the switch to the mid position. This action aligned the CR switch contacts to restore the interlock and changed the switch semaphore from green to red. |
| | III. SYSTEM DESCRIPTION The trip of all SGFW pumps is a non-safety related AFW actuation feature. AFW will automatically actuate on the loss of both feedwater pumps under normal operating conditions, as described in Section 9.11.2 of the Updated Final Safety Analysis Report (UFSAR). The AFW automatic start feature is an anticipatory AFW actuation for a Steam Generator (SJ:sg) Low-Low level condition associated with the Loss of Feedwater Flow event. This anticipatory Engineering Safety Feature (ESF) actuation is required in Technical Specification Table, 3.3-2, Item G.e. The Technical Specifications minimum channel operable requirement is one channel per breaker per operating pump, in Modes 1 and 2. |
| | The SGFW pump CR console switch is a three position, STOP/START and spring return to middle position switch. These CR console switches have a semaphore (small red/green flag) window which indicates if the switch was last in the open (green) or closed (red) position. The SGFW pump switches are part of the AFW initiation logic in order to avoid an AFW initiation when the SGFW pumps are manually stopped. |
| | With either of the two pump control switches in the middle position after having been in the start position and with both of the two pump breakers open, AFW will be initiated. When only one pump is operating, the tripping of that pump will initiate AFW. |
| | Starting a SGFW pump locally does not enable the AFW automatic start logic. Using the local push-button, AFW automatic start would not be actuated if a pump breaker failed to close. Following the SGFW pump start using the local push-button, the CR console switch must be cycled to the start position in order to enable the AFW automatic actuation circuit as evidenced by the red flag. |
| | IV. ANALYSIS OF THE EVENT An event investigation was performed to determine the causes of the mismatched CR switch semaphore on the 3B SGFW pump that existed from July 30, 1997 to November 14, 1997. The results of the event investigation identified the following: |
| | The 3B SGFW pump was started locally on July '30, 1997, at 1634 hours while Unit 3 was in Mode 3. |
| | Operator log reviews and personnel interviews show that historically the SGFW pumps have been started from the control room with the exception of tests, for example, bumping the motor for rotation, stroking the motor operated discharge valve. |
| | An information tag was placed over the 3B SGFW pump CR console switch semaphore indicator because of recent pump casing deficiencies. The CR console switch semaphore was not considered as an indicator for the SGFW pump. Operations personnel did not zegard the tag as improperly placed over a SGFW pump indicator. This tag hid the status of the switch from operators performing board walkdowns. |
| | |
| | LICENSEE EVENT REPORT (LER) TEXT CONTINUATION FACILITY NAME DOCKET NUMBER LER NUMBER PAGE NO. |
| | TURKEY POINT UNIT 3 05000250 97-009-00 4 OF 6 |
| | ~ The procedure utilized to start the 3B SGFW pump locally, Procedure 3-OP-74, Steam Generator Feedwater Pump, did not provide specific guidance to start the SGFW pump locally. Operations personnel were aware that Engineering had evaluated the use of the local start control switch as a method to prevent an inadvertent AFW actuation when attempting to start the first SGFW pump. The procedural changes to incorporate specific guidance to start a SGFW pump locally were initiated on July 22, 1997. These changes were approved on August 25, 1997. |
| | Previous start failures of the SGFW pumps led to a decision to perform local starts of the pumps when in Modes 3, 4, 5. This evolution creates the potential for not meeting Technical Specification Table 3.3-2, Item 6.e. |
| | requirements if the CR console switch is left in the stop (returned to middle) position (green flagged) when entering Modes 1, and 2. |
| | The 3B SGFW pump was started locally, but the CR console switch was not placed to start to actuate the AFW automatic start interlock after the pump was running. The Technical Specification Table 3.3-2, Item 6.e was not met from July 31, 1997, when Mode 2 was entered at approximately 0413 hours, until November 14, 1997, at approximately 1820 hours, when the AFW automatic start actuation on SGFW pump trip for the 3B SGFW pump was restored. However, the AFW automatic start actuation on SGFW pump trip was disabled only when 3A SGFW pump was not running during Modes 1 and 2, for approximately 14.5 hours on July 31, 1997, and for approximately 24 hours during August 14-15, 1997. |
| | CAUSE OF THE EVENT The root cause for this event is inadequate procedural guidance for starting the SGFW pump locally without enabling the AFW automatic start circuit by momentarily placing the CR console switch to start. This information needed to be provided to the CR Operators, that entry into Modes 1 and 2 without momentarily placing the CR console switch to start (as evidenced by the switch semaphore red flag) would not meet the requirements of Technical Specification Table 3.3-2, Item 6.e. |
| | There are several causal factors that contributed to the duration of time before the SGFW pump CR console switch was repositioned to restore the AFW actuation interlock. |
| | The CR console switch semaphore flag was covered by an information tag that prevented the discovery during operator board walkdowns. |
| | Operations personnel were not aware of the significance associated with the SGFW pump CR console switch alignment and semaphore indication. |
| | Operations personnel did not have an adequate knowledge level associated with the SGFW pump CR console switch alignment requirements and the significance of the semaphore indication. Operations personnel had been instructed not to reposition switches to align semaphores unless directed by procedure.- |
| | General Operating Procedure, 3/4-GOP-301, Hot Standby to Power Operations, requires a CR console switch alignment check prior to a mode change, but this verification did not include the SGFW pump control switches or semaphores. |
| | |
| | - 0 LICENSEE EVENT REPORT (LER) TEXT CONTINUATION FACILITY NAME DOCKET NUMBER LER NUMBER PAGE NO. |
| | TURKEY POINT UNIT 3 05000250 97-009-00 5 OF 6 VI. SAFETY SIGNIFICANCE The three turbine driven AFW pumps (shared by Turkey Point Units 3&4) aze started on any of the following signals: a) Low-Low water level in any steam generator, b) any Safety Injection signal, c) loss of offsite power d) loss of either A or B 4.16 kv bus on either unit, e) trip of all running Main Feedwater pumps on either unit f) ATWS Mitigating System Actuation Circuitry (AMSAC), g) manual actuation. |
| | The UFSAR Chapter 14 accident analysis credits AFW for mitigation of several events. The following events which credit AFW were reviewed: 1) Loss of Normal Feedwater, 2) Loss of Non Emergency AC to plant auxiliaries, 3) Steam Generator Tube Rupture, 4) Main Steam Line Break, and 5) Small Break Loss of Coolant Accident. |
| | The loss of Normal Feedwater Flow transient is analyzed in Section 14.1.11 of the UFSAR. The event assumes that AFW is initiated conservatively 120 seconds following the start of the signal on the Low-Low Steam Generator level signal. |
| | The loss of Non Emergency AC Power to plant auxiliaries is analyzed in Section 14.1.12 of the UFSAR. The analysis assumes that AFW is initiated on the Low-Low Steam Generator level signal. |
| | The Steam Generator Tube Rupture transient is analyzed in Section 14.2.4 of the UFSAR. For this event AFW i's initiated on the Safety Injection signal. |
| | The Main Steam Line Break transient is analyzed in Section 14.2.5 of the UFSAR. |
| | AFW is initiated on the Safety Injection signal. |
| | The Small Break LOCA is analyzed in Section 14.3.2.2 of the UFSAR ~ AFW is initiated on the Safety Injection signal. |
| | Based on the review of these events, it is concluded that the AFW automatic start initiation credited in the analyses is based on Safety Injection or Low-Low Steam Generator Water Level signals. There are no analyses which credit the AFW automatic initiation on the trip of all running Main Feedwater pumps. The actuation of AFW due to loss of the running SGFW pump is anticipatory. Additionally, all risk dominant scenarios requiring the operation of AFW are associated with Low-Low steam generator levels. Since Low-Low steam generator level would have provided actuation of the AFW, the risk impact of the Main Feedwater related AFW actuation failure is not significant. Therefore, it is concluded that there is no safety significance associated with the as found condition. |
| | VII.'ORRECTIVE ACTIONS |
| | : 1) Procedures 3/4-OP-074, Steam Generator Feed Pump, were revised to incorporate the requirements to locally start the first SGFW pump in Modes 3,4, and 5. |
| | These revisions were reviewed to ensure they contain all necessary guidance for local SGFW pump starts. |
| | : 2) An Operations Department Night Order has been issued informing personnel of the event. Emphasis was placed on the SGFW pump CR console switch alignment requirements and the placement of information tags. |
| | : 3) The control room was walked down to ensure other information tags were not obscuring control board indication. |
| | |
| | LICENSEE EVENT REPORT (LER) TEXT CONTINUATION FACILITY NAME DOCKET NUMBER LER NUMBER PAGE NO. |
| | TURKEY POINT UNIT 3 05000250 97-009-00 6 OF 6 |
| | : 4) Training Brief 703, AFW pump Automatic-Start Logic, has been issued describing the event and the logic of the AFW automatic actuation on loss of all running SGFW pumps. |
| | : 5) General Operating Procedure, 3/4-GOP-301, Hot Standby to Power Operations, has been revised to incorporate switch alignment checks for the SGFW pump CR console switches including verification of the semaphore indication. |
| | : 6) Operations performed a control board walkdown and verified that CR switch semaphores match associated component indicating lights. |
| | : 7) Engineering semaphore will perform indication a review to determine have a control function that if other CR switches with is inhibited if the semaphore does not match the component indicating light. |
| | : 8) FPL is pursuing an enhanced information tag or method of controlling tag installation to ensure control board indication is not obscured from view. |
| | : 9) The SGFW pump CR console switch semaphore alignment and AFW actuation logic has been verified on the plant simulator. The Training Department will demonstrate this event during licensed operator simulator training. |
| | VIII. ADDITIONAL INFORMATION There have been two other events reported related to the AFW Actuation Automatic Start logic. These events were LERs 250/96-004, and 250/97-004. |
| | LER 250/96-004 pertained to the inadequate surveillance testing of the AFW actuation circuitry. |
| | LER 250/97-004 is directly related to this event. The local start of the SGFW pump was an approved corrective action for preventing an inadvertent AFW initiation when the breaker for the first pump fails to close while attempting to start the first SGFW pump from the CR console switch. |
| | The AFW Initiation logic diagram for the loss of SGFW pumps is attached. |
| | EIIS Codes are shown in the format [EIIS SYSTEM: IEEE component function identifier, second component identifier {if appropriate)).}} |
|
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Category:LICENSEE EVENT REPORT (SEE ALSO AO
MONTHYEARML17355A3891999-07-20020 July 1999 LER 99-001-00:on 990623,manual Rt from 100% Power Following Multiple Control Rod Drops Was Noted.Caused by Manual Action Taken by Reactor Control Operator.Inspected & Repaired Stationary Gripper Regulating Cards.With 990720 Ltr ML17354B1921998-11-18018 November 1998 LER 98-007-00:on 981020,containment Purge Supply,Valve Opened Wider than TS Limit.Caused by Improper Setting of Mechanical Stops.Incorporated Improved Standard Method of Measuring Angular Valve Position Into Sp.With 981118 Ltr ML17354B1361998-10-16016 October 1998 LER 98-004-00:on 980921,automatic Reactor Trip Occurred. Caused by Inadequate re-correlation of Intermediate Range Neutron Flux Instrumentation Reactor Trip Bistable. Enhanced Applicable Plant Procedures.With 981016 Ltr ML17354B0341998-07-15015 July 1998 LER 98-003-00:on 980619,discovered That Auxiliary Feedwater Sys Was Inoperable Due to Inadequate Inservice Testing of Valves.Caused by Misunderstanding of Testing Criteria.Util Revised Procedures & Verified Operability of Valves ML17354A9841998-06-18018 June 1998 LER 97-007-01:on 970730,automatic Reactor Trip Occurred Due to Closure of B Msiv.Caused by Failed BFD22S Relay.Six Relays on 3A,3B & 3C MSIVs Were Replaced & Implemented Plant Change to Disable Electronic Trip Function on 3 AFW Pumps ML17354A9741998-06-0909 June 1998 LER 98-002-00:on 980513,discovered Potential LOCA-initiated Electrical Fault Which Places ECCS Outside Design Basis. Caused by Inadequate Review of Effect on non-safety Circuit failures.Re-powered PC-*-600A Relays ML17354A8511998-03-24024 March 1998 LER 97-009-01:on 971114,discovered That CR Console Switch for 3B Sgfp Was Not in Start Position.Caused by Inadequate Procedural Guidance.Revised Procedures 3/4-OP-074,informed Personnel of Event & Performed Walkdown of CR ML17354A8441998-03-18018 March 1998 LER 98-001-00:on 980216,manual Reactor Trip Occurred Due to Loss of Turbine Control Oil Pressure W/Steam Leak in Auxiliary Feedwater Steam Supply Piping.Auxiliary Governor Maint Instructions Will Be revised.W/980318 Ltr ML17354A7361997-12-12012 December 1997 LER 97-009-01:on 971114,identified That CR Console Switch for 3B SG Feedwater Pump Was Not in Start Position.Caused by Inadequate Procedural Guidance.Procedures 3/4-OP-074,SGFP Were revised.W/971212 Ltr ML17354A6801997-10-0808 October 1997 LER 97-008-00:on 970909,containment Sump Debris Screens Outside Design Basis Due to Stress Damage Was Discovered. Caused by Inadequate Procedural Guidance & Personnel Error. Discrepancies Found on Screens corrected.W/971008 Ltr ML17354A6121997-08-29029 August 1997 LER 97-007-00:on 970730,automatic Reactor Trip Occurred. Caused by Closure of B Main Steam Isolation Valve.Failed W Relay & Equivalent Relays Were replaced.W/970829 Ltr ML17354A6081997-08-18018 August 1997 LER 97-006-00:on 970722,manual Reactor Trip Occurred Due to Failed Rod Control Power Supplies.Replaced Twelve Power Supplies in Rod Control Logic & Power cabinets.W/970818 Ltr ML17354A5801997-07-14014 July 1997 LER 97-005-00:on 970618,RCP Oil Collection Sys Was Found Outside Design Basis.Caused Because Design Did Not Consider Component Parts to Be Potential Leakage Sources.Entire RCP Oil Collection Sys Was reviewed.W/970714 Ltr ML17354A5141997-05-22022 May 1997 LER 97-002-00:on 970423,automatic Reactor Tripped.Caused by Actuation of Turbine Overspeed Protection Circuit. Administrative Procedures Governing Inadequate Work Controls Will Be Revised to Capture Lessons learned.W/970522 Ltr ML17354A5061997-05-0909 May 1997 LER 97-003-00:on 970410,mode Changed W/O Meeting Requirements of TS 3.0.4 Due to Inadequate Procedural Guidance.Night Order Was Issued to Inform Personnel That S/G Blowdown Keylock Switches Were Left in drain.W/970509 Ltr ML17354A5051997-05-0909 May 1997 LER 97-004-00:on 970411,auxiliary Feedwater Automatic Start Upon Trip of All Main Feedwater Pumps,Occurred.Caused by Mispositioned Valve Closing.Valves Listed as Inappropriately Positioned Were repositioned.W/970509 Ltr ML17354A4781997-04-25025 April 1997 LER 97-001-00:on 970327,ECCS Recirculation Loop Leakage Was Found to Be in Condition Outside Design Basis Due to Gasket Movement During Installation During Spring 1966 Reassembly. Gasket Replaced & Pump tested.W/970425 Ltr ML17354A4581997-03-28028 March 1997 LER 97-002-00:on 970303,manual Reactor Trip Following Rod Control Urgent Failure Alarm Occurred.Caused by Phase Failure Detection on Stationary a Circuits of 2BD Rod Control Cabinet.Air Conditioning replaced.W/970328 Ltr ML17354A4511997-03-26026 March 1997 LER 97-001-00:on 970118,missed Surveillance on CR Position Verification Occurred Due to Inoperable Rod Deviation Monitor.Faulty Circuit Common Connection Was Corrected & Rdm Operability Was restored.W/970326 Ltr ML17354A4061997-02-0303 February 1997 LER 96-004-03:on 970107,identified Three Instances of Inadequate Surveillance Testing.Caused by Inadequate Surveillance Procedures.Surveillance Procedures Revised ML17354A3771996-12-27027 December 1996 LER 96-012-00:on 961204,determined Containment Average Temp Being Determined Based on Only Two Temp Elements Instead of Three as Required by Tss.Caused by Log Only Requiring One Entry.Log revised.W/961227 Ltr ML17354A3261996-11-0606 November 1996 LER 96-011-00:on 961009,potential for Overpressurizing Post Accident Containment Vent Filter Housings Occurred.Caused by Improper Change Mgt.Monitoring Sys Operating Procedures revised.W/961106 Ltr ML17354A3071996-10-22022 October 1996 LER 96-010-00:on 960924,manual Reactor Shutdown Occurred. Caused by Failed Rod Control Sys Regulation Card in 2AC Power cabinet.2AC Power Cabinet DC Power Supplies,Cabling & Connectors checked.W/961022 Ltr ML17353A8711996-08-27027 August 1996 LER 96-009-00:on 960729,failed to Reflect Heavy Load Design Info in Procedural Controls.Caused by Failure to Incorporate 1982 Procedure Changes.Suspended Lifting of Heavy Loads & Took Turbine Bldg Crane OOS.W/960827 Ltr ML17353A7411996-06-18018 June 1996 LER 96-008-00:on 960521,surveillance Method for Testing Emergency Diesel Generators (EDG) Determined Inadequate. Caused by Personnel Error.All Four EDGs Rapid Start Tested & EDG Surveillance Procedures modified.W/960618 Ltr ML17353A7401996-06-18018 June 1996 LER 96-004-02:on 960524,identified Inadequate Surveillance Testing.Caused by Inadequate Surveillance Procedures.Entered Tech Spec Statements,Tested Required Instruments Functions & Revised Plant procedure.W/960618 Ltr ML17353A6901996-05-13013 May 1996 LER 96-004-01:on 960220,identified Potential Tech Spec non-compliance Associated W/Surveillance Testing of AFW Actuation Circuitry on Sg.Caused by Inadequate Surveillance Procedures.Procedures revised.W/960513 Ltr ML17353A6741996-05-0606 May 1996 LER 96-001-00:on 960409,manual Rt Occurred Due to Turbine Governer Control Oil Perturbation.Disassembled & Inspected Governor Valve for Cleanliness & Corrosion products.W/960506 Ltr ML17353A6651996-04-29029 April 1996 LER 96-007-00:on 960329,inadvertent ESF Actuation Occurred During Refueling Outage Due to Cognitive Personnel Error. Personnel Involved Counseled & Integrated Safeguards Test Procedures Being revised.W/960429 Ltr ML17353A6601996-04-25025 April 1996 LER 96-006-00:on 960327,manual Rt Occurred Due to 3C Transformer Lockout & Loss of 3B SG Mfp.Replaced SAM Timer Relay in 3AC16.W/960425 Ltr ML17353A6491996-04-23023 April 1996 LER 96-005-00:on 960326,certain Safety Injection Accumulator Filled Evolutions Resulted in cross-tied Configuration.C/A: Night Order Written & Operations Procedure 3/4-OP-064 revised.W/960423 Ltr ML17353A6051996-03-18018 March 1996 LER 96-003-00:on 960222,two Arpi Inoperable & TS 3.0.3 Entered.Proposed License Amend Submitted to Revise Allowed Misalignment from +/-12 Steps to =/-18 Steps Between Arpi & Dpi at Less than 90% power.W/960318 Ltr ML17353A6041996-03-18018 March 1996 LER 96-004-00:on 960220,surveillance Testing of AFW Actuation Circuitry Was Inadequate.Caused by Inadequate Surveillance Procedures.Tested Untested Portions of Actuation Logic for AFW Automatic Start signal.W/960318 Ltr ML17353A5861996-03-0606 March 1996 LER 96-002-00:on 960209,automatic Turbine Trip/Rt Occurred Due to High SG Level.Caused by Personnel Error.Replaced Both Hinge Pins on B Sgfp Discharge Check valve.W/960306 Ltr ML17353A5761996-03-0101 March 1996 LER 96-001-00:on 960131,intake CWS Flow Rates Found W/ Potential to Be Less than Required by Design Basis.Caused by Influx of Aquatic Grass & Algae Onto Basket Strainers of Icw Flow Path.Mechanically Cleaned strainers.W/960301 Ltr ML17353A4451995-11-0909 November 1995 LER 95-007-00:on 951017,manual Rt Occurred Following Drop of Four Control Rods.Caused by Water Intrusion Into Rod Control Power Cabinet 2BD.Inspected Control Power Cabinet 2BD for Other Water damage.W/951109 Ltr ML17353A4241995-10-12012 October 1995 LER 95-006-00:on 950913,analysis Showed That CCW Exchangers Susceptible to Damage Due to flow-induced Vibration.Ccw Sys Has Been Flow Balanced to Closer tolerances.W/951012 Ltr ML17353A3601995-09-13013 September 1995 LER 95-005-00:on 950818,containment Pressure Testing Procedure Resulted in Inhibiting Both Trains of Containment Pressure from Initiated Esf.Revised Procedure to Require Testing of Each Train separately.W/950913 Ltr ML17353A2951995-07-17017 July 1995 LER 94-005-02:on 941103,both Units Outside Design Basis Due to Design Defect in Safeguards Bus Sequencer Test Logic. Resumed Monthly Manual Testing of Sequencer ML17352B1581995-05-0505 May 1995 LER 95-004-00:on 950407,unit Being Shutdown to Investigate Recurring non-urgent Failure Alarms from Redundant Rod Control Power Supplies.Reactor Manually Tripped.All Four PS-3 Power Supplies replaced.W/950505 Ltr ML17352B1181995-04-0707 April 1995 LER 95-003-00:on 950309,intake Cooling Water Flow Rate Through CCW Heat Exchangers Fell Below Assumed Design Basis. Caused by an Influx of Aquatic Grass & Algae Onto Basket Strainers.Strainers cleaned.W/950407 Ltr ML17352B0701995-03-13013 March 1995 LER 95-002-00:on 950215,inadequate Definition of Loops Filled Resulted in Units in Condition Prohibited by Ts. Issued TS Position Statement to Define Term Loops Filled as Used in TS 6.4.1.1.4.W/950313 Ltr ML17352B0321995-02-0909 February 1995 LER 94-005-01:on 941103,design Defect Found in Safeguards Bus Sequencer Test Logic,Placing Facility Outside Design Basis.Design Mods to Eliminate Software Logic Problems Will Be Implemented During Next Refueling outages.W/950209 Ltr ML17352B0101995-01-20020 January 1995 LER 94-006-00:on 941226,C Main Feedwater Control Valve Failed Closed,Causing Reactor & Turbine Trips.Caused by Loose Screw Terminal Connection.I/P Transducers Replaced W/ New Model W/Different Design Wire connection.W/950120 Ltr ML17352A9511994-12-13013 December 1994 LER 94-006-00:on 941130,Unit 4 Tripped Automatically.Caused by Failure of Flexible Link Connection Between Main Generator B Phase Bus & Associated Isolated Phase Bus Bar. All Bolts on Flexible Link checked.W/941213 Ltr ML17352A8871994-11-10010 November 1994 LER 94-005-00:on 941103,design Defect in Safeguards Bus Sequencer Test Logic Places Both Units Outside Design Basis. Caused by 3A Sequencer Failed to Respond as Expected to Opposite Unit SI signal.W/941110 Ltr ML17352A8851994-11-10010 November 1994 LER 94-004-00:on 941103,Unit 3 Outside Design Basis Due to Two of Three Required Safety Injection Pumps Inoperable. Control Switches for 3A & 3B Safety Injection Pumps Immediately Returned to automatic.W/941110 Ltr ML17352A8421994-10-21021 October 1994 LER 94-004-00:on 940923,Unit 4 Tripped Automatically from Rated Power.Caused by Faulty Regulator Transistor.Faulty Backup Power Supply Replaced & Maint History for Power Supplies reviewed.W/941021 Ltr ML17352A8431994-10-20020 October 1994 LER 94-005-00:on 940924,Unit 4 Manually Tripped.Caused by Manual Actuation.Light Bulb & Socket replaced.W/941020 Ltr ML17352B1671994-08-16016 August 1994 LER 94-003-00:on 940720 & 21,util Discovered That Several Required Valve Stroke Time Surveillances Had Not Been Performed.Caused by Personnel Error.Personnel Reassigned & Procedures and Surveillance Tracking Software Enhanced 1999-07-20
[Table view] Category:RO)
MONTHYEARML17355A3891999-07-20020 July 1999 LER 99-001-00:on 990623,manual Rt from 100% Power Following Multiple Control Rod Drops Was Noted.Caused by Manual Action Taken by Reactor Control Operator.Inspected & Repaired Stationary Gripper Regulating Cards.With 990720 Ltr ML17354B1921998-11-18018 November 1998 LER 98-007-00:on 981020,containment Purge Supply,Valve Opened Wider than TS Limit.Caused by Improper Setting of Mechanical Stops.Incorporated Improved Standard Method of Measuring Angular Valve Position Into Sp.With 981118 Ltr ML17354B1361998-10-16016 October 1998 LER 98-004-00:on 980921,automatic Reactor Trip Occurred. Caused by Inadequate re-correlation of Intermediate Range Neutron Flux Instrumentation Reactor Trip Bistable. Enhanced Applicable Plant Procedures.With 981016 Ltr ML17354B0341998-07-15015 July 1998 LER 98-003-00:on 980619,discovered That Auxiliary Feedwater Sys Was Inoperable Due to Inadequate Inservice Testing of Valves.Caused by Misunderstanding of Testing Criteria.Util Revised Procedures & Verified Operability of Valves ML17354A9841998-06-18018 June 1998 LER 97-007-01:on 970730,automatic Reactor Trip Occurred Due to Closure of B Msiv.Caused by Failed BFD22S Relay.Six Relays on 3A,3B & 3C MSIVs Were Replaced & Implemented Plant Change to Disable Electronic Trip Function on 3 AFW Pumps ML17354A9741998-06-0909 June 1998 LER 98-002-00:on 980513,discovered Potential LOCA-initiated Electrical Fault Which Places ECCS Outside Design Basis. Caused by Inadequate Review of Effect on non-safety Circuit failures.Re-powered PC-*-600A Relays ML17354A8511998-03-24024 March 1998 LER 97-009-01:on 971114,discovered That CR Console Switch for 3B Sgfp Was Not in Start Position.Caused by Inadequate Procedural Guidance.Revised Procedures 3/4-OP-074,informed Personnel of Event & Performed Walkdown of CR ML17354A8441998-03-18018 March 1998 LER 98-001-00:on 980216,manual Reactor Trip Occurred Due to Loss of Turbine Control Oil Pressure W/Steam Leak in Auxiliary Feedwater Steam Supply Piping.Auxiliary Governor Maint Instructions Will Be revised.W/980318 Ltr ML17354A7361997-12-12012 December 1997 LER 97-009-01:on 971114,identified That CR Console Switch for 3B SG Feedwater Pump Was Not in Start Position.Caused by Inadequate Procedural Guidance.Procedures 3/4-OP-074,SGFP Were revised.W/971212 Ltr ML17354A6801997-10-0808 October 1997 LER 97-008-00:on 970909,containment Sump Debris Screens Outside Design Basis Due to Stress Damage Was Discovered. Caused by Inadequate Procedural Guidance & Personnel Error. Discrepancies Found on Screens corrected.W/971008 Ltr ML17354A6121997-08-29029 August 1997 LER 97-007-00:on 970730,automatic Reactor Trip Occurred. Caused by Closure of B Main Steam Isolation Valve.Failed W Relay & Equivalent Relays Were replaced.W/970829 Ltr ML17354A6081997-08-18018 August 1997 LER 97-006-00:on 970722,manual Reactor Trip Occurred Due to Failed Rod Control Power Supplies.Replaced Twelve Power Supplies in Rod Control Logic & Power cabinets.W/970818 Ltr ML17354A5801997-07-14014 July 1997 LER 97-005-00:on 970618,RCP Oil Collection Sys Was Found Outside Design Basis.Caused Because Design Did Not Consider Component Parts to Be Potential Leakage Sources.Entire RCP Oil Collection Sys Was reviewed.W/970714 Ltr ML17354A5141997-05-22022 May 1997 LER 97-002-00:on 970423,automatic Reactor Tripped.Caused by Actuation of Turbine Overspeed Protection Circuit. Administrative Procedures Governing Inadequate Work Controls Will Be Revised to Capture Lessons learned.W/970522 Ltr ML17354A5061997-05-0909 May 1997 LER 97-003-00:on 970410,mode Changed W/O Meeting Requirements of TS 3.0.4 Due to Inadequate Procedural Guidance.Night Order Was Issued to Inform Personnel That S/G Blowdown Keylock Switches Were Left in drain.W/970509 Ltr ML17354A5051997-05-0909 May 1997 LER 97-004-00:on 970411,auxiliary Feedwater Automatic Start Upon Trip of All Main Feedwater Pumps,Occurred.Caused by Mispositioned Valve Closing.Valves Listed as Inappropriately Positioned Were repositioned.W/970509 Ltr ML17354A4781997-04-25025 April 1997 LER 97-001-00:on 970327,ECCS Recirculation Loop Leakage Was Found to Be in Condition Outside Design Basis Due to Gasket Movement During Installation During Spring 1966 Reassembly. Gasket Replaced & Pump tested.W/970425 Ltr ML17354A4581997-03-28028 March 1997 LER 97-002-00:on 970303,manual Reactor Trip Following Rod Control Urgent Failure Alarm Occurred.Caused by Phase Failure Detection on Stationary a Circuits of 2BD Rod Control Cabinet.Air Conditioning replaced.W/970328 Ltr ML17354A4511997-03-26026 March 1997 LER 97-001-00:on 970118,missed Surveillance on CR Position Verification Occurred Due to Inoperable Rod Deviation Monitor.Faulty Circuit Common Connection Was Corrected & Rdm Operability Was restored.W/970326 Ltr ML17354A4061997-02-0303 February 1997 LER 96-004-03:on 970107,identified Three Instances of Inadequate Surveillance Testing.Caused by Inadequate Surveillance Procedures.Surveillance Procedures Revised ML17354A3771996-12-27027 December 1996 LER 96-012-00:on 961204,determined Containment Average Temp Being Determined Based on Only Two Temp Elements Instead of Three as Required by Tss.Caused by Log Only Requiring One Entry.Log revised.W/961227 Ltr ML17354A3261996-11-0606 November 1996 LER 96-011-00:on 961009,potential for Overpressurizing Post Accident Containment Vent Filter Housings Occurred.Caused by Improper Change Mgt.Monitoring Sys Operating Procedures revised.W/961106 Ltr ML17354A3071996-10-22022 October 1996 LER 96-010-00:on 960924,manual Reactor Shutdown Occurred. Caused by Failed Rod Control Sys Regulation Card in 2AC Power cabinet.2AC Power Cabinet DC Power Supplies,Cabling & Connectors checked.W/961022 Ltr ML17353A8711996-08-27027 August 1996 LER 96-009-00:on 960729,failed to Reflect Heavy Load Design Info in Procedural Controls.Caused by Failure to Incorporate 1982 Procedure Changes.Suspended Lifting of Heavy Loads & Took Turbine Bldg Crane OOS.W/960827 Ltr ML17353A7411996-06-18018 June 1996 LER 96-008-00:on 960521,surveillance Method for Testing Emergency Diesel Generators (EDG) Determined Inadequate. Caused by Personnel Error.All Four EDGs Rapid Start Tested & EDG Surveillance Procedures modified.W/960618 Ltr ML17353A7401996-06-18018 June 1996 LER 96-004-02:on 960524,identified Inadequate Surveillance Testing.Caused by Inadequate Surveillance Procedures.Entered Tech Spec Statements,Tested Required Instruments Functions & Revised Plant procedure.W/960618 Ltr ML17353A6901996-05-13013 May 1996 LER 96-004-01:on 960220,identified Potential Tech Spec non-compliance Associated W/Surveillance Testing of AFW Actuation Circuitry on Sg.Caused by Inadequate Surveillance Procedures.Procedures revised.W/960513 Ltr ML17353A6741996-05-0606 May 1996 LER 96-001-00:on 960409,manual Rt Occurred Due to Turbine Governer Control Oil Perturbation.Disassembled & Inspected Governor Valve for Cleanliness & Corrosion products.W/960506 Ltr ML17353A6651996-04-29029 April 1996 LER 96-007-00:on 960329,inadvertent ESF Actuation Occurred During Refueling Outage Due to Cognitive Personnel Error. Personnel Involved Counseled & Integrated Safeguards Test Procedures Being revised.W/960429 Ltr ML17353A6601996-04-25025 April 1996 LER 96-006-00:on 960327,manual Rt Occurred Due to 3C Transformer Lockout & Loss of 3B SG Mfp.Replaced SAM Timer Relay in 3AC16.W/960425 Ltr ML17353A6491996-04-23023 April 1996 LER 96-005-00:on 960326,certain Safety Injection Accumulator Filled Evolutions Resulted in cross-tied Configuration.C/A: Night Order Written & Operations Procedure 3/4-OP-064 revised.W/960423 Ltr ML17353A6051996-03-18018 March 1996 LER 96-003-00:on 960222,two Arpi Inoperable & TS 3.0.3 Entered.Proposed License Amend Submitted to Revise Allowed Misalignment from +/-12 Steps to =/-18 Steps Between Arpi & Dpi at Less than 90% power.W/960318 Ltr ML17353A6041996-03-18018 March 1996 LER 96-004-00:on 960220,surveillance Testing of AFW Actuation Circuitry Was Inadequate.Caused by Inadequate Surveillance Procedures.Tested Untested Portions of Actuation Logic for AFW Automatic Start signal.W/960318 Ltr ML17353A5861996-03-0606 March 1996 LER 96-002-00:on 960209,automatic Turbine Trip/Rt Occurred Due to High SG Level.Caused by Personnel Error.Replaced Both Hinge Pins on B Sgfp Discharge Check valve.W/960306 Ltr ML17353A5761996-03-0101 March 1996 LER 96-001-00:on 960131,intake CWS Flow Rates Found W/ Potential to Be Less than Required by Design Basis.Caused by Influx of Aquatic Grass & Algae Onto Basket Strainers of Icw Flow Path.Mechanically Cleaned strainers.W/960301 Ltr ML17353A4451995-11-0909 November 1995 LER 95-007-00:on 951017,manual Rt Occurred Following Drop of Four Control Rods.Caused by Water Intrusion Into Rod Control Power Cabinet 2BD.Inspected Control Power Cabinet 2BD for Other Water damage.W/951109 Ltr ML17353A4241995-10-12012 October 1995 LER 95-006-00:on 950913,analysis Showed That CCW Exchangers Susceptible to Damage Due to flow-induced Vibration.Ccw Sys Has Been Flow Balanced to Closer tolerances.W/951012 Ltr ML17353A3601995-09-13013 September 1995 LER 95-005-00:on 950818,containment Pressure Testing Procedure Resulted in Inhibiting Both Trains of Containment Pressure from Initiated Esf.Revised Procedure to Require Testing of Each Train separately.W/950913 Ltr ML17353A2951995-07-17017 July 1995 LER 94-005-02:on 941103,both Units Outside Design Basis Due to Design Defect in Safeguards Bus Sequencer Test Logic. Resumed Monthly Manual Testing of Sequencer ML17352B1581995-05-0505 May 1995 LER 95-004-00:on 950407,unit Being Shutdown to Investigate Recurring non-urgent Failure Alarms from Redundant Rod Control Power Supplies.Reactor Manually Tripped.All Four PS-3 Power Supplies replaced.W/950505 Ltr ML17352B1181995-04-0707 April 1995 LER 95-003-00:on 950309,intake Cooling Water Flow Rate Through CCW Heat Exchangers Fell Below Assumed Design Basis. Caused by an Influx of Aquatic Grass & Algae Onto Basket Strainers.Strainers cleaned.W/950407 Ltr ML17352B0701995-03-13013 March 1995 LER 95-002-00:on 950215,inadequate Definition of Loops Filled Resulted in Units in Condition Prohibited by Ts. Issued TS Position Statement to Define Term Loops Filled as Used in TS 6.4.1.1.4.W/950313 Ltr ML17352B0321995-02-0909 February 1995 LER 94-005-01:on 941103,design Defect Found in Safeguards Bus Sequencer Test Logic,Placing Facility Outside Design Basis.Design Mods to Eliminate Software Logic Problems Will Be Implemented During Next Refueling outages.W/950209 Ltr ML17352B0101995-01-20020 January 1995 LER 94-006-00:on 941226,C Main Feedwater Control Valve Failed Closed,Causing Reactor & Turbine Trips.Caused by Loose Screw Terminal Connection.I/P Transducers Replaced W/ New Model W/Different Design Wire connection.W/950120 Ltr ML17352A9511994-12-13013 December 1994 LER 94-006-00:on 941130,Unit 4 Tripped Automatically.Caused by Failure of Flexible Link Connection Between Main Generator B Phase Bus & Associated Isolated Phase Bus Bar. All Bolts on Flexible Link checked.W/941213 Ltr ML17352A8871994-11-10010 November 1994 LER 94-005-00:on 941103,design Defect in Safeguards Bus Sequencer Test Logic Places Both Units Outside Design Basis. Caused by 3A Sequencer Failed to Respond as Expected to Opposite Unit SI signal.W/941110 Ltr ML17352A8851994-11-10010 November 1994 LER 94-004-00:on 941103,Unit 3 Outside Design Basis Due to Two of Three Required Safety Injection Pumps Inoperable. Control Switches for 3A & 3B Safety Injection Pumps Immediately Returned to automatic.W/941110 Ltr ML17352A8421994-10-21021 October 1994 LER 94-004-00:on 940923,Unit 4 Tripped Automatically from Rated Power.Caused by Faulty Regulator Transistor.Faulty Backup Power Supply Replaced & Maint History for Power Supplies reviewed.W/941021 Ltr ML17352A8431994-10-20020 October 1994 LER 94-005-00:on 940924,Unit 4 Manually Tripped.Caused by Manual Actuation.Light Bulb & Socket replaced.W/941020 Ltr ML17352B1671994-08-16016 August 1994 LER 94-003-00:on 940720 & 21,util Discovered That Several Required Valve Stroke Time Surveillances Had Not Been Performed.Caused by Personnel Error.Personnel Reassigned & Procedures and Surveillance Tracking Software Enhanced 1999-07-20
[Table view] Category:TEXT-SAFETY REPORT
MONTHYEARML20217L9371999-10-20020 October 1999 Safety Evaluation Supporting Licensee Proposed Alternative from Certain Requirements of ASME Code,Section XI for First 10-Yr Interval Request for Relief for Containment Inservice Insp Program ML17355A4471999-09-30030 September 1999 Monthly Operating Repts for Sept 1999 for Turkey Point,Units 3 & 4.With 991008 Ltr ML17355A4121999-08-31031 August 1999 Monthly Operating Repts for Aug 1999 for Turkey Point,Units 3 & 4.With 990909 Ltr ML17355A3981999-07-31031 July 1999 Monthly Operating Repts for July 1999 for Turkey Point,Units 3 & 4.With 990809 Ltr ML17355A3891999-07-20020 July 1999 LER 99-001-00:on 990623,manual Rt from 100% Power Following Multiple Control Rod Drops Was Noted.Caused by Manual Action Taken by Reactor Control Operator.Inspected & Repaired Stationary Gripper Regulating Cards.With 990720 Ltr ML17355A3841999-06-30030 June 1999 Monthly Operating Repts for June 1999 for Turkey Point,Units 3 & 4.With 990713 Ltr ML17355A3681999-06-30030 June 1999 Revised Update to Topical QA Rept, Dtd June 1999 ML17355A3611999-06-30030 June 1999 Refueling Outage ISI Rept. ML17355A3511999-05-31031 May 1999 Monthly Operating Repts for May 1999 for Turkey Point,Units 3 & 4.With 990609 Ltr ML17355A3331999-04-30030 April 1999 Monthly Operating Repts for Apr 1999 for Turkey Point,Units 3 & 4.With 990511 Ltr ML20217B9871999-04-0808 April 1999 Changes,Tests & Experiments Made as Allowed by 10CFR50.59 for Period Covering 971014-990408 ML17355A2881999-04-0505 April 1999 COLR for Turkey Point Unit 4 Cycle 18. ML17355A2911999-03-31031 March 1999 Monthly Operating Repts for Mar 1999 for Turkey Point,Units 3 & 4.With 990414 Ltr ML17355A2551999-02-28028 February 1999 Monthly Operating Repts for Feb 1999 for Turkey Point Nuclear Power Plant,Units 3 & 4.With 990315 Ltr ML17355A2261999-01-31031 January 1999 Monthly Operating Repts for Jan 1999 for Turkey Point,Units 3 & 4.With 990211 Ltr ML17355A2201999-01-20020 January 1999 Refueling Outage ISI Rept. ML17355A1911998-12-31031 December 1998 Monthly Operating Repts for Dec 1998 for Turkey Point,Units 3 & 4.With 990112 Ltr ML18008A0461998-11-30030 November 1998 Monthly Operating Repts for Nov 1998 for Turkey Point,Units 3 & 4.With 981209 Ltr ML17354B1921998-11-18018 November 1998 LER 98-007-00:on 981020,containment Purge Supply,Valve Opened Wider than TS Limit.Caused by Improper Setting of Mechanical Stops.Incorporated Improved Standard Method of Measuring Angular Valve Position Into Sp.With 981118 Ltr ML17354B1891998-11-0909 November 1998 Simulatory Certification Update 2. ML17354B1901998-10-31031 October 1998 Monthly Operating Repts for Oct 1998 for Turkey Point,Units 3 & 4.With 981112 Ltr ML17354B1591998-10-23023 October 1998 COLR for Turkey Point Unit 3 Cycle 17. ML17354B1361998-10-16016 October 1998 LER 98-004-00:on 980921,automatic Reactor Trip Occurred. Caused by Inadequate re-correlation of Intermediate Range Neutron Flux Instrumentation Reactor Trip Bistable. Enhanced Applicable Plant Procedures.With 981016 Ltr ML17354B1311998-09-30030 September 1998 Monthly Operating Repts for Sept 1998 for Turkey Point Unit 3 & 4.With 981012 Ltr ML17354B0971998-09-0909 September 1998 Part 21 Rept Re Possible Machining Defect in Certain One Inch Stainless Steel Swagelok Front Ferrules,Part Number SS-1613-1.Caused by Tubing Slipping Out of Fitting at Three Times Working Pressure of Tubing.Notified Affected Utils ML17354B0981998-08-31031 August 1998 Monthly Operating Repts for Aug 1998 for Turkey Points,Units 3 & 4.With 980915 Ltr ML17354B0771998-07-31031 July 1998 Monthly Operating Repts for July 1998 for Turkey Point,Units 3 & 4.W/980810 Ltr ML17354B0341998-07-15015 July 1998 LER 98-003-00:on 980619,discovered That Auxiliary Feedwater Sys Was Inoperable Due to Inadequate Inservice Testing of Valves.Caused by Misunderstanding of Testing Criteria.Util Revised Procedures & Verified Operability of Valves ML17354B0241998-06-30030 June 1998 Monthly Operating Repts for June 1998 for Turkey Point,Units 3 & 4.W/980709 Ltr ML17354B0171998-06-29029 June 1998 Rev 1 to PTN-FPER-97-013, Evaluation of Turbine Lube Oil Fire. ML17354A9841998-06-18018 June 1998 LER 97-007-01:on 970730,automatic Reactor Trip Occurred Due to Closure of B Msiv.Caused by Failed BFD22S Relay.Six Relays on 3A,3B & 3C MSIVs Were Replaced & Implemented Plant Change to Disable Electronic Trip Function on 3 AFW Pumps ML17354A9741998-06-0909 June 1998 LER 98-002-00:on 980513,discovered Potential LOCA-initiated Electrical Fault Which Places ECCS Outside Design Basis. Caused by Inadequate Review of Effect on non-safety Circuit failures.Re-powered PC-*-600A Relays ML20248F7441998-05-31031 May 1998 Reactor Vessel Working Group,Response to RAI Regarding Reactor Pressure Vessel Integrity ML17354A9711998-05-31031 May 1998 Monthly Operating Repts for Turkey Point,Units 3 & 4. W/980611 Ltr ML17354A9231998-04-30030 April 1998 Monthly Operating Repts for Apr 1998 for Turkey Point,Units 3 & 4.W/980511 Ltr ML17354A8821998-03-31031 March 1998 Monthly Operating Repts for Mar 1998 for Turkey Point,Units 3 & 4.W/980409 Ltr ML17354A8511998-03-24024 March 1998 LER 97-009-01:on 971114,discovered That CR Console Switch for 3B Sgfp Was Not in Start Position.Caused by Inadequate Procedural Guidance.Revised Procedures 3/4-OP-074,informed Personnel of Event & Performed Walkdown of CR ML17354B0001998-03-18018 March 1998 Florida Power & Light Topical Quality Asurance Rept, Dtd June 1998 ML17354A8441998-03-18018 March 1998 LER 98-001-00:on 980216,manual Reactor Trip Occurred Due to Loss of Turbine Control Oil Pressure W/Steam Leak in Auxiliary Feedwater Steam Supply Piping.Auxiliary Governor Maint Instructions Will Be revised.W/980318 Ltr ML17354A8311998-02-28028 February 1998 Monthly Operating Repts for Feb 1998 for Turkey Point,Units 3 & 4.W/980311 Ltr ML17354A7871998-01-31031 January 1998 Monthly Operating Repts for Jan 1998 for Turkey Point,Units 3 & 4.W/980209 Ltr ML17354A7581997-12-31031 December 1997 Monthly Operating Repts for Dec 1997 for Turkey Point,Unit 3 & 4.W/980112 Ltr ML17354A7361997-12-12012 December 1997 LER 97-009-01:on 971114,identified That CR Console Switch for 3B SG Feedwater Pump Was Not in Start Position.Caused by Inadequate Procedural Guidance.Procedures 3/4-OP-074,SGFP Were revised.W/971212 Ltr ML17354A7381997-11-30030 November 1997 Monthly Operating Repts for Nov 1997 for Turkey Point,Units 3 & 4.W/971215 Ltr ML17354A7211997-10-31031 October 1997 Monthly Operating Repts for Oct 1997 for Turkey Point,Units 3 & 4.W/971114 Ltr ML17354A7491997-10-13013 October 1997 SG Insp Rept. ML17354A8851997-10-13013 October 1997 FPL Units 3 & 4 Changes,Tests & Experiments Made as Allowed by 10CFR50.59 for Period Covering 960408-971013. ML17354A6801997-10-0808 October 1997 LER 97-008-00:on 970909,containment Sump Debris Screens Outside Design Basis Due to Stress Damage Was Discovered. Caused by Inadequate Procedural Guidance & Personnel Error. Discrepancies Found on Screens corrected.W/971008 Ltr ML17354A6791997-10-0606 October 1997 COLR Unit 4 Cycle 17, for Turkey Point ML17354A6811997-09-30030 September 1997 Monthly Operating Repts for Sept 1997 for Turkey Point,Units 3 & 4.W/971009 Ltr 1999-09-30
[Table view] |
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CATEGORY 3g
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REGULATORY INFORMATION DISTRIBUTION SYSTEM (RIDS)
ACCESSION NBR:9712170281 DOC.DATE: 97/12/12 NOTARIZED: NO DOCKET FACIL:50-250 Turkey Point Plant, Unit 3, Florida Power and Light C 05000250 AUTH. NAME AUTHOR AFFILIATION MIHALAKEA,S. Florida Power &, Light Co.
HOVEY,R.J. Florida Power 6 Light Co.
RECIP.NAME RECIPIENT AFFILIATION
SUBJECT:
LER 97-009-01:on 971114,identified that CR console switch for 3B SG feedwater pump was not in start position. Caused by inadequate procedural guidance. Procedures 3/4-OP-074,SGFP revised.W/971212 ltr. 'ere DISTRIBUTION CODE: IE22T COPIES RECEIVED:LTR ENCL SIZE:
TITLE: 50.73/50.9 Licensee Event Report (LER), Incident Rpt, etc.
NOTES:
RECIPIENT COPIES RECIPIENT COPIES ID CODE/NAME LTTR ENCL ID CODE/NAME LTTR ENCL PD2-3 PD 1 1. CROTEAU,R 1 1 INTERNAL: AEO~D~)gl/ 2 2 AEOD/S PD/RRAB 1 1 E CENTE 1 1 NRR/DE/ECGB 1 1 R EELB 1 1 NRR/DE/EMEB 1 1 NRR/DRCH/HHFB 1 1 NRR/DRCH/HICB 1 1 NRR/DRCH/HOLB 1 1 NRR/DRCH/HQMB 1 1 NRR/DRPM/PECB 1 1 NRR/DSSA/SPLB 1 1 NRR/DSSA/SRXB 1 1 RES/DET/EIB 1 1 RGN2 FILE 01 1 1 D
EXTERNAL: L ST LOBBY WARD 1 1 LITCO BRYCE,J H 1 1 NOAC POORE,W. 1 1 NOAC QUEENER,DS 1 1 NRC PDR 1 1 NUDOCS FULL TXT 1 1 M
E N
NOTE TO ALL "RIDS" RECIPIENTS:
PLEASE HELP US TO REDUCE WASTE. TO HAVE YOUR NAME OR ORGANIZATION REMOVED FROM DISTRIBUTION LISTS OR REDUCE THE NUMBER OF COPIES RECEIVED BY YOU OR YOUR ORGANIZATION, CONTACT THE DOCUMENT CONTROL DESK (DCD) ON EXTENSION 415-2083 FULL TEXT CONVERSION REQUIRED TOTAL NUMBER OF COPIES REQUIRED: LTTR 24 ENCL 24
DEt. 'j. 21997 L-97-294 10 CFR 50.73 U. S. Nuclear Regulatory Commission Attn: Document Control Desk Washington, D. C. 20555 Re: Turkey Point Unit 3 Docket No. 50-250 Reportable Event: 97-009 Date of Event: November 14, 1997 Console Switch Position Disabled Auxilia Feedwater Auto Start Lo ic on 3B Steam Generator Feedwater Pum Tri The attached Licensee Event Report is being submitted pursuant to the requirements of 10 CFR 50.73 to provide notification of the subject event.
Sincerely, R. J. Hovey Vice President Turkey Point Plant SM Attachment cc: Regional Administrator, USNRC Region II Senior Resident Inspector, USNRC, Turkey Point Plant I
97i2i7028i 97i2i2 lllllllffill lllllllflllflllfll PDR ADQCK 05000250 IIIffff 8 PDR an FPL Group company
LICENSEE EVENT REPORT {LER) fACILITY t(AME (1) DOCKET NUMBER (2) PAGE (3)
TURKEY POINT UNIT 3 05000250 1 Of 6 TITLE (4) Console Switch Position Disabled Auxiliary Feedwater Auto Start Logic on 3B Steam Generator Feedwater Pump Trip EVENT DATE (5) LER NUMBER(6) RPT DATE (7) OTHER FACILITIES INV. (8)
MOH DAY YR YR SEQ ( R( MON DAY YR FACILITY NAMES DCCKET I (S) 11 14 97 97 09 00 12 12 97 OPERATING MODE (91 10 CFR 50.73 (a) (2) (I) (B)
POWDER LEVEL 100 (10)
LICENSEE CONTACT FOR THIS LER (12)
Telephone Number S MIHALAKEAg LICENS ING ENGINEER (305) 246-6454 COMPLETE ONE LINE FOR EACH COMPONENT FAILURE DESCRIBED IN THIS REPORT (13)
CAUSE SYSTEM COMPONENT MANUfACTURER NPRDS? CAUSE SYSTEM COMPONENT MANUfACTURER NPRDS?
SUPPLEMEHTAL REPORT EXPECTED (14) HO YES 0 EXPECTED SUBMISSION MOt(TH DAY DATE (15)
(if yes, complete EXPECTED SUBMISSION DATE)
ABSTRACT (16)
On 11/14/97, the Reactor Control Operator identified that the Control Room (CR) console switch for the 3B Steam Generator Feedwater Pump (SGFW) pump was not in the start position. The 3B SGFW pump had been locally started on 7/30/97, while Unit 3 was in Mode 3.
Technical Specification (TS) Table 3.3-2, Item 6.e, requires Auxiliary Feedwater (AFW) actuation on trip of all main feedwater pumps breakers during Modes 1 and 2. Item 6.e of TS Table 3.3-2, was not met from 7/31/97 (when Unit 3 entered Mode 2), until 11/14/97 because the minimum operating channels requirement includes having each pump switch semaphore in the operating position (red flag). This AFW auto-start feature is an anticipatory AFW actuation for a Steam Generator Low-Low level. The AFW auto-start on SGFW pump trip was disabled only when SGFW pump 3A was not running during Modes 1 and 2. The 3A SGFW pump was not running from 0413 until 1845 on 7/31/97, and again from 1044 on 8/14/97, until 1010 on 8/15/97.,
At 1820 on 11/14/97, the CR console switch for the 3B SGFW pump was momentarily placed in the start position, restoring the AFW automatic start actuation circuit for the 3B SGFW pump. Procedure revisions to add local start requirements for the SGFW pump in Modes 3, 4, and 5, were reviewed to ensure they contain all necessary guidance.
Operations verified that all CR switch semaphores match component indicating lights.
A training brief was issued describing the event and its significance.
C LICENSEE EVENT REPORT (LER) TEXT CONTINUATION FACILITY DOCKET NUMBER LER NUMBER PAGE NO.
POINT UNIT 3 NAME'URKEY 05000250 97-009-00 2 OF 6 BACKGROUND The 3B Steam Generator Feedwater Pump(SGFW) pump [SJ:p] was started locally on July 30, 1997, while Unit 3 was in Mode 3. The associated SGFN pump Control Room (CR) console switch [SJ:js] was not placed in the start position. Operations personnel considered the decision to start the first SGFW pump locally as conservative, because the local start would prevent an inadvertent Auxiliary Feedwater (AFN) [BA]
actuation if the SGFW pump breaker failed to close.
On April 11, 1997, with Turkey Point Unit 3 in Mode 3, AFN was inadvertently actuated during an attempt to start the 3B SGFW pump, when the associated pump breaker failed to close. This event was reported in LER 250/97-004.
determined that an inadvertent AFW actuation may occur while attempting,to start It was the pump from the CR if the breaker were to fail to close while the other SGFN pump is not operating. It was recommended that the first SGFW pump be started using the local push-button during Mode 3. Using the local push-button prevents an AFW automatic actuation if the associated pump breaker fails to close. Following the pump start using the local push-button, the CR console switch must be cycled to the start position in order to enable the AFW automatic start actuation circuit and provide evidence of this action by displaying the red flag. As a result, procedural changes were required to incorporate guidance for starting the first SGFW pump during Mode 3 using the local push-button. These procedural changes were initiated on July 22, 1997, and were not approved until August 25, 1997.
Consequently, on July 30, 1997, when a reactor trip occurred as a result of an inadvertent closure of the 3B Main Steam Isolation Valve [SB:isv](LER 250 97-007),
the procedures used to start the 3B pump had not been changed to address locally starting a SGFW pump.
II. DESCRIPTION OF THE EVENT On November 14, 1997, Turkey Point Unit 3 was running at 100% power. At approximately 1800 hours0.0208 days <br />0.5 hours <br />0.00298 weeks <br />6.849e-4 months <br />, during the once per shift review of 3-OSP-201.1, Reactor Control Operator (RCO) Daily Logs Minimum Instrumentation and Equipment List, the RCO questioned why the 3B SGFW pump CR console switch had a green flag semaphore
[SJ:js, zi] even though the pump was operating. The "green flagged" semaphore indicates that the last demand by the switch was to stop the pump.
Technical Specification Table 3.3-2, Item 6.e, requires automatic actuation of AFW on the trip of all Main Feedwater pump breakers for Modes 1 and 2. It was determined that Technical Specification Table 3.3-2, Item 6.e had not been met since Unit 3 entered Mode 2 on July 31, 1997. Operations personnel determined that the as found condition would prevent an AFW automatic start actuation on SGFW pump if trip the 3B SGFW pump was the only feed pump running and the 3B SGFW pump motor breaker tripped. Although the Technical Specification requirements were not met from July 31, 1997 until November 14, 1997, the AFW automatic start actuation on SGFW pump trip was only disabled when the SGFN pump 3A was not running during Modes 1 and 2. Operator logs show that the 3A,SGFW pump was not running from July 31, 1997, at 0413 hours0.00478 days <br />0.115 hours <br />6.828704e-4 weeks <br />1.571465e-4 months <br /> (when Unit 3 entered Mode 2), until July 31, 1997, at 1845 hours0.0214 days <br />0.513 hours <br />0.00305 weeks <br />7.020225e-4 months <br />, and again from August 14, 1997, at 1044 hours0.0121 days <br />0.29 hours <br />0.00173 weeks <br />3.97242e-4 months <br /> until August 15, 1997, at 1010 hours0.0117 days <br />0.281 hours <br />0.00167 weeks <br />3.84305e-4 months <br />.
The entry into Mode 2 on July 31, 1997, also violated Technical Specification 3.0.4, which requires that, "Entry into an OPERATIONAL MODE...shall not be made when the conditions for the Limiting Condition for Operation are not met...".
During the period in which the condition existed, Technical Specification 3.0.4 was violated twice more when mode changes took place; when Unit 3 entered Mode 1 later on July 31, 1997, and again when Unit 3 entered Mode 1, on August 15, 1997.
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TURKEY POINT UNIT 3 05000250 97-009-00 3 OF 6 The AFW automatic start actuation on SGFW pump trip for the 3B SGFW pump was restored on November 14, 1997, at 1820 hours0.0211 days <br />0.506 hours <br />0.00301 weeks <br />6.9251e-4 months <br /> by momentarily placing the CR console switch to the start position and returning the switch to the mid position. This action aligned the CR switch contacts to restore the interlock and changed the switch semaphore from green to red.
III. SYSTEM DESCRIPTION The trip of all SGFW pumps is a non-safety related AFW actuation feature. AFW will automatically actuate on the loss of both feedwater pumps under normal operating conditions, as described in Section 9.11.2 of the Updated Final Safety Analysis Report (UFSAR). The AFW automatic start feature is an anticipatory AFW actuation for a Steam Generator (SJ:sg) Low-Low level condition associated with the Loss of Feedwater Flow event. This anticipatory Engineering Safety Feature (ESF) actuation is required in Technical Specification Table, 3.3-2, Item G.e. The Technical Specifications minimum channel operable requirement is one channel per breaker per operating pump, in Modes 1 and 2.
The SGFW pump CR console switch is a three position, STOP/START and spring return to middle position switch. These CR console switches have a semaphore (small red/green flag) window which indicates if the switch was last in the open (green) or closed (red) position. The SGFW pump switches are part of the AFW initiation logic in order to avoid an AFW initiation when the SGFW pumps are manually stopped.
With either of the two pump control switches in the middle position after having been in the start position and with both of the two pump breakers open, AFW will be initiated. When only one pump is operating, the tripping of that pump will initiate AFW.
Starting a SGFW pump locally does not enable the AFW automatic start logic. Using the local push-button, AFW automatic start would not be actuated if a pump breaker failed to close. Following the SGFW pump start using the local push-button, the CR console switch must be cycled to the start position in order to enable the AFW automatic actuation circuit as evidenced by the red flag.
IV. ANALYSIS OF THE EVENT An event investigation was performed to determine the causes of the mismatched CR switch semaphore on the 3B SGFW pump that existed from July 30, 1997 to November 14, 1997. The results of the event investigation identified the following:
The 3B SGFW pump was started locally on July '30, 1997, at 1634 hours0.0189 days <br />0.454 hours <br />0.0027 weeks <br />6.21737e-4 months <br /> while Unit 3 was in Mode 3.
Operator log reviews and personnel interviews show that historically the SGFW pumps have been started from the control room with the exception of tests, for example, bumping the motor for rotation, stroking the motor operated discharge valve.
An information tag was placed over the 3B SGFW pump CR console switch semaphore indicator because of recent pump casing deficiencies. The CR console switch semaphore was not considered as an indicator for the SGFW pump. Operations personnel did not zegard the tag as improperly placed over a SGFW pump indicator. This tag hid the status of the switch from operators performing board walkdowns.
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~ The procedure utilized to start the 3B SGFW pump locally, Procedure 3-OP-74, Steam Generator Feedwater Pump, did not provide specific guidance to start the SGFW pump locally. Operations personnel were aware that Engineering had evaluated the use of the local start control switch as a method to prevent an inadvertent AFW actuation when attempting to start the first SGFW pump. The procedural changes to incorporate specific guidance to start a SGFW pump locally were initiated on July 22, 1997. These changes were approved on August 25, 1997.
Previous start failures of the SGFW pumps led to a decision to perform local starts of the pumps when in Modes 3, 4, 5. This evolution creates the potential for not meeting Technical Specification Table 3.3-2, Item 6.e.
requirements if the CR console switch is left in the stop (returned to middle) position (green flagged) when entering Modes 1, and 2.
The 3B SGFW pump was started locally, but the CR console switch was not placed to start to actuate the AFW automatic start interlock after the pump was running. The Technical Specification Table 3.3-2, Item 6.e was not met from July 31, 1997, when Mode 2 was entered at approximately 0413 hours0.00478 days <br />0.115 hours <br />6.828704e-4 weeks <br />1.571465e-4 months <br />, until November 14, 1997, at approximately 1820 hours0.0211 days <br />0.506 hours <br />0.00301 weeks <br />6.9251e-4 months <br />, when the AFW automatic start actuation on SGFW pump trip for the 3B SGFW pump was restored. However, the AFW automatic start actuation on SGFW pump trip was disabled only when 3A SGFW pump was not running during Modes 1 and 2, for approximately 14.5 hours5.787037e-5 days <br />0.00139 hours <br />8.267196e-6 weeks <br />1.9025e-6 months <br /> on July 31, 1997, and for approximately 24 hours2.777778e-4 days <br />0.00667 hours <br />3.968254e-5 weeks <br />9.132e-6 months <br /> during August 14-15, 1997.
CAUSE OF THE EVENT The root cause for this event is inadequate procedural guidance for starting the SGFW pump locally without enabling the AFW automatic start circuit by momentarily placing the CR console switch to start. This information needed to be provided to the CR Operators, that entry into Modes 1 and 2 without momentarily placing the CR console switch to start (as evidenced by the switch semaphore red flag) would not meet the requirements of Technical Specification Table 3.3-2, Item 6.e.
There are several causal factors that contributed to the duration of time before the SGFW pump CR console switch was repositioned to restore the AFW actuation interlock.
The CR console switch semaphore flag was covered by an information tag that prevented the discovery during operator board walkdowns.
Operations personnel were not aware of the significance associated with the SGFW pump CR console switch alignment and semaphore indication.
Operations personnel did not have an adequate knowledge level associated with the SGFW pump CR console switch alignment requirements and the significance of the semaphore indication. Operations personnel had been instructed not to reposition switches to align semaphores unless directed by procedure.-
General Operating Procedure, 3/4-GOP-301, Hot Standby to Power Operations, requires a CR console switch alignment check prior to a mode change, but this verification did not include the SGFW pump control switches or semaphores.
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TURKEY POINT UNIT 3 05000250 97-009-00 5 OF 6 VI. SAFETY SIGNIFICANCE The three turbine driven AFW pumps (shared by Turkey Point Units 3&4) aze started on any of the following signals: a) Low-Low water level in any steam generator, b) any Safety Injection signal, c) loss of offsite power d) loss of either A or B 4.16 kv bus on either unit, e) trip of all running Main Feedwater pumps on either unit f) ATWS Mitigating System Actuation Circuitry (AMSAC), g) manual actuation.
The UFSAR Chapter 14 accident analysis credits AFW for mitigation of several events. The following events which credit AFW were reviewed: 1) Loss of Normal Feedwater, 2) Loss of Non Emergency AC to plant auxiliaries, 3) Steam Generator Tube Rupture, 4) Main Steam Line Break, and 5) Small Break Loss of Coolant Accident.
The loss of Normal Feedwater Flow transient is analyzed in Section 14.1.11 of the UFSAR. The event assumes that AFW is initiated conservatively 120 seconds following the start of the signal on the Low-Low Steam Generator level signal.
The loss of Non Emergency AC Power to plant auxiliaries is analyzed in Section 14.1.12 of the UFSAR. The analysis assumes that AFW is initiated on the Low-Low Steam Generator level signal.
The Steam Generator Tube Rupture transient is analyzed in Section 14.2.4 of the UFSAR. For this event AFW i's initiated on the Safety Injection signal.
The Main Steam Line Break transient is analyzed in Section 14.2.5 of the UFSAR.
AFW is initiated on the Safety Injection signal.
The Small Break LOCA is analyzed in Section 14.3.2.2 of the UFSAR ~ AFW is initiated on the Safety Injection signal.
Based on the review of these events, it is concluded that the AFW automatic start initiation credited in the analyses is based on Safety Injection or Low-Low Steam Generator Water Level signals. There are no analyses which credit the AFW automatic initiation on the trip of all running Main Feedwater pumps. The actuation of AFW due to loss of the running SGFW pump is anticipatory. Additionally, all risk dominant scenarios requiring the operation of AFW are associated with Low-Low steam generator levels. Since Low-Low steam generator level would have provided actuation of the AFW, the risk impact of the Main Feedwater related AFW actuation failure is not significant. Therefore, it is concluded that there is no safety significance associated with the as found condition.
VII.'ORRECTIVE ACTIONS
- 1) Procedures 3/4-OP-074, Steam Generator Feed Pump, were revised to incorporate the requirements to locally start the first SGFW pump in Modes 3,4, and 5.
These revisions were reviewed to ensure they contain all necessary guidance for local SGFW pump starts.
- 2) An Operations Department Night Order has been issued informing personnel of the event. Emphasis was placed on the SGFW pump CR console switch alignment requirements and the placement of information tags.
- 3) The control room was walked down to ensure other information tags were not obscuring control board indication.
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- 4) Training Brief 703, AFW pump Automatic-Start Logic, has been issued describing the event and the logic of the AFW automatic actuation on loss of all running SGFW pumps.
- 5) General Operating Procedure, 3/4-GOP-301, Hot Standby to Power Operations, has been revised to incorporate switch alignment checks for the SGFW pump CR console switches including verification of the semaphore indication.
- 6) Operations performed a control board walkdown and verified that CR switch semaphores match associated component indicating lights.
- 7) Engineering semaphore will perform indication a review to determine have a control function that if other CR switches with is inhibited if the semaphore does not match the component indicating light.
- 8) FPL is pursuing an enhanced information tag or method of controlling tag installation to ensure control board indication is not obscured from view.
- 9) The SGFW pump CR console switch semaphore alignment and AFW actuation logic has been verified on the plant simulator. The Training Department will demonstrate this event during licensed operator simulator training.
VIII. ADDITIONAL INFORMATION There have been two other events reported related to the AFW Actuation Automatic Start logic. These events were LERs 250/96-004, and 250/97-004.
LER 250/96-004 pertained to the inadequate surveillance testing of the AFW actuation circuitry.
LER 250/97-004 is directly related to this event. The local start of the SGFW pump was an approved corrective action for preventing an inadvertent AFW initiation when the breaker for the first pump fails to close while attempting to start the first SGFW pump from the CR console switch.
The AFW Initiation logic diagram for the loss of SGFW pumps is attached.
EIIS Codes are shown in the format [EIIS SYSTEM: IEEE component function identifier, second component identifier {if appropriate)).