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| | issue date = 03/29/1999 | | | issue date = 03/29/1999 |
| | title = LER 99-002-00:on 990227,discovered That Surveillance Had Not Been Performed at Frequency,Per Ts.Caused by Personnel Error.Procedure O-6.13 Will Be Evaluated for Enhancement Documentation of Completion of ITS Srs.With 990329 Ltr | | | title = LER 99-002-00:on 990227,discovered That Surveillance Had Not Been Performed at Frequency,Per Ts.Caused by Personnel Error.Procedure O-6.13 Will Be Evaluated for Enhancement Documentation of Completion of ITS Srs.With 990329 Ltr |
| | author name = MECREDY R C, ST MARTIN J T | | | author name = Mecredy R, St Martin J |
| | author affiliation = ROCHESTER GAS & ELECTRIC CORP. | | | author affiliation = ROCHESTER GAS & ELECTRIC CORP. |
| | addressee name = VISSING G S | | | addressee name = Vissing G |
| | addressee affiliation = NRC (Affiliation Not Assigned), NRC OFFICE OF INFORMATION RESOURCES MANAGEMENT (IRM) | | | addressee affiliation = NRC (Affiliation Not Assigned), NRC OFFICE OF INFORMATION RESOURCES MANAGEMENT (IRM) |
| | docket = 05000244 | | | docket = 05000244 |
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| {{#Wiki_filter:~CATEGORYlaREGULATORYINFORMATIONDISTRIBUTIONSYSTEM(RIDS)ACCESSIONNBR:9904080022DOC.DATE:99/03/29NOTARIZED:NOFACIL:50-244RobertEmmetGinnaNuclearPlant,Unit1,RochesterGAUTH.NAME.AUTHORAFFILIATIONSTMARTIN,J.T.RochesterGas&ElectricCorp.MECREDY,R.C.RochesterGasFElectricCorp.RECIP.NAMERECIPIENTAFFILIATIONDOCKET05000244VISSING,G.S.EQ050002440NOTES:LicenseExpdateinaccordancewith10CFR2,2.109(9/19/72). | | {{#Wiki_filter:~ CATEGORY la REGULATORY INFORMATION DISTRIBUTION SYSTEM (RIDS) |
| | ACCESSION NBR:9904080022 DOC.DATE: 99/03/29 NOTARIZED: NO DOCKET FACIL:50-244 Robert Emmet Ginna Nuclear Plant, Unit 1, Rochester G 05000244 AUTH. NAME . AUTHOR AFFILIATION ST MARTIN,J.T. Rochester Gas & Electric Corp. |
| | MECREDY,R.C. Rochester Gas F Electric Corp. |
| | RECIP.NAME RECIPIENT AFFILIATION VISSING,G.S. |
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| ==SUBJECT:== | | ==SUBJECT:== |
| LER99-002-00:bn990227,discoveredthatsurveillancehadnotbeenperfohnedatfrequency,perTS.Causedbypersonnelerror.Procedure0-6.13willbeevaluatedforenhancementdocumentationofcompletionofITSSRs.With990329ltr.DISTRIBUTIONCODE:IE22TCOPIESRECEIVED:LTRENCLSIZE:TITLE:50.73/50.9LicenseeEventReport(LER),IncidentRpt,etc.RECIPIENTIDCODE/NAMEPD1-1PDINTERNAL:AEODSCENT~DRG-QMBNRR/DSSA/SPLBRGN1FILE01EXTERNAL:LSTLOBBYWARDNOACPOORE,W.NRCPDRCOPIESLTTRENCL112211111111111111'RECIPIENTIDCODE/NAMEVISSING,G.AEOD/SPD/RRABNRR/DRCH/HOHBNRR/DRPM/PECBRES/DET/EIBLMITCOMARSHALLNOACQUEENER,DSNUDOCSFULLTXTCOPIESLTTRENCL1111111111111111D0NTNOTETOALL"RZDS"RECIPIENTS:PLEASEHELPUSTOREDUCEWASTE.TOHAVEYOURNAMEORORGANIZATIONREMOVEDFROMDISTRZBUTIONLISTSORREDUCETHENUMBEROFCOPIESRECEIVEDBYYOUORYOURORGANIZATION,CONTACTTHEDOCUMENTCONTROLDESK(DCDjONEXTENSION415-2083FULLTEXTCONVERSIONREQUIREDTOTALNUMBEROFCOPIESREQUIRED:LTTR18ENCL18 ANDg~gPjP~Pw~'qP~,P'V'(',e'>'4i<v'AA>>i".EsMarch29,1999U.S.NuclearRegulatoryCommissionDocumentControlDeskAttn:GuyS.VissingProjectDirectorateI-1Washington,D.C.20555
| | LER 99-002-00:bn 990227,discovered that surveillance had not been perfohned at frequency,per TS.Caused by personnel error. Procedure 0-6.13 will be evaluated for enhancement documentation of completion of ITS SRs.With 990329 ltr. |
| | DISTRIBUTION CODE: IE22T COPIES RECEIVED:LTR ENCL SIZE: E TITLE: 50.73/50.9 Licensee Event Report (LER), Incident Rpt, etc. |
| | Q NOTES:License Exp date in accordance with 10CFR2,2.109(9/19/72) . 05000244 0 |
| | RECIPIENT COPIES 'RECIPIENT COPIES ID CODE/NAME LTTR ENCL ID CODE/NAME LTTR ENCL PD1-1 PD 1 1 VISSING,G. 1 1 INTERNAL: AEOD S 2 2 AEOD/SPD/RRAB 1 1 CENT 1 1 NRR/DRCH/HOHB 1 1 |
| | ~DRG - QMB 1 1 NRR/DRPM/PECB 1 1 NRR/DSSA/SPLB 1 1 RES/DET/EIB 1 1 RGN1 FILE 01 1 1 D |
| | EXTERNAL: L ST LOBBY WARD 1 1 LMITCO MARSHALL 1 1 NOAC POORE,W. 1 1 NOAC QUEENER,DS 1 1 0 NRC PDR 1 1 NUDOCS FULL TXT 1 1 N |
| | T NOTE TO ALL "RZDS" RECIPIENTS: |
| | PLEASE HELP US TO REDUCE WASTE. TO HAVE YOUR NAME OR ORGANIZATION REMOVED FROM DISTRZBUTION LISTS OR REDUCE THE NUMBER OF COPIES RECEIVED BY YOU OR YOUR ORGANIZATION, CONTACT THE DOCUMENT CONTROL DESK (DCDj ON EXTENSION 415-2083 FULL TEXT CONVERSION REQUIRED TOTAL NUMBER OF COPIES REQUIRED: LTTR 18 ENCL 18 |
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| | AND g~gPjP~Pw ~ 'qP ~,P 'V'(', e'>'4 i <v'A A>> i".E s March 29, 1999 U. S. Nuclear Regulatory Commission Document Control Desk Attn: Guy S. Vissing Project Directorate I-1 Washington, D.C. 20555 |
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| ==Subject:== | | ==Subject:== |
| LER1999-002,SurveillanceNotPerformed,DuetoPersonnelError,ResultedinViolationofTechnicalSpecificationsR.E.GinnaNuclearPowerPlantDocketNo.50-244
| | LER 1999-002, Surveillance Not Performed, Due to Personnel Error, Resulted in Violation of Technical Specifications R.E. Ginna Nuclear Power Plant Docket No. 50-244 |
| | |
| | ==Dear Mr. Vissing:== |
| | |
| | In accordance with 10 CFR 50.73, Licensee Event Report System, item (a) (2) (i) (B), which requires a report of, "Any operation or condition prohibited by the plant's Technical Specifications", |
| | the attached Licensee Event Report LER 1999-002 is hereby submitted. |
| | This event has in no way affected the public's health and safety. |
| | Very ruly yours, Robert C. Me redy xc: Mr. Guy S. Vissing (Mail Stop SC2) |
| | Project Directorate I-1 Division of Reactor Projects - I/II Office of Nuclear Reactor Regulation U.S. Nuclear Regulatory Commission Washington, D.C. 20555 Regional Administrator, Region I |
| | 'U.S. Nuclear Regulatory Commission 475 Allendale Road King of Prussia, PA 19406 U.S. NRC Ginna Senior Resident Inspector |
| | '7904080022 9'70329 PDR ADOCK 05000244 8 PDR |
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| ==DearMr.Vissing:==
| | NRC FORM 366 U.S. NUCLEAR REGULATORY COMMISSION g(PF'IPJ(DQY OMB NOB 3$ 50$ IPWILS 0+63@2001 (9 1998). |
| Inaccordancewith10CFR50.73,LicenseeEventReportSystem,item(a)(2)(i)(B),whichrequiresareportof,"Anyoperationorconditionprohibitedbytheplant'sTechnicalSpecifications",theattachedLicenseeEventReportLER1999-002isherebysubmitted.Thiseventhasinnowayaffectedthepublic'shealthandsafety.Veryrulyyours,RobertC.Meredyxc:Mr.GuyS.Vissing(MailStopSC2)ProjectDirectorateI-1DivisionofReactorProjects-I/IIOfficeofNuclearReactorRegulationU.S.NuclearRegulatoryCommissionWashington,D.C.20555RegionalAdministrator,RegionI'U.S.NuclearRegulatoryCommission475AllendaleRoadKingofPrussia,PA19406U.S.NRCGinnaSeniorResidentInspector'79040800229'70329PDRADOCK050002448PDR NRCFORM366(91998).U.S.NUCLEARREGULATORYCOMMISSIONLICENSEEEVENTREPORT(LER)(Seereverseforrequirednumberofdigits/charactersforeachblock)g(PF'IPJ(DQYOMBNOB3$50$IPWILS0+63@2001infotmaUoncot(ectionrequest:50hrs.Reportedlessonslearnedaroincorporatedintothelicensingprocessandfodbacktoindustry.FonvardcommentsregardingburdenesUmatotothoRecordsManagementBranch(TWF33).U.S.Nuc(oarRegulatoryCommission,Washington,DC20555000(,andtothoPapetwotkReductionProject(315(40104),OfrcoofManagementandBudget,Washington,DC20503.IfaninformationcoBectiondoesnctdisplayacurrentlyvalidOMBcontrolnumber.theNRCmaynctconductorsponsor.andaFACILITYNAME(1)R.E.GinnaNuclearPowerPlant00CKETNUMBER(2I05000244PAGE(3)1OF5TITLEte)SurveillanceNotPerformed,DuetoPersonnelError,ResultedinViolationofTechnicalSpecificationsEVENTDATE(5)LERNUMBER(6)REPORTDATE(7)OTHERFACILITIESINVOLVED(8)MONTHOAYYEARYEARSEQUENTIALNUMBERREVISIONNUMB(RMONTHOAYYEARFACILITYNAMEDOCKETNUMBER050000227OPERATINGMODE(9)POWERLEVEL(10)1999701999-002-0003291999FACILITYNAMEDOCKETNUMBER0500020.2201(b)20.2203(a)(1)20.2203(a)(2)(I)20.2203(a)(2)(v)20.2203(a)(3)(l)20.2203(a)(3)(n)50.73(a)(2)(l)50.73(a)(2)(II50.73(a)(2)(III50.73(a)(2)(vill)50.73(a)(2)(xl73.71URSUANTTOTHEREQUIREMENTSOF10CFREI(Checkonoormore)(11)THISREPORTISSUBMITTEDP20.2203(a)(2)(II)20.2203(a)(2)(Ill)20.2203(a)(2)(lv)20.2203(a)(4)50.36(c)(1)50.36(c)(2)LICENSEECONTACTFORTHISLER(12)50.73(a)(2)((v50.73(a)(2)(v50.73(a)(2)(vlOTHERSpecifyinAbstractbelowor(nNRCForm366ANAMETELEPHONENUMBERUscexfeAtesCode)JohnT.St.Martin-TechnicalAssistant(716)771-3641CAUSESYSTEMCOMPONENT'ANUFACTURERREPORTABLETOEPIXCAUSESYSTEMCOMPONENTMANUFACTURERREPORTABLETOEPIXSUPPLEMENTALREPORTEXPECTEDR4)YES(Ifyes,completeEXPECTEDSUBMISSIONDATE).XNOEXPECTEDSUBMISSIONDATE((5)MONTHOAYABSTRACT(Llmltto1400Spaces,I.e.,approximately15single-spacedtypewrittenHnos)(16)OnFebruary27,1999,atapproximately1600EST,theplantwasincoastdownpriortothe1999refuelingoutage,inMode1atapproximately70%steadystatereactorpower.Itwasdiscoveredthatasurveillancehadnotbeenperformedatthefrequencyrequiredbytheplant'sTechnicalSpecifications.Thisconstitutedamissedsurveillance,whichisaconditionprohibitedbytheplant'stechnicalspecifications.ControlRoomoperatorsverifiedthattheplantwascurrentlyincompliancewiththesesurveillancerequirements.Noimmediatecorrectiveactionwasneeded.Theunderlyingcauseofnotperformingthissurveillancewasapersonnelerror.CorrectiveactiontopreventrecurrenceisoutlinedinSectionV.B.
| | infotmaUon cot(ection request: 50 hrs. Reported lessons learned aro incorporated into the licensing process and fod back to LICENSEE EVENT REPORT (LER) industry. Fonvard comments regarding burden esUmato to tho Records Management Branch (TW F33). U.S. Nuc(oar Regulatory Commission, Washington, DC 20555000(, and to (See reverse for required number of tho Papetwotk Reduction Project (315(40104), Ofrco of digits/characters for each block) Management and Budget, Washington, DC 20503. If an information coBection does nct display a currently valid OMB control number. the NRC may nct conduct or sponsor. and a FACILITY NAME (1) 00CKET NUMBER (2I PAGE (3) |
| | R.E. Ginna Nuclear Power Plant 05000244 1 OF 5 TITLE te) |
| | Surveillance Not Performed, Due to Personnel Error, Resulted in Violation of Technical Specifications EVENT DATE (5) LER NUMBER (6) REPORT DATE (7) OTHER FACILITIES INVOLVED (8) |
| | FACILITY N AME DOCKET NUMBER SEQUENTIAL REVISION MONTH OAY YEAR YEAR MONTH OAY YEAR NUMBER NUMB(R 05000 02 27 1999 1999 - 002 - 00 03 29 1999 FACILITYNAME DOCKET NUMBER 05000 OPERATING THIS REPORT IS SUBMITTED P URSUANTTO THE REQUIREMENTS OF 10 CFR EI (Check ono or more) (11) |
| | MODE (9) 20.2201(b) 20.2203(a)(2)(v) 50.73(a) (2)(l) 50.73(a)(2) (vill) |
| | POWER 20.2203(a)(1) 20.2203(a)(3)(l) 50.73(a)(2)(II 50.73(a) (2) (xl LEVEL (10) 70 20.2203(a)(2) (I) 20.2203(a) (3) (n) 50.73(a)(2)(III 73.71 20.2203(a) (2) (II) 20.2203(a)(4) 50.73(a) (2)((v OTHER 20.2203(a) (2) (Ill) 50.36(c)(1) 50.73(a) (2)(v Specify in Abstract below or 20.2203(a)(2)(lv) 50.36(c) (2) 50.73(a) (2) (vl (n NRC Form 366A LICENSEE CONTACT FOR THIS LER (12) |
| | NAME TELEPHONE NUMBER Uscexfe Ates Code) |
| | John T. St. Martin - Technical Assistant (716) 771-3641 REPORTABLE REPORTABLE CAUSE SYSTEM COMPONENT'ANUFACTURER CAUSE SYSTEM COMPONENT MANUFACTURER TO EPIX TO EPIX SUPPLEMENTAL REPORT EXPECTED R4) MONTH OAY EXPECTED YES SUBMISSION (If yes, complete EXPECTED SUBMISSION DATE). X NO DATE ((5) |
| | ABSTRACT (Llmlt to 1400 Spaces, I.e., approximately 15 single-spaced typewritten Hnos) (16) |
| | On February 27, 1999, at approximately 1600 EST, the plant was in coastdown prior to the 1999 refueling outage, in Mode 1 at approximately 70% steady state reactor power. It was discovered that a surveillance had not been performed at the frequency required by the plant's Technical Specifications. This constituted a missed surveillance, which is a condition prohibited by the plant's technical specifications. |
| | Control Room operators verified that the plant was currently in compliance with these surveillance requirements. No immediate corrective action was needed. |
| | The underlying cause of not performing this surveillance was a personnel error. |
| | Corrective action to prevent recurrence is outlined in Section V.B. |
| | |
| | 0 NRC FORM 366A U.S. NUCLEAR REGULATORY COMMISSION (6 1996) |
| | LICENSEE EVENT REPORT (LER) |
| | TEXT CONTINUATION FACILITY NAME (1) DOCKET (2) LER NUMBER (6) PAGE (3) |
| | SEQUENTIAL REVISI yEAR ON NUMBER NUMBE R.E. Ginna Nuclear Power Plant 05000244 2 OF 5 1999 002 00 TEXT ill more spaceis reouired, use additional copies ol NRC Form 366AI (171 PRE-EVENT PLANT CONDITIONS: |
| | On February 27, 1999, at approximately 1600 EST, the plant was in coastdown prior to the 1999 refueling outage, in Mode 1 at approximately 70% steady state reactor power. One of the responsibilities of the Control Room operators is to perform the computer checks in accordance with plant procedure S-26.1 (Computer Program Check). Control Room operators had just completed these computer checks, to meet the Surveillance Requirements (SR) of the Ginna Station Improved Technical Specifications (ITS). Step 5.4 of plant procedure 0-6.13 (Daily Surveillance Log) requires that the computer program checks be performed every 8 hours. |
| | II. DESCRIPTION OF EVENT: |
| | A. DATES AND APPROXIMATE TIMES,OF MAJOR OCCURRENCES o February 26, 1999, 2318 EST: SR 3.2.3.1 is performed. |
| | o February 27, 1999, 0728 EST: It was intended that SR 3.2.3.1 be performed. |
| | o February 27, 1999, 1418 EST: Event date and time. |
| | o February 27, 1999, 1539 EST: SR 3.2.3.1 is performed. |
| | o February 27, 1999, 1600 EST: Discovery date and time. |
| | o February 27, 1999, 2326 EST: SR 3.2.3.1 is performed. |
| | EVENT: |
| | On February 27, 1999, at approximately 1600 EST, the plant was in coastdown prior to the 1999 refueling outage, in Mode 1 at approximately 70% steady state reactor power. Control Room operators had just completed computer checks, to meet the SR of the ITS. Specifically, SR 3.2.3.1, which verifies operability of the Axial Flux Difference (AFD) monitor, had been performed at approximately 1539 EST. Performance of this SR is required at a Frequency of 12 hours, per ITS SR 3.2.3.1. Ginna Station administrative requirements, as listed in Operations Procedure 0-6.13, "Daily Surveillance Log", are to perform this SR once during every eight hour time block. One of the operators mentally questioned whether he had actually performed SR 3.2.3.1 when he had previously performed these computer checks at approximately 0728 EST. Note that proper performance of SR 3.2.3.1 results in the receipt of several alarms which are received on the Plant Process Computer System (PPCS) and documented on the PPCS alarm printout. |
| | The Control Room operator conducted additional self-checking. He realized his error during the second check of the day when, using the procedure, he could not recall performing step 5.4 of procedure S-26.1. He immediately informed the Control Room Foreman about the potential missed surveillance. After a check of the PPCS alarm printout, both the Foreman and the Control Room Operator realized that the surveillance had, in fact, been missed. They discovered that there had been no PPCS alarms generated around the timeframe of 0738 EST, and concluded that SR 3.2.3.1 had not been performed at 0728 EST. Review of the PPCS alarm printout confirmed that SR 3.2.3.1 had been performed at approximately 2318 EST on February 26, 1999. |
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| 0NRCFORM366A(61996)LICENSEEEVENTREPORT(LER)TEXTCONTINUATIONU.S.NUCLEARREGULATORYCOMMISSIONFACILITYNAME(1)DOCKET(2)LERNUMBER(6)yEARSEQUENTIALONREVISINUMBERNUMBEPAGE(3)R.E.GinnaNuclearPowerPlant050002441999002-002OF5TEXTillmorespaceisreouired,useadditionalcopiesolNRCForm366AI(171PRE-EVENTPLANTCONDITIONS:OnFebruary27,1999,atapproximately1600EST,theplantwasincoastdownpriortothe1999refuelingoutage,inMode1atapproximately70%steadystatereactorpower.OneoftheresponsibilitiesoftheControlRoomoperatorsistoperformthecomputerchecksinaccordancewithplantprocedureS-26.1(ComputerProgramCheck).ControlRoomoperatorshadjustcompletedthesecomputerchecks,tomeettheSurveillanceRequirements(SR)oftheGinnaStationImprovedTechnicalSpecifications(ITS).Step5.4ofplantprocedure0-6.13(DailySurveillanceLog)requiresthatthecomputerprogramchecksbeperformedevery8hours.II.DESCRIPTIONOFEVENT:A.DATESANDAPPROXIMATETIMES,OFMAJOROCCURRENCESoFebruary26,1999,2318EST:SR3.2.3.1isperformed.oFebruary27,1999,0728EST:ItwasintendedthatSR3.2.3.1beperformed.oFebruary27,1999,1418EST:Eventdateandtime.oFebruary27,1999,1539EST:SR3.2.3.1isperformed.oFebruary27,1999,1600EST:Discoverydateandtime.oFebruary27,1999,2326EST:SR3.2.3.1isperformed.EVENT:OnFebruary27,1999,atapproximately1600EST,theplantwasincoastdownpriortothe1999refuelingoutage,inMode1atapproximately70%steadystatereactorpower.ControlRoomoperatorshadjustcompletedcomputerchecks,tomeettheSRoftheITS.Specifically,SR3.2.3.1,whichverifiesoperabilityoftheAxialFluxDifference(AFD)monitor,hadbeenperformedatapproximately1539EST.PerformanceofthisSRisrequiredataFrequencyof12hours,perITSSR3.2.3.1.GinnaStationadministrativerequirements,aslistedinOperationsProcedure0-6.13,"DailySurveillanceLog",aretoperformthisSRonceduringeveryeighthourtimeblock.OneoftheoperatorsmentallyquestionedwhetherhehadactuallyperformedSR3.2.3.1whenhehadpreviouslyperformedthesecomputerchecksatapproximately0728EST.NotethatproperperformanceofSR3.2.3.1resultsinthereceiptofseveralalarmswhicharereceivedonthePlantProcessComputerSystem(PPCS)anddocumentedonthePPCSalarmprintout.TheControlRoomoperatorconductedadditionalself-checking.Herealizedhiserrorduringthesecondcheckofthedaywhen,usingtheprocedure,hecouldnotrecallperformingstep5.4ofprocedureS-26.1.HeimmediatelyinformedtheControlRoomForemanaboutthepotentialmissedsurveillance.AfteracheckofthePPCSalarmprintout,boththeForemanandtheControlRoomOperatorrealizedthatthesurveillancehad,infact,beenmissed.TheydiscoveredthattherehadbeennoPPCSalarmsgeneratedaroundthetimeframeof0738EST,andconcludedthatSR3.2.3.1hadnotbeenperformedat0728EST.ReviewofthePPCSalarmprintoutconfirmedthatSR3.2.3.1hadbeenperformedatapproximately2318ESTonFebruary26,1999.
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| NRCFORM366A(6.1998)LICENSEEEVENTREPORT(LER)TEXTCONTINUATIONU.S.NUCLEARREGULATORYCOMMISSIONFACILITYNAMEI1)R.E.GinnaNuclearPowerPlantDOCKET(2)05000244LERNUMBER(6)SEQUENTIALREVISINUMBERNUMBE1999-002-00PAGEI3)3OF5TEXTfffmorespeceisrerfuired,useedditionelcopiesofNRCForm366Af)171InaccordancewithITSSR3.2.3.1,thisSRwasduewithin12hours.Applyingtheapplicabilityrequirements'ofITSSR3.0.2,thespecificFrequencyismetifthesurveillanceisperformedwithin1.25timestheintervalspecified(1.25times12resultsin15hours).Thus,thelatestSR3.2.3.1couldbeperformedwouldhavebeen15hoursafter2318hours,orapproximately1418ESTonFebruary27,1999.Time1418onFebruary27istheEventdateandtime.AlthoughSR3.2.3.1hadbeenmissedat0728EST,theAFDmonitorcontinuedtobefullyfunctional.ReviewofPPCSalarmsconfirmedthatSR3.2.3.1hadbeenproperlyperformedatallothertimesinFebruary1999,atthefrequencyrequiredbytheplant'sTechnicalSpecificationsandprocedure0-6.13.C.INOPERABLESTRUCTURES,COMPONENTS,ORSYSTEMSTHATCONTRIBUTEDTOTHEEVENT:NoneD.OTHERSYSTEMSORSECONDARYFUNCTIONSAFFECTED:NoneE.METHODOFDISCOVERY:Thiseventwasindicatedduringmentalquestioningofprevious.actions,andwasformallydiscoveredbyreviewofPPCSalarmprintouts.F.OPERATORACTION:TheControlRoomoperatorsidentifiedthatSR3.2.3.1hadinadvertentlynotbeenperformedatapproximately0728ESTonFebruary27.Atthetimeofdiscovery(1600EST),ControlRoomoperatorsverifiedthattheplantwascurrentlyincompliancewiththesesurveillancerequirementsandthattheAFDmonitorwas,andhadbeen,operable.Noimmediatecorrectiveactionwasneeded.G.SAFETYSYSTEMRESPONSES:NoneIII.CAUSEOFEVENT:A.IMMEDIATECAUSE:TheimmediatecauseoftheconditionprohibitedbyTechnicalSpecificationswasamissedsurveillanceinthatSR3.2.3.1wasnotperformedwithin15hoursafter2318ESTonFebruary26.
| | NRC FORM 366A U.S. NUCLEAR REGULATORY COMMISSION (6.1998) |
| rt ONRCFORM366A(6.1999)LICENSEEEVENTREPORT(LERJTEXTCONTINUATIONU.S.NUCLEARREGULATORYCOMMISSIONFACILITYNAME(1)R.E.GinnaNuclearPowerPlantOOCKET(2)05000244LERNUMBER(6)YEARSEQUENTIALONREVISINUMBERNUMBE1999-002-00PAGE(3)4OF5TEXTfilmorespecoisrecurred,usoeddidonelcopiesofNRCForm366AJ1171B.INTERMEDIATECAUSE:TheintermediatecauseofthemissedsurveillancewasinadvertentlynotperformingSR3.2.3.1atapproximately0728ESTonFebruary27.ROOTCAUSE:TheunderlyingcauseofthemissedsurveillancewasapersonnelerrorbyanRG(tIElicensedoperator,whoperformedseveralseparatetasksassociatedwithsomeroutineITSSRsthatareperformedusingthePPCS,andinadvertentlydidnotperformITSSR3.2:3.1atthattime.ThiserrorwasacognitiveerrorinthatthelicensedoperatordidnotrecognizeordetectthathehadfailedtoperformSR3.2.3.1at0728EST.InadvertentlynotperformingSR3.2.3.1wascontrarytoapprovedprocedures,inthattheprocedurerequiredtheSRbeperformedeveryeighthours.TherewerenounusualcharacteristicsintheControlRoomthatdirectlycontributedtotheerror.IV.ANALYSISOFEVENT:Thiseventisreportableinaccordancewith10CFR50.73,LicenseeEventReportSystem,item(a)(2)(i)(B),whichrequiresareportof,"Anyoperationorconditionprohibitedbytheplant'sTechnicalSpecifications".Themissedsurveillanceisaconditionprohibitedbytheplant'stechncialspecifications.Anassessmentwasperformedconsideringboththesafetyconsequencesandimplicationsofthiseventwiththefollowingresultsandconclusions:Therewerenooperationalorsafetyconsequencesorimplicationsattributedtothemissedsurveillancebecause:TheAFDisameasureofaxialpowerdistributionskewingtothetoporbottomhalfofthecore.TheAFDis.definedasthedifferenceinnormalizedfluxsignalsbetweenthetopandbottomhalvesofatwosectionexcoreneutrondetectorineachdetectorwell.Forconvenience,thisfluxdifferenceisconvertedtoprovidefluxdifferenceunits.TheallowedrangeoftheAFDisusedinthenucleardesignprocesstohelpensurethatcorepeakingfactorsandaxialpowerdistributionsmeetsafetyanalysisrequirements.SR3.2.3.1istheverificationthattheAFDmonitorisoperable.ThisisnormallyaccomplishedbyiritroducingasignalintothePPCStoverifycontrolroomannunciationofAFDnotwithinthetargetband.TheFrequencyof12hoursissufficienttoensureoperabilityoftheAFDmonitor,sinceundernormalplantoperationtheAFDisnotexpectedtosignificantlychange.SR3.2.3.1hadbeenproperlyperformedatalltimespriortothisevent,andwasproperlyperformedatapproximately1539ESTand2326ESTonFebruary27,confirmingthattheAFDmonitorwasoperable.ThefrequencyofmonitoringtheAFDbythePPCSisnominallyonceperminute.Thismonitoringcontinuedthroughoutthisevent.
| | LICENSEE EVENT REPORT (LER) |
| NRCFORM366A1619)8)LICENSEEEVENTREPORT(LER)TEXTCONTINUATIONU.S.NUCLEARREGULATORYCOMMISSION~FACILITYNAMEI1)R.E.GinnaNuclearPowerPlantDOCKETI2)05000244LERNUMBERI6)YEARSEOUENTIALONREVISINUMBERNUMBE1999-002-00PAGEI3)5OF5TEXTillmorespeceisrequired,useeddaionelcopiesolltiRCFormJ66AI117)oWiththermalpower(90%ofreactorthermalpower(RTP),theAFDmaybeoutsidethetarget'bandprovidedthatthedeviationtimeisrestricted.ItisintendedthattheplantisoperatedwiththeAFDwithinthetargetbandaboutthetargetfluxdifference.oInoperabilityofthealarmdoesnotnecessarilypreventtheactualAFDvaluesfrombeingavailable(e.g.,fromthecomputerlogsorhandlogs).AFDvaluesforthepreceding24hourscanbeobtainedfromthehourlyPPCSprintoutsorhandlogs.IftheAFDmonitorhadbeeninoperableduringoperationat(90%RTP,theAFDmeasurementismonitoredataSurveillanceFrequencyof1hourtoensurethattheAFDiswithinitslimits.Basedontheabove,itcanbeconcludedthattherewerenounreviewedsafetyquestions,andthatthepublic'shealthandsafetywasassuredatalltimes.V.CORRECTIVEACTION:A.ACTIONTAKENTORETURNAFFECTEDSYSTEMSTOPRE-EVENTNORMALSTATUS:SincetheAFDmonitorwasoperableatthetimeofdiscovery,noimmediatecorrectiveactionswereneeded.B.ACTIONTAKENORPLANNEDTOPREVENTRECURRENCE:oProcedure0-6.13willbeevaluatedfortheenhancementofdocumentationofthecompletionofITSSRs.oLessonslearnedfromthiseventwerediscussedwiththelicensedoperatorwhoinadvertentlydidnotperformSR3.2.3.1.Emphasiswasplacedonattentiontodetail.oOperationssupervisionwillreviewthisLERandcorrectiveactionswithalloperatingshifts.VI.ADDITIONALINFORMATION:A.FAILEDCOMPONENTS:NoneB.PREVIOUSLERsONSIMILAREVENTS:AsimilarLEReventhistoricalsearchwasconductedwiththefollowingresults:NodocumentationofsimilarLEReventswiththesamerootcauseatGinnaStationcouldbeidentified.C.SPECIALCOMMENTS:None}}
| | TEXT CONTINUATION FACILITY NAME I1) DOCKET (2) LER NUMBER (6) PAGE I3) |
| | SEQUENTIAL REVISI NUMBER NUMBE R.E. Ginna Nuclear Power Plant 05000244 - - 3 OF 5 1999 002 00 TEXT fffmore spece is rerfuired, use eddi tionel copies of NRC Form 366Af )171 In accordance with ITS SR 3.2.3.1, this SR was due within 12 hours. Applying the applicability requirements'of ITS SR 3.0.2, the specific Frequency is met if the surveillance is performed within 1.25 times the interval specified (1.25 times 12 results in 15 hours). Thus, the latest SR 3.2.3.1 could be performed would have been 15 hours after 2318 hours, or approximately 1418 EST on February 27, 1999. Time 1418 on February 27 is the Event date and time. |
| | Although SR 3.2.3.1 had been missed at 0728 EST, the AFD monitor continued to be fully functional. Review of PPCS alarms confirmed that SR 3.2.3.1 had been properly performed at all other times in February 1999, at the frequency required by the plant's Technical Specifications and procedure 0-6.13. |
| | C. INOPERABLE STRUCTURES, COMPONENTS, OR SYSTEMS THAT CONTRIBUTED TO THE EVENT: |
| | None D. OTHER SYSTEMS OR SECONDARY FUNCTIONS AFFECTED: |
| | None E. METHOD OF DISCOVERY: |
| | This event was indicated during mental questioning of previous. actions, and was formally discovered by review of PPCS alarm printouts. |
| | F. OPERATOR ACTION: |
| | The Control Room operators identified that SR 3.2.3.1 had inadvertently not been performed at approximately 0728 EST on February 27. At the time of discovery (1600 EST), Control Room operators verified that the plant was currently in compliance with these surveillance requirements and that the AFD monitor was, and had been, operable. No immediate corrective action was needed. |
| | G. SAFETY SYSTEM RESPONSES: |
| | None III. CAUSE OF EVENT: |
| | A. IMMEDIATE CAUSE: |
| | The immediate cause of the condition prohibited by Technical Specifications was a missed surveillance in that SR 3.2.3.1 was not performed within 15 hours after 2318 EST on February 26. |
| | |
| | r t |
| | |
| | O NRC FORM 366A U.S. NUCLEAR REGULATORY COMMISSION (6.1999) |
| | LICENSEE EVENT REPORT (LERJ TEXT CONTINUATION FACILITY NAME (1) OOCKET (2) LER NUMBER (6) PAGE (3) |
| | REVISI YEAR SEQUENTIAL ON NUMBER NUMBE R.E. Ginna Nuclear Power Plant 05000244 - - 4 5 1999 002 00 OF TEXT filmore speco is recurred, uso eddidonel copies of NRC Form 366AJ 1171 B. INTERMEDIATE CAUSE: |
| | The intermediate cause of the missed surveillance was inadvertently not performing SR 3.2.3.1 at approximately 0728 EST on February 27. |
| | ROOT CAUSE: |
| | The underlying cause of the missed surveillance was a personnel error by an RG(tIE licensed operator, who performed several separate tasks associated with some routine ITS SRs that are performed using the PPCS, and inadvertently did not perform ITS SR 3.2:3.1 at that time. This error was a cognitive error in that the licensed operator did not recognize or detect that he had failed to perform SR 3.2.3.1 at 0728 EST. Inadvertently not performing SR 3.2.3.1 was contrary to approved procedures, in that the procedure required the SR be performed every eight hours. There were no unusual characteristics in the Control Room that directly contributed to the error. |
| | IV. ANALYSIS OF EVENT: |
| | This event is reportable in accordance with 10 CFR 50.73, Licensee Event Report System, item (a) (2) (i) |
| | (B), which requires a report of, "Any operation or condition prohibited by the plant's Technical Specifications". The missed surveillance is a condition prohibited by the plant's techncial specifications. |
| | An assessment was performed considering both the safety consequences and implications of this event with the following results and conclusions: |
| | There were no operational or safety consequences or implications attributed to the missed surveillance because: |
| | The AFD is a measure of axial power distribution skewing to the top or bottom half of the core. The AFD is. defined as the difference in normalized flux signals between the top and bottom halves of a two section excore neutron detector in each detector well. For convenience, this flux difference is converted to provide flux difference units. The allowed range of the AFD is used in the nuclear design process to help ensure that core peaking factors and axial power distributions meet safety analysis requirements. |
| | SR 3.2.3.1 is the verification that the AFD monitor is operable. This is normally accomplished by iritroducing a signal into the PPCS to verify control room annunciation of AFD not within the target band. The Frequency of 12 hours is sufficient to ensure operability of the AFD monitor, since under normal plant operation the AFD is not expected to significantly change. |
| | SR 3.2.3.1 had been properly performed at all times prior to this event, and was properly performed at approximately 1539 EST and 2326 EST on February 27, confirming that the AFD monitor was operable. |
| | The frequency of monitoring the AFD by the PPCS is nominally once per minute. This monitoring continued throughout this event. |
| | |
| | NRC FORM 366A U.S. NUCLEAR REGULATORY COMMISSION 16 19)8) |
| | LICENSEE EVENT REPORT (LER) |
| | TEXT CONTINUATION |
| | ~ FACILITY NAME I1) DOCKET I2) LER NUMBER I6) PAGE I3) |
| | REVISI YEAR SEOUENTIAL ON NUMBER NUMBE R.E. Ginna Nuclear Power Plant 05000244 - 5 OF 5 1999 002 00 TEXT illmore speceis required, use eddaionel copies ol ltiRC Form J66AI 117) o With thermal power (90% of reactor thermal power (RTP), the AFD may be outside the target'band provided that the deviation time is restricted. It is intended that the plant is operated with the AFD within the target band about the target flux difference. |
| | o Inoperability of the alarm does not necessarily prevent the actual AFD values from being available (e.g., from the computer logs or hand logs). AFD values for the preceding 24 hours can be obtained from the hourly PPCS printouts or hand logs. If the AFD monitor had been inoperable during operation at (90% RTP, the AFD measurement is monitored at a Surveillance Frequency of 1 hour to ensure that the AFD is within its limits. |
| | Based on the above, it can be concluded that there were no unreviewed safety questions, and that the public's health and safety was assured at all times. |
| | V. CORRECTIVE ACTION: |
| | A. ACTION TAKEN TO RETURN AFFECTED SYSTEMS TO PRE-EVENT NORMAL STATUS: |
| | Since the AFD monitor was operable at the time of discovery, no immediate corrective actions were needed. |
| | B. ACTION TAKEN OR PLANNED TO PREVENT RECURRENCE: |
| | o Procedure 0-6.13 will be evaluated for the enhancement of documentation of the completion of ITS SRs. |
| | o Lessons learned from this event were discussed with the licensed operator who inadvertently did not perform SR 3.2.3.1. Emphasis was placed on attention to detail. |
| | o Operations supervision will review this LER and corrective actions with all operating shifts. |
| | VI. ADDITIONALINFORMATION: |
| | A. FAILED COMPONENTS: |
| | None B. PREVIOUS LERs ON SIMILAR EVENTS: |
| | A similar LER event historical search was conducted with the following results: No documentation of similar LER events with the same root cause at Ginna Station could be identified. |
| | C. SPECIAL COMMENTS: |
| | None}} |
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Category:LICENSEE EVENT REPORT (SEE ALSO AO
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[Table view] Category:RO)
MONTHYEARML17265A7541999-09-22022 September 1999 LER 99-011-00:on 990823,small Tears Were Discovered in Flexible Duct Work Connector at Inlet of CR HVAC Sys Return Air Fan (AKF08).Caused by in-leakage Greater than That Assumed.Implemented Temporary Mod 99-029.With 990922 Ltr ML17265A7431999-08-24024 August 1999 LER 99-004-01:on 990412,discovered That Containment Recirculation Fan Chevron Separator Vanes Were Installed Backwards.Caused by Improper Assembly by Mfg.Moisture Separator Vanes Were Dismantled & Correctly re-installed ML17265A7181999-07-23023 July 1999 LER 99-007-01:on 990423,reactor Trip Occurred Due to Instrument & Control Technicians Inadvertently Pulling Fuses from Wrong Nuclear Instrument Channel.Setpoint Adjustments Were Completed by Different Crew of Technicians ML17265A7081999-07-22022 July 1999 LER 98-003-02:on 980904,actuations of CR Emergency Air Treatment Sys Was Noted Due to Invalid Causes.Caused by Various Degraded Components in CR RM Sys.Creats Actuation Signal Was Reset & Normal Ventilation Was Restored ML17265A7031999-07-19019 July 1999 LER 99-S01-00:on 990617,determined That Temporary Unescorted Access Had Been Granted to Contractor Employee.Caused by Incomplete Info Re Circumstances of Individual Military Separation.Individual Access Was Revoked.With 990719 Ltr ML17265A7021999-07-15015 July 1999 LER 99-010-00:on 990615,ventilation Isolation of Auxiliary Bldg Occurred When Auxiliary Bldg Gas Radiation Monitor R-14 Reached High Alarm Setpoint.Cr Operators Rest Auxiliary Bldg Ventilation Isolation Signal.With 990715 Ltr ML17265A6851999-06-21021 June 1999 LER 99-001-01:on 990222,deficiencies in NSSS Vendor steam- Line Brake Mass & Energy Release Analysis Results in Plant Being Outside Design Bases Occurred.Caused by Deficiencies in W.Temporary Administrative Replaced.With 990621 Ltr ML17265A6661999-06-0202 June 1999 LER 99-009-00:on 990503,instrumentation Declared Inoperable in Multiple Channels Resulted in Condition Prohibited by Ts. 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Caused by Personnel Error.Blown Fuse Was Replaced & Offsite Power Was Restored to Safeguards Bus 17.With 990513 Ltr ML17265A6431999-05-12012 May 1999 LER 99-004-00:on 990412,discovered That Containment Recirculation Fan Moisture Separator Vanes Were Incorrectly Installed,Per 10CFR21.Caused by Improper Assembly by Mfg. Subject Vanes Were Dismantled & Correctly re-installed ML17265A6141999-03-31031 March 1999 LER 99-003-00:on 990301,two Main Steam non-return Check Valves Were Declared Inoperable Due to Exceedance of Acceptance Criteria.Caused by Changes in Methodology & Matls.Packing Gland Torque Will Be Adjusted.With 990331 Ltr ML17265A6131999-03-29029 March 1999 LER 99-002-00:on 990227,discovered That Surveillance Had Not Been Performed at Frequency,Per Ts.Caused by Personnel Error.Procedure O-6.13 Will Be Evaluated for Enhancement Documentation of Completion of ITS Srs.With 990329 Ltr ML17265A6061999-03-24024 March 1999 LER 99-001-00:on 990222,plant Was Noted Outside Design Basis.Caused by Deficiencies in NSSS Vendor Slb Mass & Energy Release.Placed Temporary Administrative Restriction 40 Degrees F Max on Screenhouse Bay Temp ML17265A4951998-12-21021 December 1998 LER 98-005-00:on 981120,loss of 34.5 Kv Offsite Power Circuit 751,resulted in Automatic Start of B Edg.Caused by Faulted Cable Splice.Performed Appropriate Actions of Abnormal Procedure AP-ELEC.1.With 981221 Ltr ML17265A4931998-12-17017 December 1998 LER 98-004-00:on 971030,determined That Improperly Performed Surveillance Resulted in Condition Prohibited by Ts.Caused by Procedure non-adherence.Appropriate Calibr Procedures Were Properly Performed with 24 H of Condition Discovery ML17265A4691998-11-25025 November 1998 LER 98-003-01:on 980904,actuations of CR Emergency Air Treatment Systems (Creats) Occurred.Caused by Radon build-up During Temp Inversion.Creats Actuation Signal Was Reset & Normal Ventilation Was Restored to CR ML17265A4271998-10-0505 October 1998 LER 98-003-00:on 980904,actuations of CR Emergency Air Treatment Sys Occurred.Caused by Radon build-up During Temp Inversion.Air Samples Were Taken & Determined That Source of Radiation Was Naturally Occurring Radon.With 981005 Ltr ML17265A3671998-07-14014 July 1998 LER 98-002-00:on 971019,CR Emergency Air Treatment Sys Actuating Function Was Not Operable.Caused by Mispositioned Switch.Revised Procedure CPI-MON-R37.W/980714 Ltr ML17265A1921998-03-11011 March 1998 LER 98-001-00:on 980209,discovered That Boraflex Degradation in SPF Was Greater than Was Assumed.Caused by Dissolution of Boron on Boraflex Matrix,Per 10CFR50.21.Removed Spent Fuel Assemblies from Selected Degraded Storage Rack Cells ML17265A1641998-02-0606 February 1998 LER 97-007-01:on 971117,reactor Engineer Recognized That Neutron Flux Low Range Trip Circuitry for Channel Was Not in Tripped Condition as Required.Caused by Technical Inadequacies.Channel Defeat Will Be Identified ML17265A1601998-02-0606 February 1998 LER 97-006-01:on 971103,verification of B Concentration Was Not Performed Due to Misinterpretation of Event Sequence. Audible Count Rate Function Was Restored to Operable Status ML17264B1441997-12-17017 December 1997 LER 97-007-00:on 971117,NF Low Range Trip Circuitry for Channel N-44 Was Not Placed in Tripped Condition.Caused by Technical Inadequacies in Procedures.Implemented EWR 4862 to Resolve Design deficiency.W/971217 Ltr ML17264B1291997-12-0303 December 1997 LER 97-006-00:on 971103,NIS Audible Count Rate Function Was Inoperable.Caused by Misinterpretation of Event Sequence Due to Not Verifying Boron Concentration.B Verification Occurred Every 12 H Per ITS LCO Action 3.9.2.C.3.W/971203 Ltr ML17264B1271997-12-0101 December 1997 LER 97-005-00:on 971031,undetected Unblocking of SI Actuation Signal Occurred at Low Pressure Condition,Due to Faulty Bistable Which Resulted in Inadvertent SI Actuation Signal.Sias,Ci & CVI Signals Were Reset ML17264B1211997-11-24024 November 1997 LER 97-004-00:on 971024,radiation Monitor Alarm Were Noted Due to Higher than Normal Radioactive Gas Concentration Resulted in Cvi.New R-12 Alarm Setpoint Was Maintained for Duration of Refueling Outage ML17264B0461997-09-29029 September 1997 LER 97-003-01:on 970730,bistable Instrument Trip Setpoint Could Have Exceeded Allowable Value.Caused by Insufficient Existing Margin Between Trip Setpoint & Allowable Value. Held Switches in Tripped configuration.W/970929 Ltr ML17264B0111997-08-27027 August 1997 LER 97-003-00:on 970730,high Steam Flow Bistable Instrument Setpoint Plus Instrument Uncertainty Could Exceed Allowable Value in ITS Was Identified.Caused by Entry Into ITS LCO 3.0.3.Switches Placed in Tripped configuration.W/970827 Ltr ML17264A9941997-08-19019 August 1997 LER 97-002-00:on 970720,34.5 Kv Offsite Power Circuit 751 Was Lost.Caused by Automatic Actuation of B Emergency DG Due to Undervoltage on Safeguards Buses 16 & 17.Offsite Power Restored to Safeguards Buses 16 & 17.W/970819 Ltr ML17264A9911997-08-11011 August 1997 LER 96-009-02:on 960723,determined That Leak Rate Outside Containment Was Greater than Program Limit.Caused by Weld Defect.Isolated Leak & Cut Out & Replaced Leaking Pipe ML17264A8271997-03-0303 March 1997 LER 97-001-00:on 970131,discovered Service Water Temp Was Less than Specified Value.Caused by non-representative Method of Monitoring.Increased Water Temp in Screenhouse Bay to Greater than 35 Degrees F.W/970303 Ltr ML17264A8071997-01-22022 January 1997 LER 96-015-00:on 961223,discovered Thermally Induced Overpressure Transient Could Occur.Caused by Thermal Expansion of Fluid During Design Basis Accident Condition. Installed Relief Valve on Affected line.W/970122 Ltr ML17264A7471996-11-27027 November 1996 LER 96-013-00:on 961029,circuit Breakers Closed While in Mode 3 & Resulted in Condition Prohibited by TS Due to Personnel Error.Circuit Breakers for MOV-878B & MOV-878D Were re-opened.W/961127 Ltr ML17264A6051996-09-19019 September 1996 LER 96-012-00:on 960820,feedwater Transient Occurred,Due to Closure of Feedwater Regulating Valve,Causing Lo Lo Steam Generator Level Reactor Trip.Sgs Were Restored & Missing Screw in 1/P-476 Was replaced.W/960919 Ltr ML17264A6061996-09-19019 September 1996 LER 96-009-01:on 960723,leakage Outside Containment Occurred,Due to Weld Defect,Resulting in Leak Rate Greater than Program Limits.Source of Leakage Isolated from RWST by Freeze Seal,Allowing Exit from ITS LCO 3.0.3.W/960919 Ltr ML17264A5911996-09-0505 September 1996 LER 96-011-00:on 960807,improper Configuration of Circuit Breaker Occurred,Due to Undetected Internal Interference, Resulting in Automatic Start of Both Auxiliary Feedwater Pumps.Running AFW Pumps Were secured.W/960905 Ltr ML17264A5921996-09-0505 September 1996 LER 96-010-00:on 960806,latching of Main Turbine While in Mode 4 Occurred,Due to Defective Procedure,Resulting in Automatic Start of Auxiliary Feedwater Pump.Caused by Defective Maint Procedure.Procedure revised.W/960905 Ltr ML17264A5891996-08-22022 August 1996 LER 96-009-00:on 960723,determined Leak on Piping Sys Outside Containment Greater than Program Limit.Caused by Weld Defect.Pipe & Socket Welds Were Cut Out & Replaced. W/960822 Ltr ML17264A5781996-08-0606 August 1996 LER 96-008-00:on 960707,main Feedwater Pump Breakers Opened. Caused by Change in Seal Water Differential Pressure Occurred During Sys Realignment.Afw Flow Controlled as Desired to Maintain S/G level.W/960806 Ltr ML17264A5561996-07-12012 July 1996 LER 96-007-00:on 960612,CR Operators Identified Control Rods Misaligned & Not Moving in Proper Sequence.Caused by Faulty Firing Circuit Card in Rod Control Sys.Faulty Firing Circuit Card in 1BD Power Cabinet replaced.W/960712 Ltr ML17264A5421996-06-20020 June 1996 LER 96-006-00:on 960521,discovered Containment Penetration Not in Required Status.Caused by Personnel Error.Installed Flange Inside Containment Penetration 2.W/960620 Ltr ML17264A5411996-06-17017 June 1996 LER 96-005-00:on 960516,PORC Determined Deficient Procedures Do Not Meet SRs for Testing safety-related Logic Circuits. Caused by Inadequancies in Individual Testing Procedures. Procedures Re Improved TSs revised.W/960617 Ltr ML17264A5051996-05-17017 May 1996 LER 96-003-01:on 960308,identified That Both Pressurizer PORVs Inoperable Concurrently Due to Disconnection of Flex Hose to Both PORV Actuators to Install air-sets for Benchset & Limit Switch Activities.Hpes Completed ML17264A4481996-04-0808 April 1996 LER 96-003-00:on 960308,both Pressurizer Relief Valves Inoperable.Hpes Evaluation Is Being Conducted to Determined Cause of Event.C/As:Both PORVs restored.W/960408 Ltr ML17264A4471996-04-0808 April 1996 LER 96-002-00:on 960307,secondary Transient Occurred.Caused by Loss of B Condenser Circulating Water Pump.C/As: Thermography performed.W/960408 Ltr ML17264A4101996-03-18018 March 1996 LER 96-001-00:on 950504,inservice Test Not Performed During Refueling Outage.Caused by Inadequate Tracking of Surveillance Frequency.Valve Test Performed & Disassembled. W/960318 Ltr ML17264A2971995-12-14014 December 1995 LER 95-009-00:on 950817,surveillance Was Not Performed Due to Improper Application of TS Requirements Resulting in TS Violation.Testing of MOV-515 Was Performed on 951115.W/ 951214 Ltr ML17264A1711995-09-25025 September 1995 LER 95-008-00:on 950825,secondary Transient Occurred.Caused by Loss of B Condenser Circulating Water Pump That Resulted in Manual Rt.Returned S/G Levels to Normal Operating levels.W/950925 Ltr 1999-09-22
[Table view] Category:TEXT-SAFETY REPORT
MONTHYEARML17265A7601999-10-0505 October 1999 Part 21 Rept Re W2 Switch Supplied by W Drawn from Stock, Did Not Operate Properly After Being Installed on 990409. Switch Returned to W on 990514 for Evaluation & Root Cause Analysis ML17265A7621999-09-30030 September 1999 Monthly Operating Rept for Sept 1999 for Re Ginna Npp.With 991008 Ltr ML17265A7531999-09-23023 September 1999 Part 21 Rept Re Corrective Action & Closeout of 10CFR21 Rept of Noncompliance Re Unacceptable Part for 30-4 Connector. Unacceptable Parts Removed from Stock & Scrapped ML17265A7541999-09-22022 September 1999 LER 99-011-00:on 990823,small Tears Were Discovered in Flexible Duct Work Connector at Inlet of CR HVAC Sys Return Air Fan (AKF08).Caused by in-leakage Greater than That Assumed.Implemented Temporary Mod 99-029.With 990922 Ltr ML17265A7471999-08-31031 August 1999 Monthly Operating Rept for Aug 1999 for Re Ginna Npp.With 990909 Ltr ML17265A7431999-08-24024 August 1999 LER 99-004-01:on 990412,discovered That Containment Recirculation Fan Chevron Separator Vanes Were Installed Backwards.Caused by Improper Assembly by Mfg.Moisture Separator Vanes Were Dismantled & Correctly re-installed ML17265A7341999-07-31031 July 1999 Monthly Operating Rept for July 1999 for Re Ginna Npp.With 990806 Ltr ML17265A7291999-07-29029 July 1999 Interim Part 21 Rept Re safety-related DB-25 Breaker Mechanism Procured from W Did Not Pas Degradatin Checks When Drawn from Stock to Be Installed Into BUS15/03A.Holes Did Not line-up & Tripper Pan Bent ML17265A7181999-07-23023 July 1999 LER 99-007-01:on 990423,reactor Trip Occurred Due to Instrument & Control Technicians Inadvertently Pulling Fuses from Wrong Nuclear Instrument Channel.Setpoint Adjustments Were Completed by Different Crew of Technicians ML17265A7081999-07-22022 July 1999 LER 98-003-02:on 980904,actuations of CR Emergency Air Treatment Sys Was Noted Due to Invalid Causes.Caused by Various Degraded Components in CR RM Sys.Creats Actuation Signal Was Reset & Normal Ventilation Was Restored ML17265A7131999-07-22022 July 1999 Special Rept:On 990407,radiation Monitor RM-14A Was Declared Inoperable.Caused by Failed Communication Link from TSC to Plant Process Computer Sys.Communication Link Was re-established & RM-14A Was Declaed Operable on 990521 ML17265A7031999-07-19019 July 1999 LER 99-S01-00:on 990617,determined That Temporary Unescorted Access Had Been Granted to Contractor Employee.Caused by Incomplete Info Re Circumstances of Individual Military Separation.Individual Access Was Revoked.With 990719 Ltr ML17265A7211999-07-19019 July 1999 ISI Rept for Third Interval (1990-1999) Third Period, Second Outage (1999) at Re Ginna Npp. ML17265A7021999-07-15015 July 1999 LER 99-010-00:on 990615,ventilation Isolation of Auxiliary Bldg Occurred When Auxiliary Bldg Gas Radiation Monitor R-14 Reached High Alarm Setpoint.Cr Operators Rest Auxiliary Bldg Ventilation Isolation Signal.With 990715 Ltr ML17265A7661999-06-30030 June 1999 1999 Rept of Facility Changes,Tests & Experiments Conducted Without Prior NRC Approval for Jan 1998 Through June 1999, Per 10CFR50.59.With 991020 Ltr ML17265A7011999-06-30030 June 1999 Monthly Operating Rept for June 1999 for Re Ginna Npp.With 990712 Ltr ML17265A6851999-06-21021 June 1999 LER 99-001-01:on 990222,deficiencies in NSSS Vendor steam- Line Brake Mass & Energy Release Analysis Results in Plant Being Outside Design Bases Occurred.Caused by Deficiencies in W.Temporary Administrative Replaced.With 990621 Ltr ML17265A6761999-06-16016 June 1999 Part 21 Rept Re Defects & noncompliances,10CFR21(d)(3)(ii), Which Requires Written Notification to NRC on Identification of Defect or Failure to Comply. Relays Were Returned to Eaton for Evaluation & Root Cause Analysis ML17265A6661999-06-0202 June 1999 LER 99-009-00:on 990503,instrumentation Declared Inoperable in Multiple Channels Resulted in Condition Prohibited by Ts. Caused by Unanticipated High Frequency AC Voltage Ripple. Entered TS LCO 3.0.3.With 990602 Ltr ML17265A6681999-05-31031 May 1999 Monthly Operating Rept for May 1999 for Re Ginna Nuclear Power Plant.With 990608 Ltr ML17265A6651999-05-27027 May 1999 Interim Rept Re W2 Control Switch,Procured from W,Did Not Operate Satisfactorily When Drawn from Stock to Be Installed in Main Control Board for 1C2 Safety Injection Pump. Estimated That Evaluation Will Be Completed by 991001 ML17309A6541999-05-27027 May 1999 LER 99-008-00:on 990427,overtemperature Delta T Reactor Trip Occurred Due to Faulted Bistable During Calibr of Redundant Channel.Plant Was Stabilized in Mode 3 & Faulted Bistable Was Subsequently Replaced.With 990527 Ltr ML17265A6631999-05-24024 May 1999 LER 99-007-00:on 990423,technicians Inadvertently Pulled Fuses from Wrong Nuclear Instrument Cahnnel,Causing Reactor Trip,Due to High Range Flux Trip.Caused by Personnel Error. Labeling Scheme Improved ML17265A6601999-05-21021 May 1999 LER 99-006-00:on 990421,start of turbine-driven Auxiliary Feedwater Pump Was Noted.Caused by MOV Being Left in Open Position.Closed Manual Isolation Valve to Secure Steam to Pump.With 990521 Ltr ML17265A6591999-05-17017 May 1999 Part 21 Rept Re Relay Deficiency Detected During pre-installation Testing.Caused by Incorrectly Wired Relay Coil.Relays Were Returned to Eaton Corp for Investigation. Relays Were Repaired & Retested ML17265A6441999-05-13013 May 1999 LER 99-005-00:on 990413,undervoltage Signal of Safeguards Bus During Testing Resulted in Automatic Start of B Edg. Caused by Personnel Error.Blown Fuse Was Replaced & Offsite Power Was Restored to Safeguards Bus 17.With 990513 Ltr ML17265A6431999-05-12012 May 1999 LER 99-004-00:on 990412,discovered That Containment Recirculation Fan Moisture Separator Vanes Were Incorrectly Installed,Per 10CFR21.Caused by Improper Assembly by Mfg. Subject Vanes Were Dismantled & Correctly re-installed ML17265A6381999-05-0707 May 1999 Part 21 Rept Re Replacement Turbocharger Exhaust Turbine Side Drain Port Not Functioning as Design Intended.Caused by Manufacturing Deficiency.Turbocharger Was Reaasembled & Reinstalled on B EDG ML17265A6391999-04-30030 April 1999 Monthly Operating Rept for Apr 1999 for Re Ginna Nuclear Power Plant.With 990510 Ltr ML17265A6361999-04-23023 April 1999 Part 21 Rept Re Power Supply That Did Not Work Properly When Drawn from Stock & Installed in -25 Vdc Slot.Power Supply Will Be Sent to Vendor to Perform Failure Mode Assessment.Evaluation Will Be Completed by 991001 ML17265A6301999-04-18018 April 1999 Rev 1 to Cycle 28 COLR for Re Ginna Npp. ML17265A6251999-04-15015 April 1999 Special Rept:On 990309,halon Systems Were Removed from Svc & Fire Door F502 Was Blocked Open.Caused by Mods Being Made to CR Emergency Air Treatment Sys.Continuous Fire Watch Was Established with Backup Fire Suppression Equipment ML17265A6551999-04-0909 April 1999 Initial Part 21 Rept Re Mfg Deficiency in Replacement Turbocharger for B EDG Supplied by Coltec Industries. Deficiency Consisted of Missing Drain Port in Intermediate Casing.Required Oil Drain Port Machined Open ML17265A6291999-03-31031 March 1999 Rev 0 to Cycle 28 COLR for Re Ginna Npp. ML17265A6241999-03-31031 March 1999 Monthly Operating Rept for Mar 1999 for Ginna Station.With 990409 Ltr ML17265A6141999-03-31031 March 1999 LER 99-003-00:on 990301,two Main Steam non-return Check Valves Were Declared Inoperable Due to Exceedance of Acceptance Criteria.Caused by Changes in Methodology & Matls.Packing Gland Torque Will Be Adjusted.With 990331 Ltr ML17265A6131999-03-29029 March 1999 LER 99-002-00:on 990227,discovered That Surveillance Had Not Been Performed at Frequency,Per Ts.Caused by Personnel Error.Procedure O-6.13 Will Be Evaluated for Enhancement Documentation of Completion of ITS Srs.With 990329 Ltr ML17265A6061999-03-24024 March 1999 LER 99-001-00:on 990222,plant Was Noted Outside Design Basis.Caused by Deficiencies in NSSS Vendor Slb Mass & Energy Release.Placed Temporary Administrative Restriction 40 Degrees F Max on Screenhouse Bay Temp ML17265A5661999-03-0101 March 1999 Rev 26 to QA Program for Station Operation. ML17265A5961999-02-28028 February 1999 Monthly Operating Rept for Feb 1999 for Ginna Nuclear Power Plant.With 990310 Ltr ML17265A5371999-01-31031 January 1999 Monthly Operating Rept for Jan 1999 for Re Ginna Nuclear Power Plant.With 990205 Ltr ML17265A5951998-12-31031 December 1998 Rg&E 1998 Annual Rept. ML17265A5001998-12-21021 December 1998 Rev 26 to QA Program for Station Operation. ML17265A4951998-12-21021 December 1998 LER 98-005-00:on 981120,loss of 34.5 Kv Offsite Power Circuit 751,resulted in Automatic Start of B Edg.Caused by Faulted Cable Splice.Performed Appropriate Actions of Abnormal Procedure AP-ELEC.1.With 981221 Ltr ML17265A4931998-12-17017 December 1998 LER 98-004-00:on 971030,determined That Improperly Performed Surveillance Resulted in Condition Prohibited by Ts.Caused by Procedure non-adherence.Appropriate Calibr Procedures Were Properly Performed with 24 H of Condition Discovery ML17265A4761998-11-30030 November 1998 Monthly Operating Rept for Nov 1998 for Re Ginna Nuclear Power Plant.With 981210 Ltr ML17265A4691998-11-25025 November 1998 LER 98-003-01:on 980904,actuations of CR Emergency Air Treatment Systems (Creats) Occurred.Caused by Radon build-up During Temp Inversion.Creats Actuation Signal Was Reset & Normal Ventilation Was Restored to CR ML17265A4531998-10-31031 October 1998 Monthly Operating Rept for Oct 1998 for Re Ginna Nuclear Power Plant.With 981110 Ltr ML17265A4271998-10-0505 October 1998 LER 98-003-00:on 980904,actuations of CR Emergency Air Treatment Sys Occurred.Caused by Radon build-up During Temp Inversion.Air Samples Were Taken & Determined That Source of Radiation Was Naturally Occurring Radon.With 981005 Ltr ML17265A4291998-09-30030 September 1998 Monthly Operating Rept for Sept 1998 for Re Ginna Nuclear Power Plant.With 981009 Ltr 1999-09-30
[Table view] |
Text
~ CATEGORY la REGULATORY INFORMATION DISTRIBUTION SYSTEM (RIDS)
ACCESSION NBR:9904080022 DOC.DATE: 99/03/29 NOTARIZED: NO DOCKET FACIL:50-244 Robert Emmet Ginna Nuclear Plant, Unit 1, Rochester G 05000244 AUTH. NAME . AUTHOR AFFILIATION ST MARTIN,J.T. Rochester Gas & Electric Corp.
MECREDY,R.C. Rochester Gas F Electric Corp.
RECIP.NAME RECIPIENT AFFILIATION VISSING,G.S.
SUBJECT:
LER 99-002-00:bn 990227,discovered that surveillance had not been perfohned at frequency,per TS.Caused by personnel error. Procedure 0-6.13 will be evaluated for enhancement documentation of completion of ITS SRs.With 990329 ltr.
DISTRIBUTION CODE: IE22T COPIES RECEIVED:LTR ENCL SIZE: E TITLE: 50.73/50.9 Licensee Event Report (LER), Incident Rpt, etc.
Q NOTES:License Exp date in accordance with 10CFR2,2.109(9/19/72) . 05000244 0
RECIPIENT COPIES 'RECIPIENT COPIES ID CODE/NAME LTTR ENCL ID CODE/NAME LTTR ENCL PD1-1 PD 1 1 VISSING,G. 1 1 INTERNAL: AEOD S 2 2 AEOD/SPD/RRAB 1 1 CENT 1 1 NRR/DRCH/HOHB 1 1
~DRG - QMB 1 1 NRR/DRPM/PECB 1 1 NRR/DSSA/SPLB 1 1 RES/DET/EIB 1 1 RGN1 FILE 01 1 1 D
EXTERNAL: L ST LOBBY WARD 1 1 LMITCO MARSHALL 1 1 NOAC POORE,W. 1 1 NOAC QUEENER,DS 1 1 0 NRC PDR 1 1 NUDOCS FULL TXT 1 1 N
T NOTE TO ALL "RZDS" RECIPIENTS:
PLEASE HELP US TO REDUCE WASTE. TO HAVE YOUR NAME OR ORGANIZATION REMOVED FROM DISTRZBUTION LISTS OR REDUCE THE NUMBER OF COPIES RECEIVED BY YOU OR YOUR ORGANIZATION, CONTACT THE DOCUMENT CONTROL DESK (DCDj ON EXTENSION 415-2083 FULL TEXT CONVERSION REQUIRED TOTAL NUMBER OF COPIES REQUIRED: LTTR 18 ENCL 18
AND g~gPjP~Pw ~ 'qP ~,P 'V'(', e'>'4 i <v'A A>> i".E s March 29, 1999 U. S. Nuclear Regulatory Commission Document Control Desk Attn: Guy S. Vissing Project Directorate I-1 Washington, D.C. 20555
Subject:
LER 1999-002, Surveillance Not Performed, Due to Personnel Error, Resulted in Violation of Technical Specifications R.E. Ginna Nuclear Power Plant Docket No. 50-244
Dear Mr. Vissing:
In accordance with 10 CFR 50.73, Licensee Event Report System, item (a) (2) (i) (B), which requires a report of, "Any operation or condition prohibited by the plant's Technical Specifications",
the attached Licensee Event Report LER 1999-002 is hereby submitted.
This event has in no way affected the public's health and safety.
Very ruly yours, Robert C. Me redy xc: Mr. Guy S. Vissing (Mail Stop SC2)
Project Directorate I-1 Division of Reactor Projects - I/II Office of Nuclear Reactor Regulation U.S. Nuclear Regulatory Commission Washington, D.C. 20555 Regional Administrator, Region I
'U.S. Nuclear Regulatory Commission 475 Allendale Road King of Prussia, PA 19406 U.S. NRC Ginna Senior Resident Inspector
'7904080022 9'70329 PDR ADOCK 05000244 8 PDR
NRC FORM 366 U.S. NUCLEAR REGULATORY COMMISSION g(PF'IPJ(DQY OMB NOB 3$ 50$ IPWILS 0+63@2001 (9 1998).
infotmaUon cot(ection request: 50 hrs. Reported lessons learned aro incorporated into the licensing process and fod back to LICENSEE EVENT REPORT (LER) industry. Fonvard comments regarding burden esUmato to tho Records Management Branch (TW F33). U.S. Nuc(oar Regulatory Commission, Washington, DC 20555000(, and to (See reverse for required number of tho Papetwotk Reduction Project (315(40104), Ofrco of digits/characters for each block) Management and Budget, Washington, DC 20503. If an information coBection does nct display a currently valid OMB control number. the NRC may nct conduct or sponsor. and a FACILITY NAME (1) 00CKET NUMBER (2I PAGE (3)
R.E. Ginna Nuclear Power Plant 05000244 1 OF 5 TITLE te)
Surveillance Not Performed, Due to Personnel Error, Resulted in Violation of Technical Specifications EVENT DATE (5) LER NUMBER (6) REPORT DATE (7) OTHER FACILITIES INVOLVED (8)
FACILITY N AME DOCKET NUMBER SEQUENTIAL REVISION MONTH OAY YEAR YEAR MONTH OAY YEAR NUMBER NUMB(R 05000 02 27 1999 1999 - 002 - 00 03 29 1999 FACILITYNAME DOCKET NUMBER 05000 OPERATING THIS REPORT IS SUBMITTED P URSUANTTO THE REQUIREMENTS OF 10 CFR EI (Check ono or more) (11)
MODE (9) 20.2201(b) 20.2203(a)(2)(v) 50.73(a) (2)(l) 50.73(a)(2) (vill)
POWER 20.2203(a)(1) 20.2203(a)(3)(l) 50.73(a)(2)(II 50.73(a) (2) (xl LEVEL (10) 70 20.2203(a)(2) (I) 20.2203(a) (3) (n) 50.73(a)(2)(III 73.71 20.2203(a) (2) (II) 20.2203(a)(4) 50.73(a) (2)((v OTHER 20.2203(a) (2) (Ill) 50.36(c)(1) 50.73(a) (2)(v Specify in Abstract below or 20.2203(a)(2)(lv) 50.36(c) (2) 50.73(a) (2) (vl (n NRC Form 366A LICENSEE CONTACT FOR THIS LER (12)
NAME TELEPHONE NUMBER Uscexfe Ates Code)
John T. St. Martin - Technical Assistant (716) 771-3641 REPORTABLE REPORTABLE CAUSE SYSTEM COMPONENT'ANUFACTURER CAUSE SYSTEM COMPONENT MANUFACTURER TO EPIX TO EPIX SUPPLEMENTAL REPORT EXPECTED R4) MONTH OAY EXPECTED YES SUBMISSION (If yes, complete EXPECTED SUBMISSION DATE). X NO DATE ((5)
ABSTRACT (Llmlt to 1400 Spaces, I.e., approximately 15 single-spaced typewritten Hnos) (16)
On February 27, 1999, at approximately 1600 EST, the plant was in coastdown prior to the 1999 refueling outage, in Mode 1 at approximately 70% steady state reactor power. It was discovered that a surveillance had not been performed at the frequency required by the plant's Technical Specifications. This constituted a missed surveillance, which is a condition prohibited by the plant's technical specifications.
Control Room operators verified that the plant was currently in compliance with these surveillance requirements. No immediate corrective action was needed.
The underlying cause of not performing this surveillance was a personnel error.
Corrective action to prevent recurrence is outlined in Section V.B.
0 NRC FORM 366A U.S. NUCLEAR REGULATORY COMMISSION (6 1996)
LICENSEE EVENT REPORT (LER)
TEXT CONTINUATION FACILITY NAME (1) DOCKET (2) LER NUMBER (6) PAGE (3)
SEQUENTIAL REVISI yEAR ON NUMBER NUMBE R.E. Ginna Nuclear Power Plant 05000244 2 OF 5 1999 002 00 TEXT ill more spaceis reouired, use additional copies ol NRC Form 366AI (171 PRE-EVENT PLANT CONDITIONS:
On February 27, 1999, at approximately 1600 EST, the plant was in coastdown prior to the 1999 refueling outage, in Mode 1 at approximately 70% steady state reactor power. One of the responsibilities of the Control Room operators is to perform the computer checks in accordance with plant procedure S-26.1 (Computer Program Check). Control Room operators had just completed these computer checks, to meet the Surveillance Requirements (SR) of the Ginna Station Improved Technical Specifications (ITS). Step 5.4 of plant procedure 0-6.13 (Daily Surveillance Log) requires that the computer program checks be performed every 8 hours9.259259e-5 days <br />0.00222 hours <br />1.322751e-5 weeks <br />3.044e-6 months <br />.
II. DESCRIPTION OF EVENT:
A. DATES AND APPROXIMATE TIMES,OF MAJOR OCCURRENCES o February 26, 1999, 2318 EST: SR 3.2.3.1 is performed.
o February 27, 1999, 0728 EST: It was intended that SR 3.2.3.1 be performed.
o February 27, 1999, 1418 EST: Event date and time.
o February 27, 1999, 1539 EST: SR 3.2.3.1 is performed.
o February 27, 1999, 1600 EST: Discovery date and time.
o February 27, 1999, 2326 EST: SR 3.2.3.1 is performed.
EVENT:
On February 27, 1999, at approximately 1600 EST, the plant was in coastdown prior to the 1999 refueling outage, in Mode 1 at approximately 70% steady state reactor power. Control Room operators had just completed computer checks, to meet the SR of the ITS. Specifically, SR 3.2.3.1, which verifies operability of the Axial Flux Difference (AFD) monitor, had been performed at approximately 1539 EST. Performance of this SR is required at a Frequency of 12 hours1.388889e-4 days <br />0.00333 hours <br />1.984127e-5 weeks <br />4.566e-6 months <br />, per ITS SR 3.2.3.1. Ginna Station administrative requirements, as listed in Operations Procedure 0-6.13, "Daily Surveillance Log", are to perform this SR once during every eight hour time block. One of the operators mentally questioned whether he had actually performed SR 3.2.3.1 when he had previously performed these computer checks at approximately 0728 EST. Note that proper performance of SR 3.2.3.1 results in the receipt of several alarms which are received on the Plant Process Computer System (PPCS) and documented on the PPCS alarm printout.
The Control Room operator conducted additional self-checking. He realized his error during the second check of the day when, using the procedure, he could not recall performing step 5.4 of procedure S-26.1. He immediately informed the Control Room Foreman about the potential missed surveillance. After a check of the PPCS alarm printout, both the Foreman and the Control Room Operator realized that the surveillance had, in fact, been missed. They discovered that there had been no PPCS alarms generated around the timeframe of 0738 EST, and concluded that SR 3.2.3.1 had not been performed at 0728 EST. Review of the PPCS alarm printout confirmed that SR 3.2.3.1 had been performed at approximately 2318 EST on February 26, 1999.
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NRC FORM 366A U.S. NUCLEAR REGULATORY COMMISSION (6.1998)
LICENSEE EVENT REPORT (LER)
TEXT CONTINUATION FACILITY NAME I1) DOCKET (2) LER NUMBER (6) PAGE I3)
SEQUENTIAL REVISI NUMBER NUMBE R.E. Ginna Nuclear Power Plant 05000244 - - 3 OF 5 1999 002 00 TEXT fffmore spece is rerfuired, use eddi tionel copies of NRC Form 366Af )171 In accordance with ITS SR 3.2.3.1, this SR was due within 12 hours1.388889e-4 days <br />0.00333 hours <br />1.984127e-5 weeks <br />4.566e-6 months <br />. Applying the applicability requirements'of ITS SR 3.0.2, the specific Frequency is met if the surveillance is performed within 1.25 times the interval specified (1.25 times 12 results in 15 hours1.736111e-4 days <br />0.00417 hours <br />2.480159e-5 weeks <br />5.7075e-6 months <br />). Thus, the latest SR 3.2.3.1 could be performed would have been 15 hours1.736111e-4 days <br />0.00417 hours <br />2.480159e-5 weeks <br />5.7075e-6 months <br /> after 2318 hours0.0268 days <br />0.644 hours <br />0.00383 weeks <br />8.81999e-4 months <br />, or approximately 1418 EST on February 27, 1999. Time 1418 on February 27 is the Event date and time.
Although SR 3.2.3.1 had been missed at 0728 EST, the AFD monitor continued to be fully functional. Review of PPCS alarms confirmed that SR 3.2.3.1 had been properly performed at all other times in February 1999, at the frequency required by the plant's Technical Specifications and procedure 0-6.13.
C. INOPERABLE STRUCTURES, COMPONENTS, OR SYSTEMS THAT CONTRIBUTED TO THE EVENT:
None D. OTHER SYSTEMS OR SECONDARY FUNCTIONS AFFECTED:
None E. METHOD OF DISCOVERY:
This event was indicated during mental questioning of previous. actions, and was formally discovered by review of PPCS alarm printouts.
F. OPERATOR ACTION:
The Control Room operators identified that SR 3.2.3.1 had inadvertently not been performed at approximately 0728 EST on February 27. At the time of discovery (1600 EST), Control Room operators verified that the plant was currently in compliance with these surveillance requirements and that the AFD monitor was, and had been, operable. No immediate corrective action was needed.
G. SAFETY SYSTEM RESPONSES:
None III. CAUSE OF EVENT:
A. IMMEDIATE CAUSE:
The immediate cause of the condition prohibited by Technical Specifications was a missed surveillance in that SR 3.2.3.1 was not performed within 15 hours1.736111e-4 days <br />0.00417 hours <br />2.480159e-5 weeks <br />5.7075e-6 months <br /> after 2318 EST on February 26.
r t
O NRC FORM 366A U.S. NUCLEAR REGULATORY COMMISSION (6.1999)
LICENSEE EVENT REPORT (LERJ TEXT CONTINUATION FACILITY NAME (1) OOCKET (2) LER NUMBER (6) PAGE (3)
REVISI YEAR SEQUENTIAL ON NUMBER NUMBE R.E. Ginna Nuclear Power Plant 05000244 - - 4 5 1999 002 00 OF TEXT filmore speco is recurred, uso eddidonel copies of NRC Form 366AJ 1171 B. INTERMEDIATE CAUSE:
The intermediate cause of the missed surveillance was inadvertently not performing SR 3.2.3.1 at approximately 0728 EST on February 27.
ROOT CAUSE:
The underlying cause of the missed surveillance was a personnel error by an RG(tIE licensed operator, who performed several separate tasks associated with some routine ITS SRs that are performed using the PPCS, and inadvertently did not perform ITS SR 3.2:3.1 at that time. This error was a cognitive error in that the licensed operator did not recognize or detect that he had failed to perform SR 3.2.3.1 at 0728 EST. Inadvertently not performing SR 3.2.3.1 was contrary to approved procedures, in that the procedure required the SR be performed every eight hours. There were no unusual characteristics in the Control Room that directly contributed to the error.
IV. ANALYSIS OF EVENT:
This event is reportable in accordance with 10 CFR 50.73, Licensee Event Report System, item (a) (2) (i)
(B), which requires a report of, "Any operation or condition prohibited by the plant's Technical Specifications". The missed surveillance is a condition prohibited by the plant's techncial specifications.
An assessment was performed considering both the safety consequences and implications of this event with the following results and conclusions:
There were no operational or safety consequences or implications attributed to the missed surveillance because:
The AFD is a measure of axial power distribution skewing to the top or bottom half of the core. The AFD is. defined as the difference in normalized flux signals between the top and bottom halves of a two section excore neutron detector in each detector well. For convenience, this flux difference is converted to provide flux difference units. The allowed range of the AFD is used in the nuclear design process to help ensure that core peaking factors and axial power distributions meet safety analysis requirements.
SR 3.2.3.1 is the verification that the AFD monitor is operable. This is normally accomplished by iritroducing a signal into the PPCS to verify control room annunciation of AFD not within the target band. The Frequency of 12 hours1.388889e-4 days <br />0.00333 hours <br />1.984127e-5 weeks <br />4.566e-6 months <br /> is sufficient to ensure operability of the AFD monitor, since under normal plant operation the AFD is not expected to significantly change.
SR 3.2.3.1 had been properly performed at all times prior to this event, and was properly performed at approximately 1539 EST and 2326 EST on February 27, confirming that the AFD monitor was operable.
The frequency of monitoring the AFD by the PPCS is nominally once per minute. This monitoring continued throughout this event.
NRC FORM 366A U.S. NUCLEAR REGULATORY COMMISSION 16 19)8)
LICENSEE EVENT REPORT (LER)
TEXT CONTINUATION
~ FACILITY NAME I1) DOCKET I2) LER NUMBER I6) PAGE I3)
REVISI YEAR SEOUENTIAL ON NUMBER NUMBE R.E. Ginna Nuclear Power Plant 05000244 - 5 OF 5 1999 002 00 TEXT illmore speceis required, use eddaionel copies ol ltiRC Form J66AI 117) o With thermal power (90% of reactor thermal power (RTP), the AFD may be outside the target'band provided that the deviation time is restricted. It is intended that the plant is operated with the AFD within the target band about the target flux difference.
o Inoperability of the alarm does not necessarily prevent the actual AFD values from being available (e.g., from the computer logs or hand logs). AFD values for the preceding 24 hours2.777778e-4 days <br />0.00667 hours <br />3.968254e-5 weeks <br />9.132e-6 months <br /> can be obtained from the hourly PPCS printouts or hand logs. If the AFD monitor had been inoperable during operation at (90% RTP, the AFD measurement is monitored at a Surveillance Frequency of 1 hour1.157407e-5 days <br />2.777778e-4 hours <br />1.653439e-6 weeks <br />3.805e-7 months <br /> to ensure that the AFD is within its limits.
Based on the above, it can be concluded that there were no unreviewed safety questions, and that the public's health and safety was assured at all times.
V. CORRECTIVE ACTION:
A. ACTION TAKEN TO RETURN AFFECTED SYSTEMS TO PRE-EVENT NORMAL STATUS:
Since the AFD monitor was operable at the time of discovery, no immediate corrective actions were needed.
B. ACTION TAKEN OR PLANNED TO PREVENT RECURRENCE:
o Procedure 0-6.13 will be evaluated for the enhancement of documentation of the completion of ITS SRs.
o Lessons learned from this event were discussed with the licensed operator who inadvertently did not perform SR 3.2.3.1. Emphasis was placed on attention to detail.
o Operations supervision will review this LER and corrective actions with all operating shifts.
VI. ADDITIONALINFORMATION:
A. FAILED COMPONENTS:
None B. PREVIOUS LERs ON SIMILAR EVENTS:
A similar LER event historical search was conducted with the following results: No documentation of similar LER events with the same root cause at Ginna Station could be identified.
C. SPECIAL COMMENTS:
None