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| | issue date = 10/22/1998 | | | issue date = 10/22/1998 |
| | title = LER 98-004-00:on 980923,inadvertent Actuation of Efs Occurred During Surveillance Testing.Caused by Personnel Error.Personnel Involved with Event Were Counseled & Procedure Changes Were Implemented.With 981022 Ltr | | | title = LER 98-004-00:on 980923,inadvertent Actuation of Efs Occurred During Surveillance Testing.Caused by Personnel Error.Personnel Involved with Event Were Counseled & Procedure Changes Were Implemented.With 981022 Ltr |
| | author name = SCHEIDE R H, VANDERGRIFT J | | | author name = Scheide R, Vandergrift J |
| | author affiliation = ENTERGY OPERATIONS, INC. | | | author affiliation = ENTERGY OPERATIONS, INC. |
| | addressee name = | | | addressee name = |
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| =Text= | | =Text= |
| {{#Wiki_filter:CATEGORYlyREGULATORY INFORMATION DISTRIBUTION SYSTEM(RIDS)ACCESSION NBR:9810280011 DOC.DATE: | | {{#Wiki_filter:CATEGORY ly REGULATORY INFORMATION DISTRIBUTION SYSTEM (RIDS) |
| 98/10/22NOTARIZED: | | ACCESSION NBR:9810280011 DOC.DATE: 98/10/22 NOTARIZED: NO DOCKET FACIL:50-313 Arkansas Nuclear One, Unit 1, Arkansas Power E Light 05000313 AUTH"NAME, 'UTHOR AFFILIATION SCHEIDE,R.H. Entergy Operations, Inc. |
| NOFACIL:50-313 ArkansasNuclearOne,Unit1,ArkansasPowerELightAUTH"NAME,
| | VANDERGRIFT,J. Entergy Operations, Inc. |
| 'UTHORAFFILIATION SCHEIDE,R.H. | | RECIP.NAME RECIPIENT AFFILIATION |
| EntergyOperations, Inc.VANDERGRIFT,J.
| |
| EntergyOperations, Inc.RECIP.NAME RECIPIENT AFFILIATION DOCKET05000313
| |
|
| |
|
| ==SUBJECT:== | | ==SUBJECT:== |
| LER98-004-00:on 980923,inadvertent actuation ofEFSoccurredduringsurveillance testing.Causedbypersonnel error.Personnel involvedwitheventwerecounseled
| | LER 98-004-00:on 980923,inadvertent actuation of EFS occurred during surveillance testing. Caused by personnel error. Personnel involved with event were counseled & A procedure changes were implemented. With 981022 ltr. |
| &procedure changeswereimplemented. | | DISTRIBUTION CODE: IE22T COPIES RECEIVED:LTR ENCL SIZE: |
| With981022ltr.DISTRIBUTION CODE:IE22TCOPIESRECEIVED:LTR ENCLSIZE:TITLE:50.73/50.9 LicenseeEventReport(LER),IncidentRpt,,etc.
| | TITLE: 50.73/50.9 Licensee Event Report (LER), Incident Rpt,,etc. |
| NOTES:A.RECIPIENT IDCODE/NAME PD4-1PD'NTERNAL: | | NOTES: |
| ACRSAEOD/SPD/RRAB NRR/DE/ECGB NRR/DE/EMEB NRR/DRCH/HOHB NRR/DRPM/PECB RES/DET/EIB EXTERNAL:
| | . RECIPIENT COPIES RECIPIENT COPIES ID CODE/NAME LTTR ENCL ID CODE/NAME LTTR ENCL PD4-1PD 1 1 HILTON,N 1 1 |
| LSTLOBBYWARDNOACPOORE,W.NRCPDRCOPIESLTTRENCL1111111111111111111111RECIPIENT IDCODE/NAME HILTON,NAEODSPDRABNRR/DE/EELB NRR/DRCH/HICB NRR/DRCH/HQMB NRR/DSSA/SPLB RGN4FILE01LITCOBRYCE,JHNOACQUEENER,DS NUDOCSFULLTXTCOPIESLTTRENCL1122111111111111111111NOTETOALL"BIDS"RECIPIENTS:
| | 'NTERNAL: ACRS 1 1 AEOD SPD RAB 2 2 AEOD/SPD/RRAB 1 1 1 1 NRR/DE/ECGB 1 1 NRR/DE/EELB 1 1 NRR/DE/EMEB 1 1 NRR/DRCH/HICB 1 1 NRR/DRCH/HOHB 1 1 NRR/DRCH/HQMB 1 1 NRR/DRPM/PECB 1 1 NRR/DSSA/SPLB 1 1 RES/DET/EIB 1 1 RGN4 FILE 01 1 1 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 NOTE TO ALL "BIDS" RECIPIENTS: |
| PLEASE8LPUS0REDUCEWASTE,TC'VCURNAMORORGAIZAT'ONRMOVEDROMDIS'RIBUTION LISTCRREDUCETHENUMBERO."COP:ES.="CEIVED "OUR'.ORORGA.'JZACN,CONTACTTHEDOCUMENTCONROFULLTEXTCONVERSION REQUIREDTOTALNUMBEROFCOPIESREQUIRED:
| | PLEASE 8 LP US 0 REDUCE WASTE, TC 'V CUR NAM OR ORGA I ZAT'ON R MOVED ROM DIS'RIBUTION LIST CR REDUCE THE NUMBER O." COP:ES .="CEIVED OU R '.O R ORGA.'J ZA CN, CONTACT THE DOCUMENT CON RO FULL TEXT CONVERSION REQUIRED TOTAL NUMBER OF COPIES REQUIRED: LTTR 23 ENCL 23 |
| LTTR23ENCL23
| | |
| =-EntergyEntergyOperations, Inc.1448SR333RussdhR,AR72801Te1501858.5000October22,19981CAN109801 U.S.NuclearRegulatory Commission DocumentControlDeskMailStationOP1-17Washington, DC20555 | | =- Entergy Entergy Operations, Inc. |
| | 1448 SR 333 RussdhR, AR 72801 Te1 501 858.5000 October 22, 1998 1CAN109801 U. S. Nuclear Regulatory Commission Document Control Desk Mail Station OP1-17 Washington, DC 20555 |
|
| |
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| ==Subject:== | | ==Subject:== |
| ArkansasNuclearOne-Unit-1DocketNo.50-313LicenseNo.DPR-51LicenseeEventReport50-313/98-004-00 Gentlemen:
| | Arkansas Nuclear One - Unit - 1 Docket No. 50-313 License No. DPR-51 Licensee Event Report 50-313/98-004-00 Gentlemen: |
| Inaccordance withlOCFR50.73(a)(2xiv),
| | In accordance with 10CFR50.73(a)(2xiv), enclosed is the subject report concerning an inadvertent actuation of the Emergency Peedwater System. |
| enclosedisthesubjectreportconcerning aninadvertent actuation oftheEmergency Peedwater System.Verytrulyyours,JiD.VanderD'ctor,NuclearSafetyJDV/rsenclosure 98102800ii 981022PDRADGCK05000SiSSPDR U.S.NRCOctober22,19981CAN109801 PAGE2cc:Mr.EllisW.MerschoFRegionalAdministrator U.S.NuclearRegulatory Commission RegionIV611RyanPlazaDrive,Suite400Arlington, TX76011-8064 NRCSeniorResidentInspector ArkansasNuclearOneP.O.Box310London,AR72847Institute ofNuclearPowerOperations 700GalleriaParkwayAtlanta,GA30339-5957 (5-92)LZCEMSEEEVENTREPORT(LER)APPROVEDSY(BIBNO.3150-0104 EXPIRES5/31/95ESTIHATED BURDENPERRESPONSETOCNIPLYllITHTHISINFORHATIOH COLLECTION REQUEST:50.0HRS.FORNARDCOHHENTSREGARDING BURDENESTIHATETOTHEINFORHATION AMDRECORDSHANAGEHENT BRANCH(IQIBB7714)~USTNUCLEARREGULATORY COHHISSIOMg MASHIMGTON, DC205550001,ANDTOTHEPAPERMORK REDUCTION PROJECT(31500104),OFFICEOFHANAGEHENT AMOSISGETMASHIMGTON DC20503.FACILITYNAHE(1)ArkansasNuclearOne-Unit1DOCKETNQIBER(2)05000313PAGE(3)1of3TITLE(4)Inadvertent Actuation OfTheEmergency Feeduater SystemDuringSurveillance TestingAsAResultOfPersanefErrorHONTHDAYYEAREVENTDATE5)LERNNSER(6SEQUENTIAL NQIBERREVISIONNQIBERREPORTDATE(7)OTHERFACILITIES INVOLVED(8)DOCKETNQIBERFACILITYMANEYEARHONTHDAY00102298OPERATING HOOE(9)POUERLEVEL(10)THISREPORTISSUSHITTED PURSUANT20.402(b) 20.405(a)(1)(f) 20.405(a)(1)(ll) 20.405(a)
| | Very truly yours, Ji D. Vander D'ctor, Nuclear Safety JDV/rs enclosure 98102800ii 981022 PDR S |
| (1)(Ifl)20.405(a)(1)(lv) 20.405(a)(1)(v) 20.405(c) 50.36(c)(1)50.36(c)(2) 50.73(a)(2)(l) 50.73(a)(2)(fI)50.73(a)(2)(l 1I)X50.73(a(2)(fv)50.73(a)(2)(v 50.73(a)(2)(vlf) 50.73(a)(2)(vill)(A) 50.73(a)(2)(vlf f)(B)50.73(a)(2)(x) | | ADGCK 05000SiS PDR |
| TOTHEREQUIREMENTS OF10CFR:(Checkoneormore)(11)73.71b73.71(c)OTHERSpecffylnAbstractBefouandfnTextLICENSEECONTACTFORTHISLER(12)NAHERichardH.Scheide,NuclearSafetyandLlcensfng Specialist TELEPHONE NQIBER(IncludeAreaCode)501.858.4618 COHPLETEONELINEFOREACHC(SIPONENT FAILUREDESCRIBED INTHISREPORT(13)CAUSESYSTEHCNIPONENT HAMUFACTURER REPORTABLE TONPRDSCAUSESYSTEHCOHPONENT HAMUFACTURER REPORTABLE TONPRDSSUPPLEHENTAL REPORTEXPECTED(14)YES(Ifyes,coapfeteEXPECTEDSUBHISSION DATE)XEXPECTEDSUSHISSIONDATE(15)HONTHDAYABSTRACT(Lfmltto1400spaces,f.e.,approximately 15single-spaced typeMritten fines)(16)OnSeptember 23,1998,atapproximately 1033,aninadvertent actuation oftheEmergency Feedwater System(EFW)occurredduringtheperformance oftheEmergency Feedwater Initiation andControlSystem(EFZC)monthlysurveillance test.Whenthetechnicians reachedapointintheprocedure requiring ahalftripinthe"A"and"B"EFWtraintripmodulestobereset,theleadtechnician readthestepwhichstated,"ResettheEFWTripModulesinChannelsAandB."Thetechnician performing thesteprepeatedtheinstruction; however,insteadofdepressing theresettoggleswitch,hedepressed the"B"EFWtripmoduleTrip1button.Thisactionsatisfied theactuation logicforthe"B"trainofEFWandoneEEWpumpstarted.SincetheOTSGswereatnormallevelsandpressure, noEFWflowwasin)ected.
| | |
| TheEFWpumpwasimmediately secured,"thetripmoduleswerereset,andEFICandEFWwerereturnedtotheirnormalconfiguration.
| | U. S. NRC October 22, 1998 1CAN109801 PAGE 2 cc: Mr. Ellis W. MerschoF Regional Administrator U. S. Nuclear Regulatory Commission Region IV 611 Ryan Plaza Drive, Suite 400 Arlington, TX 76011-8064 NRC Senior Resident Inspector Arkansas Nuclear One P.O. Box 310 London, AR 72847 Institute ofNuclear Power Operations 700 Galleria Parkway Atlanta, GA 30339-5957 |
| Therootcauseofthiseventwaspersonnel error.Theindividuals involvedwerecounseled.
| | |
| Also,thiseventandexpectations regarding self-checking werediscussed withappropriate pezsonnel. | | APPROVED SY (BIB NO. 3150-0104 (5-92) EXP IRES 5/31/95 ESTIHATED BURDEN PER RESPONSE TO CNIPLY llITH LZCEMSEE EVENT REPORT THIS INFORHATIOH COLLECTION REQUEST: 50.0 HRS. |
| NRCFORH366A(592)
| | (LER) FORNARD COHHENTS REGARDING BURDEN ESTIHATE TO THE INFORHATION AMD RECORDS HANAGEHENT BRANCH (IQIBB 7714) ~ U ST NUCLEAR REGULATORY COHHISSIOMg MASHIMGTON, DC 20555 0001, AND TO THE PAPERMORK REDUCTION PROJECT (3150 0104), OFFICE OF HANAGEHENT AMO SISGET MASHIMGTON DC 20503. |
| (5-92)LICENSEEEVENTREPORT(LER)TEXTCONTINUATION APPROVEDSYNNINO.31500104EXPIRES5/31/95ESTIHATED BURDENPERRESPONSETOCNIPLYHITHTHISINFORHATION COLLECTION REQUEST:50.0NRS.FORMARDCNNIENTSREGARDING BURDENESTIHATETOTHEINFORHATION ANDRECORDSHANAGEHENT BRANCH(HNBB7714),U.S.NUCLEARREGULATORY COBIISSIONg NASHINGTON, DC20555-0001, ANDTOTHEPAPERNDRK REDUCTION PROJECT(3150-0104), | | FACILITY NAHE (1) DOCKET NQIBER (2) PAGE (3) |
| OFFICEOFHANAGEHENT ANDBLNGETMASHINGTON DC20503.FACILITYNAHE(1)ArkanaaaNuclearOne-Unit1DOCKETIRBSER(2)0500031398LERNNBER(6)SEQUENTIAL NNBERREVISIONNNBERPAGE(3)2OF3TEXT(17)PlantStatusB.Atthetimethiseventoccurred, ArkansasNuclearOneUnit1(ANO-1)wasoperating insteady-state conditions at100percentpower.EventDescription OnSeptember 23,1998,atapproximately 1033,aninadvertent actuation oftheEmergency Feedwater System(EFW)[BAJ occurredduringperformance oftheEmergency Feedwater Initiation andControlSystem(EFIC)[JE]
| | Arkansas Nuclear One - Unit 1 05000313 1 of 3 TITLE (4) Inadvertent Actuation Of The Emergency Feeduater System During Surveillance Testing As A Result Of Persanef Error EVENT DATE 5) LER NNSER (6 REPORT DATE (7) OTHER FACILITIES INVOLVED (8) |
| monthlysurveillance test.TheEFWsystemisatwotrainsystemconsisting ofasteamdrivenpump(P-7A)andamotordrivenpump(P-7B).EEWisactuatedtoprotectthereactorcorefromoverheating uponlossofmainfeedwater floworreactorcoolantpump(RCP)circulation.
| | SEQUENTIAL REVISION FACILITY MANE DOCKET NQIBER HONTH DAY YEAR HONTH DAY YEAR NQIBER NQIBER 00 10 22 98 OPERATING THIS REPORT IS SUSHITTED PURSUANT TO THE REQUIREMENTS OF 10 CFR: (Check one or more ) (11) |
| EFICisafourchannelsystemthatmonitorsOnceThroughSteamGenerator (OTSG)levelsandpressures, mainfeedwater pumpstatus,RCPstatus/andEngineering Safeguazds Actuation System[JE)channels3and4inordertoinitiateEEWshouldanactuation setpointbereached.TheEFIClogicisa"oneoutoftwotakentwiceformat.ToactuateeithertrainofEEW,atleasttwoofthefourchannelsmustbeinitiated.
| | HOOE (9) 20.402(b) 20.405(c) X 50.73(a (2)(fv) 73.71 b POUER 20.405(a)(1)(f) 50.36(c) (1) 50.73(a)(2)(v 73.71(c) |
| IfonlytwoEFICchannelsareinitiated, itispossibletohaveoneorbothtrainsofEFWactuated, depending uponwhichchannelsareinitiated.
| | LEVEL (10) 20.405(a)(1)(ll) 50.36(c)(2) 50.73(a)(2)(vlf) OTHER 20.405(a) (1) ( I f l ) 50.73(a)(2)(l) 50.73(a)(2)(vill)(A) Specffy ln 20.405(a)(1)(lv) 50.73(a) (2) ( f I ) 50.73(a)(2)(vlf f)(B) Abstract Befou 20.405(a)(1)(v) 50.73(a)(2)(l 1 I) 50.73(a)(2)(x) and fn Text LICENSEE CONTACT FOR THIS LER (12) |
| ThemonthlyEFICChannel"B"surveillance testwascommenced atapproximately 0825onSeptember 23.Atapproximately 1030,thetechnicians performing thesurveillance verifiedthatasimulated lowlevelinthe"A"OTSGappropriately initiated the"Trip1"logicinthe"A"EEWTraintripmoduleandthe"Trip2"logicinthe"B"EFWTraintripmodule.Afterresetting thesimulated lowOTSGlevel,theprocedure requiredthattheEEWtripmodulesbereset.Theleadtechnician readtheprocedure stepwhichstated,"ResettheEFWTripModulesinChannelsAandB."Thetechnician performing thesteprepeatedtheinstruction; however,insteadofdepressing theresettoggleswitch,hedepressed the"B"EFWtripmoduletrip1button.Thisactionsatisfied theactuation logicforthe"B"trainofEFWandP-7Astarted.SincetheOTSGswereatnormaloperating levelsandpressure, noEFWflowwasinfected.
| | NAHE TELEPHONE NQIBER (Include Area Code) |
| Thecontrolboardoperatorimmediately securedP-7A.TheEEWtripmoduleswereproperlyreset,EFICandEEWwerereturnedtotheirnormalconfiguration, andthesurveillance procedure wasexited.Thesurveillance testwasrecommenced at1247andsuccessfully completed at1422onSeptember 23.C.RootCauseTherootcauseofthiseventwasdetermined tobepersonnel error.Thetechnician performing theactionunderstood theprocedure stepreadbytheleadtechnician andrepeatedit;however,hefailedtoself-check beforeperforming theaction.NRCFORH366A(5-92)
| | Richard H. Scheide, Nuclear Safety and Llcensfng Specialist 501.858.4618 COHPLETE ONE LINE FOR EACH C(SIPONENT FAILURE DESCRIBED IN THIS REPORT (13) |
| ;.5.92)LZCBMSBBBVENTREPORT(LER)TEXTCONTINUATION APPROVEDBT(NBNO.150.01EXPIRES5/31/95ESTINATEDBURDENPERRESPONSETOCNIPLYMITHTHISINFORHATIONCOLLECTION REQUEST:50.0HRS.FORMARDCQNENTSREGARDING BURDENESTIHATETOTHEINFORNATIONANDRECORDSHANAGENENT BRANCH(NNBB7714)~U.SoNUCLEARREGULATORY CONNISSION, MASHINGTON, DC20555-0001 | | REPORTABLE REPORTABLE CAUSE SYSTEH CNIPONENT HAMUFACTURER CAUSE SYSTEH COHPONENT HAMUFACTURER TO NPRDS TO NPRDS SUPPLEHENTAL REPORT EXPECTED (14) EXPECTED HONTH DAY YES SUSHI SS I ON (If yes, coapfete EXPECTED SUBHISSION DATE) X DATE (15) |
| ~ANDTOTHEPAPERMQRK REDUCTION PROJECT(3150-0104) | | ABSTRACT (Lfmlt to 1400 spaces, f.e., approximately 15 single-spaced typeMritten fines) (16) |
| ~OFFICEOFNANAGEHENT ANOBISGETMASHINGTON DC20503FACILITYNANE(1)ArkansasNuciearOne-Unit1DOCKETNIMBER(2)05000313LERNMBER(6)SEQUENTIAL NSIBERREVISIONNWBERPAGE(3)30F3TEXT(17)Acontributing causetothiseventwasaprocedural ambiguity. | | On September 23, 1998, at approximately 1033, an inadvertent actuation of the Emergency Feedwater System (EFW) occurred during the performance of the Emergency Feedwater Initiation and Control System (EFZC) monthly surveillance test. When the technicians reached a point in the procedure requiring a half trip in the "A" and "B" EFW train trip modules to be reset, the lead technician read the step which stated, "Reset the EFW Trip Modules in Channels A and B." The technician performing the step repeated the instruction; however, instead of depressing the reset toggle switch, he depressed the "B" EFW trip module Trip 1 button. This action satisfied the actuation logic for the "B" train of EFW and one EEW pump started. Since the OTSGs were at normal levels and pressure, no EFW flow was in)ected. The EFW pump was immediately secured, "the trip modules were reset, and EFIC and EFW were returned to their normal configuration. The root cause of this event was personnel error. The individuals involved were counseled. Also, this event and expectations regarding self-checking were discussed with appropriate pezsonnel. |
| Theprocedure step(8.3.6.K) thatresultedintheEFWactuation simplystated,"ResettheEEWTripModulesinChannelsAandB.Preceding stepsstipulating manipulation ofdevicesweremorespecificwithrespecttotheactionsrequired.
| | NRC FORH 366A (5 92) |
| Forexample,step8.3.6.I.statesinpart,"PressandreleasetheResetbutton..~."Iftheprocedure hadstated,"PressandreleasetheResettoggleswitch....,"
| | |
| theerrormightnothaveoccurred.
| | APPROVED SY NNI NO. 3150 0104 (5-92) EXPIRES 5/31/95 ESTIHATED BURDEN PER RESPONSE TO CNIPLY HITH THIS INFORHATION COLLECTION REQUEST: 50.0 NRS. |
| D.Corrective ActionsThetechnicians involvedwiththiseventwerecounseled bymanagement priortorecommencing thesurveillance test.Theimportance ofself-checking wasemphasized. | | FORMARD CNNIENTS REGARDING BURDEN ESTIHATE TO LICENSEE EVENT REPORT (LER) THE INFORHATION AND RECORDS HANAGEHENT BRANCH (HNBB 7714), U.S. NUCLEAR REGULATORY COBIISSIONg TEXT CONTINUATION NASHINGTON, DC 20555-0001, AND TO THE PAPERNDRK REDUCTION PROJECT (3150-0104), OFFICE OF HANAGEHENT AND BLNGET MASHINGTON DC 20503. |
| Thiseventandmanagement expectations regarding self-checking werediscussed withtheUnit-1Instrumentation andControlshoppersonnel duringtheirmorningmeetings.
| | FACILITY NAHE (1) DOCKET IRBSER (2) LER NNBER (6) PAGE (3) |
| Procedure changeswefeimplemented toclearlyspecifydepressing theresettoggleswitchwhenresetting theEFWtripmodules.TheMaintenance HumanPerformance Committee willdevelopasummaryofthelessonslearnedfromthiseventtobepresented totheMaintenance Departments ofANO-1andANO-2.Thesummaryisexpectedtobecompleted byDecember21,1998.E.SafetySignificance TheEFZCandEFWsystemsperformed asdesignedaftertheinadvertent actuation signalwasinitiated. | | SEQUENTIAL REVISION NNBER NNBER Arkanaaa Nuclear One - Unit 1 05000313 2OF3 98 TEXT (17) |
| However,sincetheOTSGswereatnormaloperating levelsandpressure, noEFWflowwasinitiated andnoplantperturbation resultedfromthisevent.,Therefore, thiscondition isconsidered tobeoflowsafetysignificance. | | Plant Status At the time this event occurred, Arkansas Nuclear One Unit 1 (ANO-1) was operating in steady-state conditions at 100 percent power. |
| F.BasisForReportability Thiscondition isreportable pursuantto10CFR50.73(a) | | B. Event Description On September 23, 1998, at approximately 1033, an inadvertent actuation of the Emergency Feedwater System (EFW)[BAJ occurred during performance of the Emergency Feedwater Initiation and Control System (EFIC)[JE] monthly surveillance test. |
| (2)(iv)asanactuation ofanEngineered SafetyFeature(ESF).ItwasalsoreportedtotheNRCOperations Centerat1336onSeptember 23,1998,inaccordance with10CFR50.72(b) | | The EFW system is a two train system consisting of a steam driven pump (P-7A) and a motor driven pump (P-7B). EEW is actuated to protect the reactor core from overheating upon loss of main feedwater flow or reactor coolant pump (RCP) circulation. EFIC is a four channel system that monitors Once Through Steam Generator (OTSG) levels and pressures, main feedwater pump status, RCP status/ |
| (2)(ii).G.Additional Information TherehavebeennoprevioussimilarLERssubmitted byANOregarding theinadvertent actuation ofanESFasaresultofinadequate self-checking byMaintenance personnel. | | and Engineering Safeguazds Actuation System [JE) channels 3 and 4 in order to initiate EEW should an actuation setpoint be reached. The EFIC logic is a "one out of two taken twice format. To actuate either train of EEW, at least two of the four channels must be initiated. |
| EnergyIndustryIdentification System(EIZS)codesareidentified inthetextas[XX].NRCFOHN366A(5-92)}}
| | initiated, it If only two EFIC channels are is possible to have one or both trains of EFW actuated, depending upon which channels are initiated. |
| | The monthly EFIC Channel "B" surveillance test was commenced at approximately 0825 on September 23. At approximately 1030, the technicians performing the surveillance verified that a simulated low level in the "A" OTSG appropriately initiated the "Trip 1" logic in the "A" EEW Train trip module and the "Trip 2" logic in the "B" EFW Train trip module. After resetting the simulated low OTSG level, the procedure required that the EEW trip modules be reset. The lead technician read the procedure step which stated, "Reset the EFW Trip Modules in Channels A and B." The technician performing the step repeated the instruction; however, instead of depressing the reset toggle switch, he depressed the "B" EFW trip module trip 1 button. This action satisfied the actuation logic for the "B" train of EFW and P-7A started. Since the OTSGs were at normal operating levels and pressure, no EFW flow was infected. The control board operator immediately secured P-7A. The EEW trip modules were properly reset, EFIC and EEW were returned to their normal configuration, and the surveillance procedure was exited. |
| | The surveillance test was recommenced at 1247 and successfully completed at 1422 on September 23. |
| | C. Root Cause The root cause of this event was determined to be personnel error. The technician performing the action understood the procedure step read by the lead technician and repeated it; however, he failed to self-check before performing the action. |
| | NRC FORH 366A (5-92) |
| | |
| | ;.5.92) APPROVED BT (NB NO. 150.01 EXPIRES 5/31/95 EST INATED BURDEN PER RESPONSE TO CNIPLY MITH THI S INFORHATION COLLECTION REQUEST: 50.0 HRS. |
| | FORMARD CQNENTS REGARDING BURDEN EST IHATE TO LZCBMSBB BVENT REPORT (LER) THE INFORNAT I ON AND RECORDS HANAGENENT BRANCH TEXT CONTINUATION (NNBB 7714) ~ U.So NUCLEAR REGULATORY CONNISSION, MASHINGTON, DC 20555-0001 ~ AND TO THE PAPERMQRK REDUCTION PROJECT (3150-0104) ~ OF FICE OF NANAGEHENT ANO BISGET MASHINGTON DC 20503 FACILITY NANE (1) DOCKET NIMBER (2) LER NMBER (6) PAGE (3) |
| | SEQUENTIAL REVISION NSIBER NWBER Arkansas Nuciear One - Unit 1 05000313 30F3 TEXT (17) |
| | A contributing cause to this event was a procedural ambiguity. The procedure step (8.3.6.K) that resulted in the EFW actuation simply stated, "Reset the EEW Trip Modules in Channels A and B. Preceding steps stipulating manipulation of devices were more specific with respect to the actions required. For example , |
| | step 8.3.6.I. states in part, "Press and release the Reset button.. ." If the ~ |
| | procedure had stated, "Press and release the Reset toggle switch....," the error might not have occurred. |
| | D. Corrective Actions The technicians involved with this event were counseled by management prior to recommencing the surveillance test. The importance of self-checking was emphasized. |
| | This event and management expectations regarding self-checking were discussed with the Unit-1 Instrumentation and Control shop personnel during their morning meetings. |
| | Procedure changes wefe implemented to clearly specify depressing the reset toggle switch when resetting the EFW trip modules. |
| | The Maintenance Human Performance Committee will develop a summary of the lessons learned from this event to be presented to the Maintenance Departments of ANO-1 and ANO-2. The summary is expected to be completed by December 21, 1998. |
| | E. Safety Significance The EFZC and EFW systems performed as designed after the inadvertent actuation signal was initiated. However, since the OTSGs were at normal operating levels and pressure, no EFW flow was initiated and no plant perturbation resulted from this event., Therefore, this condition is considered to be of low safety significance. |
| | F. Basis For Reportability This condition is reportable pursuant to 10CFR50.73(a) (2) (iv) as an actuation of an Engineered Safety Feature (ESF). |
| | It was also reported to the NRC Operations Center at 1336 on September 23, 1998, in accordance with 10CFR50.72(b) (2)(ii) . |
| | G. Additional Information There have been no previous similar LERs submitted by ANO regarding the inadvertent actuation of an ESF as a result of inadequate self-checking by Maintenance personnel. |
| | Energy Industry Identification System (EIZS) codes are identified in the text as [XX] . |
| | NRC FOHN 366A (5-92)}} |
|
|---|
Category:LICENSEE EVENT REPORT (SEE ALSO AO
MONTHYEARML17335A7641998-10-22022 October 1998
LER 98-004-00:on 980923,inadvertent Actuation of Efs Occurred During Surveillance Testing.Caused by Personnel Error.Personnel Involved with Event Were Counseled & Procedure Changes Were Implemented.With 981022 Ltr
ML20045B3021993-06-11011 June 1993
LER 93-001-00:on 930513,discovered That One Channel of Rvlms Inoperable Since Probe Replaced in Oct 1992.On 930507, Discovered That Two Sensors in Rvlms Indicating Wet.Caused by Design Error.Wiring Polarity corrected.W/930611 Ltr
ML20024H2281991-05-21021 May 1991
LER 91-003-00:on 910421,actuation of EFW Sys During Plant Heatup Occurred Due to Low Once Through Steam Generator Level.Caused by Leaking Feedwater Recirculation Valve.Plant Startup Procedure OP 1102.02 Will Be revised.W/910521 Ltr
ML20024H0861991-05-10010 May 1991
LER 91-002-00:on 910410,inadvertent Actuations of Combined Control Emergency Ventilation Sys Occurred.Caused by Transient Noise Spike.Mod Will Be Completed by 910531 to Install Time Delay in Actuation circuitry.W/910510 Ltr
ML20024G9781991-05-10010 May 1991
LER 90-004-01:on 900531,discovered Degraded Fire Barrier Penetration During Insp Per Generic Ltr 86-10.Caused by Failure to Identify Adequate Fire Barrier Seal During 1983 Plant Walkdown.Fire Watch posted.W/910510 Ltr
ML20029C3771991-03-22022 March 1991
LER 91-006-00:on 910222,core Protection Calculator Reactor Coolant Sys Flow Channels Not Being Calibrated within Tech Spec.Caused by Personnel Error.Operations Manager Counseled Operators Involved in event.W/910322 Ltr
ML20029B1331991-02-27027 February 1991
LER 91-004-00:on 910125,control Room Radiation Monitor Alarm/Trip Setpoint Greater than Normal.Caused by Personnel Error.Operations Manager Will Counsel Shift Supervisors & Night Order Will Be posted.W/910227 Ltr
ML20028H6841991-01-21021 January 1991
LER 90-021-00:on 901222,potential RCS Leak Noted in Area of Pressurizer Upper Level Instrument Nozzle.Caused by Pure Water Stress Corrosion Cracking.New Nozzle Installed Into Penetration from Shell OD.W/910121 Ltr
ML20043C6801990-05-31031 May 1990
LER 89-025-01:on 891221,identified That Portion of Wall Located in Auxiliary Bldg Had Not Been Previously Identified as Tech Spec Fire Barrier.Caused by Personnel Error.Wall Being Upgraded to Tech Spec status.W/900531 Ltr
ML20043C3781990-05-30030 May 1990
LER 90-012-00:on 900430,18 Month Channel Calibr of Liquid Radwaste Effluent Line Flow Monitor Not Performed as Required.Caused by Inadequate Controls to Ensure Followup Actions Taken in Timely Manner.Amends revised.W/900530 Ltr
ML20043C0361990-05-23023 May 1990
LER 90-003-01:on 900423,discovered That Incorrect Monitoring Instrumentation for Radiological Effluent Ventilation Sys Utilized to Comply W/Tech Specs.Caused by Mgt Oversight.Logs Process Monitors Will Not Be used.W/900523 Ltr
ML20043A7411990-05-17017 May 1990
LER 90-004-01:on 900212,discovered That Backwater Valve in Floor Drain Pipe in Emergency Feedwater Pump Room Missing. Caused by Inadequate Configuration Control.Backwater Pumps Installed & Will Be Included in Maint program.W/900517 Ltr
ML20042F7751990-05-0101 May 1990
LER 90-010-00:on 900401,personnel Failed to Complete Control Element Assembly Position Log.Caused by Surveillance Program Deficiencies & Lack of Mgt Involvement.Shift Briefing Completed & Procedure Change incorporated.W/900501 Ltr
ML20042F7681990-05-0101 May 1990
LER 90-002-01:on 900131,errors Identified in Calculation Used to Establish Calibr Tables for Steam Generator Water Level Transmitters.Errors in Original Calculation Not Identified.Calibr Procedures revised.W/900501 Ltr
ML20042E1981990-04-10010 April 1990
LER 90-008-00:on 900311,determined That Seal Leakage Test for Containment Personnel Air Lock Had Not Been Performed, Per Tech Specs.Caused by Personnel Error.Procedure Revs Initiated & Personnel counseled.W/900410 Ltr
ML20012F5051990-04-0505 April 1990
LER 89-027-00:on 891005,determined That Leakage Rate for Containment Isolation Check Valve in Excess of Leakage Rate Allowed Per Tech Specs.Caused by Loose Weld Slag in Valve Seat Area.Valve Cleaned & reassembled.W/900405 Ltr
ML20012F5031990-04-0505 April 1990
LER 90-007-00:on 900306,RCS Charging Line Rendered Inoperable Due to Deficient Piping Support Weld.Caused by Inadequate Work Controls & post-installation Insp Processes. Field Walkdowns & Weld Insps initiated.W/900405 Ltr
ML20012F5741990-04-0404 April 1990
LER 90-006-00:on 900305,instrumentation Channels Declared Inoperable,Resulting in Manual Actuation of Reactor Protection Sys.Caused by Procedural Deficiencies.Functional Tests of Log Power Level Channels performed.W/900404 Ltr
ML20012C7221990-03-14014 March 1990
LER 90-004-00:on 900212,identified That No Backwater Valve Located in Floor Drain Pipe in One of Emergency Feedwater Pump Rooms.Caused by Inadequate Configuration Control. Valves Installed on 900215.W/900314 Ltr
ML20012C1821990-03-12012 March 1990
LER 85-029-00:on 850520,unusual Motor Vibrations Identified on Svc Water Pump 2PM4A.On 861028,high Vibrations Noted on Upper Motor Bearings of Pump 2PM4B.Caused by Improper Installation.New Bearings installed.W/900312 Ltr
ML20012B7271990-03-0808 March 1990
LER 89-049-01:on 891220,discovered That Okonite T-95 Tape Not Used to Tape Internal Motor Lead Connections for Main Feedwater Containment Isolation Valves.Caused by Personnel Error.Valves Taped According to Design drawing.W/900308 Ltr
ML20012B5701990-03-0505 March 1990
LER 90-003-00:on 900201,failure to Perform Monthly Source Check Surveillance on Three Radiation Process Monitors Occurred.Caused by Inadequate Procedure Change by Personnel. Source Check on Monthly Basis implemented.W/900305 Ltr
ML20011F6741990-03-0202 March 1990
LER 90-002-00:on 900131,errors Identified in Calculation Used to Establish Calibr Tables for Steam Generator Water Level Transmitters.Caused by Incorrect Static Pressure Assumption.Trip Setpoint Bistable increased.W/900302 Ltr
ML20011F6781990-03-0101 March 1990
LER 89-026-00:on 891112,gaps in Piping Supports on Supply & Return Piping for Containment Coolers Identified.Caused by Inadequate Design Technique Used in Original Support Design. Shims Added Before Restart from outage.W/900301 Ltr
ML20011F5831990-02-27027 February 1990
LER 89-022-01:on 891114,normal Offsite Power Feeder Breaker to 4,160-volt Ac ESF Bus Opened,Resulting in Loss of Power to Bus 2A3.Caused by Inadequate post-maint Test Controls. Test Switch Opened & Job Order changed.W/900227 Ltr
ML20011F7311990-02-23023 February 1990
LER 90-001-00:on 900126,identified That Required Visual Insps of Containment Bldg After Entry Made Not Documented as Being Performed.Caused by Inadequate Procedural Guidance. Administrative Controls to Be established.W/900226 Ltr
ML20006D7391990-02-0606 February 1990
LER 89-034-01:on 891031,determined That Tech Spec 3.9.1 Had Likely Been Violated Re Independent Circuits of Control Room Emergency Air Conditioning Sys.Caused by Inadequate Guidance Re Equipment Svc Removal.Procedures revised.W/900206 Ltr
ML20011E2371990-01-31031 January 1990
LER 89-012-01:on 890626,RCS Backleakage Through Safety Injection Sys Check Valve Occurred Three Times.Caused by Missing Rollpins Which Connect Valve Disc to Valve Disc Shaft.Rollpins Replaced & Valves reassembled.W/900131 Ltr
ML20011E2291990-01-31031 January 1990
LER 89-039-01:on 891116,discovered That Door for Upper North Electrical Penetration Room Open & Latch Mechanism Missing. Caused by Abnormally High Differential Pressure Across Door. Ventilation Sys Flow Balance performed.W/900131 Ltr
ML20011E1451990-01-30030 January 1990
LER 89-024-00:on 891231,loose Terminal in Feedwater Control Sys Cabinet Resulted in Reactor Trip.Caused by Loose Connection on Terminal.Loose Connection Reterminated properly.W/900130 Ltr
ML20006C1451990-01-29029 January 1990
LER 89-048-00:on 891228,automatic Reactor Trip & ESF Actuation Occurred as Result of Loss of All Main Feedwater Flow Due to Inadvertent Tripping of Main Feedwater Pump. Caused by Personnel error.O-rings replaced.W/900129 Ltr
ML20006A8671990-01-22022 January 1990
LER 89-042-01:on 891209,inadvertent Actuation of Control Room Emergency Ventilation Sys Occurred.Caused by Keying of Hand Held Radio in Vicinity of Chlorine Monitors by Technician.Technician counseled.W/900122 Ltr
ML20006A8661990-01-22022 January 1990
LER 89-041-00:on 891221,automatic Actuation of Emergency Feedwater Sys Initiated.Caused by Lack of Adequate Procedural Guidance.Valve Positioners CV-2623 & CV-2673 Adjusted & Guidance Procedures developed.W/900122 Ltr
ML19354E3331990-01-22022 January 1990
LER 89-025-00:on 891221,two Piping Penetrations Located in Barrier Not Surveilled as Required by Tech Specs.Caused by Personnel Error.Fire Watch Posted When Necessary Per Tech Spec.W/900122 Ltr
ML20006B6461990-01-18018 January 1990
LER 89-047-00:on 891219,RCS Temp Increased Above 250 F W/ Oxygen Concentration Greater than Tech Specs Limit.Caused by Inadequate Procedural Guidance.Plant Startup Procedure Revised to Require Chemistry Dept signoff.W/900118 Ltr
ML20005F1551990-01-18018 January 1990
LER 89-023-01:on 891117,noted That Channel a Not Responding to Change in Power Level & Declared Inoperable.Caused by Defective Preamplifier.Evaluation of Sys Design & Channel Functional Test initiated.W/900108 Ltr
ML19354D8291990-01-15015 January 1990
LER 89-044-00:on 891214,incorrect Assumptions & Calculational Errors Identified for Low Pressure Injection & Reactor Bldg Spray Pumps When Aligned to Take Suction from Reactor Bldg sump.W/900115 Ltr
ML20005G1681990-01-0909 January 1990
LER 89-045-00:on 891210,discovered That U-bolt Supports on Two Containment Isolation Valves in Containment Bldg Not Installed & Pressurizer Sample Lines & Valves Considered Inoperable.Missing U-bolts installed.W/900109 Ltr
ML20005F1481990-01-0808 January 1990
LER 89-042-00:on 891209,inadvertent Actuation of Control Room Emergency Ventilation Sys Occurred.Caused by Keying of Hand Held Radio in Vicinity of Chlorine Monitors by Technician.Technician counseled.W/900108 Ltr
ML20005F1571990-01-0808 January 1990
LER 89-043-00:on 891208,discovered That Approx 50% of One Nut Ring Half Beneath Reactor Vessel Nozzle Flange Corroded Away.Caused by Gradual Deterioration of Gasket Matl.Design Change implemented.W/900108 Ltr
ML20005F2071990-01-0404 January 1990
LER 89-040-00:on 891205 & 06,automatic Actuations of Emergency Diesel Generator Occurred as Result of Loss of Power to 480-volt ESF Bus.Caused by Personnel Error During Bus Transfer.Mgt Briefings conducted.W/900104 Ltr
ML20005F0471990-01-0303 January 1990
LER 89-046-00:on 891204,reactor Bldg Isolation Valves Rendered Inoperable Due to Deficient Welds on Piping Supports Which Were Installed During Initial Plant Const. Deficient Supports Repaired Prior to restart.W/900103 Ltr
ML20011D2521989-12-18018 December 1989
LER 89-039-00:on 891116,discovered That Door for Upper North Electrical Penetration Room Open & Missing Latch Mechanism. Caused by Extensive Use During 56-day Refueling Outage.More Frequent Insps of Door Condition to Be done.W/891218 Ltr
ML20011D2501989-12-18018 December 1989
LER 89-023-00:on 891117,approach to Criticality Commenced After Seventh Refueling Outage W/Logarithmic Power Level Channels Inoperable.Caused by Electrical Noise in Circuitry. Defective Preamplifier replaced.W/891218 Ltr
ML19354D5521989-12-14014 December 1989
LER 89-038-00:on 891114,reactor Trip Occurred as Result of Inadvertent Closure of Main Feedwater Isolation Valve.Caused by Personnel Error.Disciplinary Action Taken Against Individual & Senior Mgt Personnel Put on shift.W/891214 Ltr
ML19351A6731989-12-14014 December 1989
LER 89-022-00:on 891114,inadequate post-maint Test Controls Resulted in de-energizing 4,160 Volt Ac ESFs Electric Bus Uexpectedly.Caused by Inadequate post-maint Test Controls. Job Order Instructions changed.W/891214 Ltr
ML19351A4651989-12-11011 December 1989
LER 89-021-00:on 891111,when Low Level Radwaste Water in Waste Condensate Tank Aligned to Be Released,Discovered That Radiation Monitor Inoperable for Duration of Release.Caused by Personnel Error.Procedure revised.W/891211 Ltr
ML19332F6171989-12-11011 December 1989
LER 89-037-00:on 891110,reactor Trip Occurred as Result of Inadvertent Grounding of Reactor Protection Sys Power Supply During Surveillance Testing.Caused by Inadequate Procedure. Procedures revised.W/891211 Ltr
ML20005D6821989-12-0101 December 1989
LER 89-005-01:on 890518 & 25,damping Board Removed from Penetration Containing Cable Tray.On 890531,voids Noted in Penetration Seals.Caused by Erroneous Vendor Procedures. Penetrations Restored & Procedures revised.W/891201 Ltr
ML19332E4821989-11-30030 November 1989
LER 89-019-00:on 890927,identified That Closing Torque on Valves May Be Insufficient Against Postulated Worst Case Differential Pressure.Caused by Initial Plant Construction. Mod to Replace Gearing Made to Motor operator.W/891130 Ltr
1998-10-22
[Table view]
Category:RO)
MONTHYEARML17335A7641998-10-22022 October 1998
LER 98-004-00:on 980923,inadvertent Actuation of Efs Occurred During Surveillance Testing.Caused by Personnel Error.Personnel Involved with Event Were Counseled & Procedure Changes Were Implemented.With 981022 Ltr
ML20045B3021993-06-11011 June 1993
LER 93-001-00:on 930513,discovered That One Channel of Rvlms Inoperable Since Probe Replaced in Oct 1992.On 930507, Discovered That Two Sensors in Rvlms Indicating Wet.Caused by Design Error.Wiring Polarity corrected.W/930611 Ltr
ML20024H2281991-05-21021 May 1991
LER 91-003-00:on 910421,actuation of EFW Sys During Plant Heatup Occurred Due to Low Once Through Steam Generator Level.Caused by Leaking Feedwater Recirculation Valve.Plant Startup Procedure OP 1102.02 Will Be revised.W/910521 Ltr
ML20024H0861991-05-10010 May 1991
LER 91-002-00:on 910410,inadvertent Actuations of Combined Control Emergency Ventilation Sys Occurred.Caused by Transient Noise Spike.Mod Will Be Completed by 910531 to Install Time Delay in Actuation circuitry.W/910510 Ltr
ML20024G9781991-05-10010 May 1991
LER 90-004-01:on 900531,discovered Degraded Fire Barrier Penetration During Insp Per Generic Ltr 86-10.Caused by Failure to Identify Adequate Fire Barrier Seal During 1983 Plant Walkdown.Fire Watch posted.W/910510 Ltr
ML20029C3771991-03-22022 March 1991
LER 91-006-00:on 910222,core Protection Calculator Reactor Coolant Sys Flow Channels Not Being Calibrated within Tech Spec.Caused by Personnel Error.Operations Manager Counseled Operators Involved in event.W/910322 Ltr
ML20029B1331991-02-27027 February 1991
LER 91-004-00:on 910125,control Room Radiation Monitor Alarm/Trip Setpoint Greater than Normal.Caused by Personnel Error.Operations Manager Will Counsel Shift Supervisors & Night Order Will Be posted.W/910227 Ltr
ML20028H6841991-01-21021 January 1991
LER 90-021-00:on 901222,potential RCS Leak Noted in Area of Pressurizer Upper Level Instrument Nozzle.Caused by Pure Water Stress Corrosion Cracking.New Nozzle Installed Into Penetration from Shell OD.W/910121 Ltr
ML20043C6801990-05-31031 May 1990
LER 89-025-01:on 891221,identified That Portion of Wall Located in Auxiliary Bldg Had Not Been Previously Identified as Tech Spec Fire Barrier.Caused by Personnel Error.Wall Being Upgraded to Tech Spec status.W/900531 Ltr
ML20043C3781990-05-30030 May 1990
LER 90-012-00:on 900430,18 Month Channel Calibr of Liquid Radwaste Effluent Line Flow Monitor Not Performed as Required.Caused by Inadequate Controls to Ensure Followup Actions Taken in Timely Manner.Amends revised.W/900530 Ltr
ML20043C0361990-05-23023 May 1990
LER 90-003-01:on 900423,discovered That Incorrect Monitoring Instrumentation for Radiological Effluent Ventilation Sys Utilized to Comply W/Tech Specs.Caused by Mgt Oversight.Logs Process Monitors Will Not Be used.W/900523 Ltr
ML20043A7411990-05-17017 May 1990
LER 90-004-01:on 900212,discovered That Backwater Valve in Floor Drain Pipe in Emergency Feedwater Pump Room Missing. Caused by Inadequate Configuration Control.Backwater Pumps Installed & Will Be Included in Maint program.W/900517 Ltr
ML20042F7751990-05-0101 May 1990
LER 90-010-00:on 900401,personnel Failed to Complete Control Element Assembly Position Log.Caused by Surveillance Program Deficiencies & Lack of Mgt Involvement.Shift Briefing Completed & Procedure Change incorporated.W/900501 Ltr
ML20042F7681990-05-0101 May 1990
LER 90-002-01:on 900131,errors Identified in Calculation Used to Establish Calibr Tables for Steam Generator Water Level Transmitters.Errors in Original Calculation Not Identified.Calibr Procedures revised.W/900501 Ltr
ML20042E1981990-04-10010 April 1990
LER 90-008-00:on 900311,determined That Seal Leakage Test for Containment Personnel Air Lock Had Not Been Performed, Per Tech Specs.Caused by Personnel Error.Procedure Revs Initiated & Personnel counseled.W/900410 Ltr
ML20012F5051990-04-0505 April 1990
LER 89-027-00:on 891005,determined That Leakage Rate for Containment Isolation Check Valve in Excess of Leakage Rate Allowed Per Tech Specs.Caused by Loose Weld Slag in Valve Seat Area.Valve Cleaned & reassembled.W/900405 Ltr
ML20012F5031990-04-0505 April 1990
LER 90-007-00:on 900306,RCS Charging Line Rendered Inoperable Due to Deficient Piping Support Weld.Caused by Inadequate Work Controls & post-installation Insp Processes. Field Walkdowns & Weld Insps initiated.W/900405 Ltr
ML20012F5741990-04-0404 April 1990
LER 90-006-00:on 900305,instrumentation Channels Declared Inoperable,Resulting in Manual Actuation of Reactor Protection Sys.Caused by Procedural Deficiencies.Functional Tests of Log Power Level Channels performed.W/900404 Ltr
ML20012C7221990-03-14014 March 1990
LER 90-004-00:on 900212,identified That No Backwater Valve Located in Floor Drain Pipe in One of Emergency Feedwater Pump Rooms.Caused by Inadequate Configuration Control. Valves Installed on 900215.W/900314 Ltr
ML20012C1821990-03-12012 March 1990
LER 85-029-00:on 850520,unusual Motor Vibrations Identified on Svc Water Pump 2PM4A.On 861028,high Vibrations Noted on Upper Motor Bearings of Pump 2PM4B.Caused by Improper Installation.New Bearings installed.W/900312 Ltr
ML20012B7271990-03-0808 March 1990
LER 89-049-01:on 891220,discovered That Okonite T-95 Tape Not Used to Tape Internal Motor Lead Connections for Main Feedwater Containment Isolation Valves.Caused by Personnel Error.Valves Taped According to Design drawing.W/900308 Ltr
ML20012B5701990-03-0505 March 1990
LER 90-003-00:on 900201,failure to Perform Monthly Source Check Surveillance on Three Radiation Process Monitors Occurred.Caused by Inadequate Procedure Change by Personnel. Source Check on Monthly Basis implemented.W/900305 Ltr
ML20011F6741990-03-0202 March 1990
LER 90-002-00:on 900131,errors Identified in Calculation Used to Establish Calibr Tables for Steam Generator Water Level Transmitters.Caused by Incorrect Static Pressure Assumption.Trip Setpoint Bistable increased.W/900302 Ltr
ML20011F6781990-03-0101 March 1990
LER 89-026-00:on 891112,gaps in Piping Supports on Supply & Return Piping for Containment Coolers Identified.Caused by Inadequate Design Technique Used in Original Support Design. Shims Added Before Restart from outage.W/900301 Ltr
ML20011F5831990-02-27027 February 1990
LER 89-022-01:on 891114,normal Offsite Power Feeder Breaker to 4,160-volt Ac ESF Bus Opened,Resulting in Loss of Power to Bus 2A3.Caused by Inadequate post-maint Test Controls. Test Switch Opened & Job Order changed.W/900227 Ltr
ML20011F7311990-02-23023 February 1990
LER 90-001-00:on 900126,identified That Required Visual Insps of Containment Bldg After Entry Made Not Documented as Being Performed.Caused by Inadequate Procedural Guidance. Administrative Controls to Be established.W/900226 Ltr
ML20006D7391990-02-0606 February 1990
LER 89-034-01:on 891031,determined That Tech Spec 3.9.1 Had Likely Been Violated Re Independent Circuits of Control Room Emergency Air Conditioning Sys.Caused by Inadequate Guidance Re Equipment Svc Removal.Procedures revised.W/900206 Ltr
ML20011E2371990-01-31031 January 1990
LER 89-012-01:on 890626,RCS Backleakage Through Safety Injection Sys Check Valve Occurred Three Times.Caused by Missing Rollpins Which Connect Valve Disc to Valve Disc Shaft.Rollpins Replaced & Valves reassembled.W/900131 Ltr
ML20011E2291990-01-31031 January 1990
LER 89-039-01:on 891116,discovered That Door for Upper North Electrical Penetration Room Open & Latch Mechanism Missing. Caused by Abnormally High Differential Pressure Across Door. Ventilation Sys Flow Balance performed.W/900131 Ltr
ML20011E1451990-01-30030 January 1990
LER 89-024-00:on 891231,loose Terminal in Feedwater Control Sys Cabinet Resulted in Reactor Trip.Caused by Loose Connection on Terminal.Loose Connection Reterminated properly.W/900130 Ltr
ML20006C1451990-01-29029 January 1990
LER 89-048-00:on 891228,automatic Reactor Trip & ESF Actuation Occurred as Result of Loss of All Main Feedwater Flow Due to Inadvertent Tripping of Main Feedwater Pump. Caused by Personnel error.O-rings replaced.W/900129 Ltr
ML20006A8671990-01-22022 January 1990
LER 89-042-01:on 891209,inadvertent Actuation of Control Room Emergency Ventilation Sys Occurred.Caused by Keying of Hand Held Radio in Vicinity of Chlorine Monitors by Technician.Technician counseled.W/900122 Ltr
ML20006A8661990-01-22022 January 1990
LER 89-041-00:on 891221,automatic Actuation of Emergency Feedwater Sys Initiated.Caused by Lack of Adequate Procedural Guidance.Valve Positioners CV-2623 & CV-2673 Adjusted & Guidance Procedures developed.W/900122 Ltr
ML19354E3331990-01-22022 January 1990
LER 89-025-00:on 891221,two Piping Penetrations Located in Barrier Not Surveilled as Required by Tech Specs.Caused by Personnel Error.Fire Watch Posted When Necessary Per Tech Spec.W/900122 Ltr
ML20006B6461990-01-18018 January 1990
LER 89-047-00:on 891219,RCS Temp Increased Above 250 F W/ Oxygen Concentration Greater than Tech Specs Limit.Caused by Inadequate Procedural Guidance.Plant Startup Procedure Revised to Require Chemistry Dept signoff.W/900118 Ltr
ML20005F1551990-01-18018 January 1990
LER 89-023-01:on 891117,noted That Channel a Not Responding to Change in Power Level & Declared Inoperable.Caused by Defective Preamplifier.Evaluation of Sys Design & Channel Functional Test initiated.W/900108 Ltr
ML19354D8291990-01-15015 January 1990
LER 89-044-00:on 891214,incorrect Assumptions & Calculational Errors Identified for Low Pressure Injection & Reactor Bldg Spray Pumps When Aligned to Take Suction from Reactor Bldg sump.W/900115 Ltr
ML20005G1681990-01-0909 January 1990
LER 89-045-00:on 891210,discovered That U-bolt Supports on Two Containment Isolation Valves in Containment Bldg Not Installed & Pressurizer Sample Lines & Valves Considered Inoperable.Missing U-bolts installed.W/900109 Ltr
ML20005F1481990-01-0808 January 1990
LER 89-042-00:on 891209,inadvertent Actuation of Control Room Emergency Ventilation Sys Occurred.Caused by Keying of Hand Held Radio in Vicinity of Chlorine Monitors by Technician.Technician counseled.W/900108 Ltr
ML20005F1571990-01-0808 January 1990
LER 89-043-00:on 891208,discovered That Approx 50% of One Nut Ring Half Beneath Reactor Vessel Nozzle Flange Corroded Away.Caused by Gradual Deterioration of Gasket Matl.Design Change implemented.W/900108 Ltr
ML20005F2071990-01-0404 January 1990
LER 89-040-00:on 891205 & 06,automatic Actuations of Emergency Diesel Generator Occurred as Result of Loss of Power to 480-volt ESF Bus.Caused by Personnel Error During Bus Transfer.Mgt Briefings conducted.W/900104 Ltr
ML20005F0471990-01-0303 January 1990
LER 89-046-00:on 891204,reactor Bldg Isolation Valves Rendered Inoperable Due to Deficient Welds on Piping Supports Which Were Installed During Initial Plant Const. Deficient Supports Repaired Prior to restart.W/900103 Ltr
ML20011D2521989-12-18018 December 1989
LER 89-039-00:on 891116,discovered That Door for Upper North Electrical Penetration Room Open & Missing Latch Mechanism. Caused by Extensive Use During 56-day Refueling Outage.More Frequent Insps of Door Condition to Be done.W/891218 Ltr
ML20011D2501989-12-18018 December 1989
LER 89-023-00:on 891117,approach to Criticality Commenced After Seventh Refueling Outage W/Logarithmic Power Level Channels Inoperable.Caused by Electrical Noise in Circuitry. Defective Preamplifier replaced.W/891218 Ltr
ML19354D5521989-12-14014 December 1989
LER 89-038-00:on 891114,reactor Trip Occurred as Result of Inadvertent Closure of Main Feedwater Isolation Valve.Caused by Personnel Error.Disciplinary Action Taken Against Individual & Senior Mgt Personnel Put on shift.W/891214 Ltr
ML19351A6731989-12-14014 December 1989
LER 89-022-00:on 891114,inadequate post-maint Test Controls Resulted in de-energizing 4,160 Volt Ac ESFs Electric Bus Uexpectedly.Caused by Inadequate post-maint Test Controls. Job Order Instructions changed.W/891214 Ltr
ML19351A4651989-12-11011 December 1989
LER 89-021-00:on 891111,when Low Level Radwaste Water in Waste Condensate Tank Aligned to Be Released,Discovered That Radiation Monitor Inoperable for Duration of Release.Caused by Personnel Error.Procedure revised.W/891211 Ltr
ML19332F6171989-12-11011 December 1989
LER 89-037-00:on 891110,reactor Trip Occurred as Result of Inadvertent Grounding of Reactor Protection Sys Power Supply During Surveillance Testing.Caused by Inadequate Procedure. Procedures revised.W/891211 Ltr
ML20005D6821989-12-0101 December 1989
LER 89-005-01:on 890518 & 25,damping Board Removed from Penetration Containing Cable Tray.On 890531,voids Noted in Penetration Seals.Caused by Erroneous Vendor Procedures. Penetrations Restored & Procedures revised.W/891201 Ltr
ML19332E4821989-11-30030 November 1989
LER 89-019-00:on 890927,identified That Closing Torque on Valves May Be Insufficient Against Postulated Worst Case Differential Pressure.Caused by Initial Plant Construction. Mod to Replace Gearing Made to Motor operator.W/891130 Ltr
1998-10-22
[Table view]
Category:TEXT-SAFETY REPORT
MONTHYEARML20217L8931999-10-31031 October 1999
Rev 1 to BAW-10235, Mgt Program for Volumetric Outer Diameter Intergranular Attack in Tubesheets of Once-Through Sgs
ML20212L1141999-10-0101 October 1999
Safety Evaluation Granting Request for Exemption from Technical Requirements of 10CFR50,App R,Section III.G.2.c
0CAN109902, Monthly Operating Repts for Sept 1999 for Arkansas Nuclear One,Units 1 & 2.With1999-09-30030 September 1999
Monthly Operating Repts for Sept 1999 for Arkansas Nuclear One,Units 1 & 2.With
ML20216J6271999-09-27027 September 1999
Rev 0 to CALC-98-R-1020-04, ANO-1 Cycle 16 Colr
ML20212F5261999-09-22022 September 1999
SER Approving Request Reliefs 1-98-001 & 1-98-200,parts 1,2 & 3 for Second 10-year ISI Interval at Arkansas Nuclear One, Unit 1
0CAN099907, Monthly Operating Repts for Aug 1999 for Ano,Units 1 & 2. with1999-08-31031 August 1999
Monthly Operating Repts for Aug 1999 for Ano,Units 1 & 2. with
ML20211F4281999-08-25025 August 1999
Safety Evaluation Concluding That Licensee Provided Acceptable Alternative to Requirements of ASME Code Section XI & That Authorization of Proposed Alternative Would Provide Acceptable Level of Quality & Safety
0CAN089904, Monthly Operating Repts for July 1999 for Ano,Units 1 & 2. with1999-07-31031 July 1999
Monthly Operating Repts for July 1999 for Ano,Units 1 & 2. with
ML20210K8831999-07-29029 July 1999
Non-proprietary Addendum B to BAW-2346P,Rev 0 Re ANO-1 Specific MSLB Leak Rates
0CAN079903, Monthly Operating Repts for June 1999 for Ano,Units 1 & 2. with1999-06-30030 June 1999
Monthly Operating Repts for June 1999 for Ano,Units 1 & 2. with
ML20207E7231999-06-0202 June 1999
Safety Evaluation Authorizing Proposed Alternative Exam Methods Proposed in Alternative Exam 99-0-002 to Perform General Visual Exam of Accessible Areas & Detailed Visual Exam of Areas Determined to Be Suspect
ML20196A0191999-05-31031 May 1999
Monthly Operating Repts for May 1999 for Arkansas Nuclear One,Units 1 & 2.With
ML20196A6251999-05-31031 May 1999
Non-proprietary Rev 0 to TR BAW-10235, Mgt Program for Volumetric Outer Diameter Intergranular Attack in Tubesheets of Once-Through Sgs
ML20195D1991999-05-28028 May 1999
Probabilistic Operational Assessment of ANO-2 SG Tubing for Cycle 14
ML20206M7711999-05-11011 May 1999
SER Accepting Relief Request from ASME Code Section XI Requirements for Plant,Units 1 & 2
0CAN059903, Monthly Operating Repts for Apr 1999 for Ano,Units 1 & 2. with1999-04-30030 April 1999
Monthly Operating Repts for Apr 1999 for Ano,Units 1 & 2. with
ML20206F0691999-04-29029 April 1999
Safety Evaluation Accepting Licensee Re ISI Plan for Third 10-year Interval & Associated Requests for Alternatives for Plant,Unit 1
ML20205M6941999-04-12012 April 1999
Safety Evaluation Granting Relief for Second 10-yr Inservice Inspection Interval for Plant,Unit 1
ML20205D6061999-03-31031 March 1999
Safety Evaluation Supporting Licensee Proposed Approach Acceptable to Perform Future Structural Integrity & Operability Assessments of Carbon Steel
ML20205R6351999-03-31031 March 1999
Monthly Operating Repts for Mar 1999 for Ano,Units 1 & 2. with
ML20205D4711999-03-26026 March 1999
SER Accepting Util Proposed Alternative to Employ Alternative Welding Matls of Code Cases 2142-1 & 2143-1 for Reactor Coolant System to Facilitate Replacement of Steam Generators at Arkansas Nuclear One,Unit 2
ML20204B1861999-03-15015 March 1999
Safety Evaluation Authorizing Licensee Request for Alternative to Augmented Exam of Certain Reactor Vessel Shell Welds,Per Provisions of 10CFR50.55a(g)(6)(ii)(A)(5)
0CAN039904, Monthly Operating Repts for Feb 1999 for Ano,Units 1 & 2. with1999-02-28028 February 1999
Monthly Operating Repts for Feb 1999 for Ano,Units 1 & 2. with
ML20212G6381999-02-25025 February 1999
Ano,Unit 2 10CFR50.59 Rept for 980411-990225
ML20203E4891999-02-11011 February 1999
Rev 1 to 97-R-2018-03, ANO-2,COLR for Cycle 14
ML20199F0351998-12-31031 December 1998
Monthly Operating Repts for Dec 1998 for Ano,Units 1 & 2
ML20198M7841998-12-29029 December 1998
SER Accepting Util Proposal to Use ASME Code Case N-578 as Alternative to ASME Code Section Xi,Table IWX-2500 for Arkansas Nuclear One,Unit 2
0CAN129805, LER 98-S02-00:on 981124,security Officer Found Not to Have Had Control of Weapon for Period of Approx 3 Minutes Due to Inadequate self-checking to Ensure That Weapon Remained Secure.All Security Officers Briefed.With1998-12-11011 December 1998
LER 98-S02-00:on 981124,security Officer Found Not to Have Had Control of Weapon for Period of Approx 3 Minutes Due to Inadequate self-checking to Ensure That Weapon Remained Secure.All Security Officers Briefed.With
ML20196F4911998-12-0101 December 1998
SER Accepting Request for Relief ISI2-09 for Waterford Steam Electric Station,Unit 3 & Arkansas Nuclear One,Unit 2
ML20198D2441998-11-30030 November 1998
Monthly Operating Repts for Nov 1998 for Ano,Units 1 & 2. with
ML20199F7401998-11-16016 November 1998
Rev 9 to ANO-1 Simulator Operability Test,Year 9 (First Cycle)
ML20195B4801998-11-0707 November 1998
Rev 20 to ANO QA Manual Operations
ML20195C4841998-11-0606 November 1998
SER Accepting QA Program Change to Consolidate Four Existing QA Programs for Arkansas Nuclear One,Grand Gulf Nuclear Station,River Bend Station & Waterford 3 Steam Electric Station Into Single QA Program
0CAN119808, Monthly Operating Repts for Oct 1998 for Ano,Units 1 & 2. with1998-10-31031 October 1998
Monthly Operating Repts for Oct 1998 for Ano,Units 1 & 2. with
ML20197H0741998-10-29029 October 1998
Rev 1 to Third Interval ISI Program for ANO-1
ML20155C1351998-10-26026 October 1998
Rev B to Entergy QA Program Manual
ML17335A7641998-10-22022 October 1998
LER 98-004-00:on 980923,inadvertent Actuation of Efs Occurred During Surveillance Testing.Caused by Personnel Error.Personnel Involved with Event Were Counseled & Procedure Changes Were Implemented.With 981022 Ltr
ML20154J2471998-10-0909 October 1998
SER Accepting Inservice Testing Program,Third ten-year Interval for License DPR-51,Arkansas Nuclear One,Unit 1
0CAN109806, Monthly Operating Repts for Sept 1998 for ANO Units 1 & 2. with1998-09-30030 September 1998
Monthly Operating Repts for Sept 1998 for ANO Units 1 & 2. with
ML20154E2171998-09-28028 September 1998
Follow-up Part 21 Rept Re Defect with 1200AC & 1200BC Recorders Built Under Westronics 10CFR50 App B Program. Westronics Has Notified Bvps,Ano & RBS & Is Currently Making Arrangements to Implement Design Mods
0CAN099803, Monthly Operating Repts for Aug 1998 for ANO Units 1 & 2. with1998-08-31031 August 1998
Monthly Operating Repts for Aug 1998 for ANO Units 1 & 2. with
ML20237B7671998-08-19019 August 1998
ANO REX-98 Exercise for 980819
ML18066A2771998-08-13013 August 1998
Part 21 Rept Re Deficiency in CE Current Screening Methodology for Determining Limiting Fuel Assembly for Detailed PWR thermal-hydraulic Sa.Evaluations Were Performed for Affected Plants to Determine Effect of Deficiency
ML20236X2351998-08-0505 August 1998
Part 21 Rept Re Defect Associated W/Westronics 1200AC & 1200BC Recorders Built Under Westronics 10CFR50,App B Program.Beaver Valley,Arkansas Nuclear One & River Bend Station Notified.Design Mod Is Being Developed
0CAN089804, Monthly Operating Repts for July 1998 for Ano,Units 1 & 21998-07-31031 July 1998
Monthly Operating Repts for July 1998 for Ano,Units 1 & 2
ML20196C7831998-07-30030 July 1998
Summary Rept of Results for ASME Class 1 & 2 Pressure Retaining Components & Support for ANO-1
ML20155H7161998-07-15015 July 1998
Rev 1 to 96-R-2030-02, Revised Reactor Vessel Fluence Determination
ML20236R0531998-06-30030 June 1998
Monthly Operating Repts for June 1998 for Ano,Units 1 & 2
ML20249B7791998-06-22022 June 1998
Part 21 Rept Re Findings,Resolutions & Conclusions Re Failure of Safety Related Siemens 4KV,350 MVA,1200 a Circuit Breakers to Latch Closed
ML20249B5091998-06-15015 June 1998
SG ISI Results for Fourteenth Refueling Outage
1999-09-30
[Table view] |
Text
CATEGORY ly REGULATORY INFORMATION DISTRIBUTION SYSTEM (RIDS)
ACCESSION NBR:9810280011 DOC.DATE: 98/10/22 NOTARIZED: NO DOCKET FACIL:50-313 Arkansas Nuclear One, Unit 1, Arkansas Power E Light 05000313 AUTH"NAME, 'UTHOR AFFILIATION SCHEIDE,R.H. Entergy Operations, Inc.
VANDERGRIFT,J. Entergy Operations, Inc.
RECIP.NAME RECIPIENT AFFILIATION
SUBJECT:
LER 98-004-00:on 980923,inadvertent actuation of EFS occurred during surveillance testing. Caused by personnel error. Personnel involved with event were counseled & A procedure changes were implemented. With 981022 ltr.
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 PD4-1PD 1 1 HILTON,N 1 1
'NTERNAL: ACRS 1 1 AEOD SPD RAB 2 2 AEOD/SPD/RRAB 1 1 1 1 NRR/DE/ECGB 1 1 NRR/DE/EELB 1 1 NRR/DE/EMEB 1 1 NRR/DRCH/HICB 1 1 NRR/DRCH/HOHB 1 1 NRR/DRCH/HQMB 1 1 NRR/DRPM/PECB 1 1 NRR/DSSA/SPLB 1 1 RES/DET/EIB 1 1 RGN4 FILE 01 1 1 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 NOTE TO ALL "BIDS" RECIPIENTS:
PLEASE 8 LP US 0 REDUCE WASTE, TC 'V CUR NAM OR ORGA I ZAT'ON R MOVED ROM DIS'RIBUTION LIST CR REDUCE THE NUMBER O." COP:ES .="CEIVED OU R '.O R ORGA.'J ZA CN, CONTACT THE DOCUMENT CON RO FULL TEXT CONVERSION REQUIRED TOTAL NUMBER OF COPIES REQUIRED: LTTR 23 ENCL 23
=- Entergy Entergy Operations, Inc.
1448 SR 333 RussdhR, AR 72801 Te1 501 858.5000 October 22, 1998 1CAN109801 U. S. Nuclear Regulatory Commission Document Control Desk Mail Station OP1-17 Washington, DC 20555
Subject:
Arkansas Nuclear One - Unit - 1 Docket No. 50-313 License No. DPR-51 Licensee Event Report 50-313/98-004-00 Gentlemen:
In accordance with 10CFR50.73(a)(2xiv), enclosed is the subject report concerning an inadvertent actuation of the Emergency Peedwater System.
Very truly yours, Ji D. Vander D'ctor, Nuclear Safety JDV/rs enclosure 98102800ii 981022 PDR S
ADGCK 05000SiS PDR
U. S. NRC October 22, 1998 1CAN109801 PAGE 2 cc: Mr. Ellis W. MerschoF Regional Administrator U. S. Nuclear Regulatory Commission Region IV 611 Ryan Plaza Drive, Suite 400 Arlington, TX 76011-8064 NRC Senior Resident Inspector Arkansas Nuclear One P.O. Box 310 London, AR 72847 Institute ofNuclear Power Operations 700 Galleria Parkway Atlanta, GA 30339-5957
APPROVED SY (BIB NO. 3150-0104 (5-92) EXP IRES 5/31/95 ESTIHATED BURDEN PER RESPONSE TO CNIPLY llITH LZCEMSEE EVENT REPORT THIS INFORHATIOH COLLECTION REQUEST: 50.0 HRS.
(LER) FORNARD COHHENTS REGARDING BURDEN ESTIHATE TO THE INFORHATION AMD RECORDS HANAGEHENT BRANCH (IQIBB 7714) ~ U ST NUCLEAR REGULATORY COHHISSIOMg MASHIMGTON, DC 20555 0001, AND TO THE PAPERMORK REDUCTION PROJECT (3150 0104), OFFICE OF HANAGEHENT AMO SISGET MASHIMGTON DC 20503.
FACILITY NAHE (1) DOCKET NQIBER (2) PAGE (3)
Arkansas Nuclear One - Unit 1 05000313 1 of 3 TITLE (4) Inadvertent Actuation Of The Emergency Feeduater System During Surveillance Testing As A Result Of Persanef Error EVENT DATE 5) LER NNSER (6 REPORT DATE (7) OTHER FACILITIES INVOLVED (8)
SEQUENTIAL REVISION FACILITY MANE DOCKET NQIBER HONTH DAY YEAR HONTH DAY YEAR NQIBER NQIBER 00 10 22 98 OPERATING THIS REPORT IS SUSHITTED PURSUANT TO THE REQUIREMENTS OF 10 CFR: (Check one or more ) (11)
HOOE (9) 20.402(b) 20.405(c) X 50.73(a (2)(fv) 73.71 b POUER 20.405(a)(1)(f) 50.36(c) (1) 50.73(a)(2)(v 73.71(c)
LEVEL (10) 20.405(a)(1)(ll) 50.36(c)(2) 50.73(a)(2)(vlf) OTHER 20.405(a) (1) ( I f l ) 50.73(a)(2)(l) 50.73(a)(2)(vill)(A) Specffy ln 20.405(a)(1)(lv) 50.73(a) (2) ( f I ) 50.73(a)(2)(vlf f)(B) Abstract Befou 20.405(a)(1)(v) 50.73(a)(2)(l 1 I) 50.73(a)(2)(x) and fn Text LICENSEE CONTACT FOR THIS LER (12)
NAHE TELEPHONE NQIBER (Include Area Code)
Richard H. Scheide, Nuclear Safety and Llcensfng Specialist 501.858.4618 COHPLETE ONE LINE FOR EACH C(SIPONENT FAILURE DESCRIBED IN THIS REPORT (13)
REPORTABLE REPORTABLE CAUSE SYSTEH CNIPONENT HAMUFACTURER CAUSE SYSTEH COHPONENT HAMUFACTURER TO NPRDS TO NPRDS SUPPLEHENTAL REPORT EXPECTED (14) EXPECTED HONTH DAY YES SUSHI SS I ON (If yes, coapfete EXPECTED SUBHISSION DATE) X DATE (15)
ABSTRACT (Lfmlt to 1400 spaces, f.e., approximately 15 single-spaced typeMritten fines) (16)
On September 23, 1998, at approximately 1033, an inadvertent actuation of the Emergency Feedwater System (EFW) occurred during the performance of the Emergency Feedwater Initiation and Control System (EFZC) monthly surveillance test. When the technicians reached a point in the procedure requiring a half trip in the "A" and "B" EFW train trip modules to be reset, the lead technician read the step which stated, "Reset the EFW Trip Modules in Channels A and B." The technician performing the step repeated the instruction; however, instead of depressing the reset toggle switch, he depressed the "B" EFW trip module Trip 1 button. This action satisfied the actuation logic for the "B" train of EFW and one EEW pump started. Since the OTSGs were at normal levels and pressure, no EFW flow was in)ected. The EFW pump was immediately secured, "the trip modules were reset, and EFIC and EFW were returned to their normal configuration. The root cause of this event was personnel error. The individuals involved were counseled. Also, this event and expectations regarding self-checking were discussed with appropriate pezsonnel.
NRC FORH 366A (5 92)
APPROVED SY NNI NO. 3150 0104 (5-92) EXPIRES 5/31/95 ESTIHATED BURDEN PER RESPONSE TO CNIPLY HITH THIS INFORHATION COLLECTION REQUEST: 50.0 NRS.
FORMARD CNNIENTS REGARDING BURDEN ESTIHATE TO LICENSEE EVENT REPORT (LER) THE INFORHATION AND RECORDS HANAGEHENT BRANCH (HNBB 7714), U.S. NUCLEAR REGULATORY COBIISSIONg TEXT CONTINUATION NASHINGTON, DC 20555-0001, AND TO THE PAPERNDRK REDUCTION PROJECT (3150-0104), OFFICE OF HANAGEHENT AND BLNGET MASHINGTON DC 20503.
FACILITY NAHE (1) DOCKET IRBSER (2) LER NNBER (6) PAGE (3)
SEQUENTIAL REVISION NNBER NNBER Arkanaaa Nuclear One - Unit 1 05000313 2OF3 98 TEXT (17)
Plant Status At the time this event occurred, Arkansas Nuclear One Unit 1 (ANO-1) was operating in steady-state conditions at 100 percent power.
B. Event Description On September 23, 1998, at approximately 1033, an inadvertent actuation of the Emergency Feedwater System (EFW)[BAJ occurred during performance of the Emergency Feedwater Initiation and Control System (EFIC)[JE] monthly surveillance test.
The EFW system is a two train system consisting of a steam driven pump (P-7A) and a motor driven pump (P-7B). EEW is actuated to protect the reactor core from overheating upon loss of main feedwater flow or reactor coolant pump (RCP) circulation. EFIC is a four channel system that monitors Once Through Steam Generator (OTSG) levels and pressures, main feedwater pump status, RCP status/
and Engineering Safeguazds Actuation System [JE) channels 3 and 4 in order to initiate EEW should an actuation setpoint be reached. The EFIC logic is a "one out of two taken twice format. To actuate either train of EEW, at least two of the four channels must be initiated.
initiated, it If only two EFIC channels are is possible to have one or both trains of EFW actuated, depending upon which channels are initiated.
The monthly EFIC Channel "B" surveillance test was commenced at approximately 0825 on September 23. At approximately 1030, the technicians performing the surveillance verified that a simulated low level in the "A" OTSG appropriately initiated the "Trip 1" logic in the "A" EEW Train trip module and the "Trip 2" logic in the "B" EFW Train trip module. After resetting the simulated low OTSG level, the procedure required that the EEW trip modules be reset. The lead technician read the procedure step which stated, "Reset the EFW Trip Modules in Channels A and B." The technician performing the step repeated the instruction; however, instead of depressing the reset toggle switch, he depressed the "B" EFW trip module trip 1 button. This action satisfied the actuation logic for the "B" train of EFW and P-7A started. Since the OTSGs were at normal operating levels and pressure, no EFW flow was infected. The control board operator immediately secured P-7A. The EEW trip modules were properly reset, EFIC and EEW were returned to their normal configuration, and the surveillance procedure was exited.
The surveillance test was recommenced at 1247 and successfully completed at 1422 on September 23.
C. Root Cause The root cause of this event was determined to be personnel error. The technician performing the action understood the procedure step read by the lead technician and repeated it; however, he failed to self-check before performing the action.
NRC FORH 366A (5-92)
- .5.92) APPROVED BT (NB NO. 150.01 EXPIRES 5/31/95 EST INATED BURDEN PER RESPONSE TO CNIPLY MITH THI S INFORHATION COLLECTION REQUEST
- 50.0 HRS.
FORMARD CQNENTS REGARDING BURDEN EST IHATE TO LZCBMSBB BVENT REPORT (LER) THE INFORNAT I ON AND RECORDS HANAGENENT BRANCH TEXT CONTINUATION (NNBB 7714) ~ U.So NUCLEAR REGULATORY CONNISSION, MASHINGTON, DC 20555-0001 ~ AND TO THE PAPERMQRK REDUCTION PROJECT (3150-0104) ~ OF FICE OF NANAGEHENT ANO BISGET MASHINGTON DC 20503 FACILITY NANE (1) DOCKET NIMBER (2) LER NMBER (6) PAGE (3)
SEQUENTIAL REVISION NSIBER NWBER Arkansas Nuciear One - Unit 1 05000313 30F3 TEXT (17)
A contributing cause to this event was a procedural ambiguity. The procedure step (8.3.6.K) that resulted in the EFW actuation simply stated, "Reset the EEW Trip Modules in Channels A and B. Preceding steps stipulating manipulation of devices were more specific with respect to the actions required. For example ,
step 8.3.6.I. states in part, "Press and release the Reset button.. ." If the ~
procedure had stated, "Press and release the Reset toggle switch....," the error might not have occurred.
D. Corrective Actions The technicians involved with this event were counseled by management prior to recommencing the surveillance test. The importance of self-checking was emphasized.
This event and management expectations regarding self-checking were discussed with the Unit-1 Instrumentation and Control shop personnel during their morning meetings.
Procedure changes wefe implemented to clearly specify depressing the reset toggle switch when resetting the EFW trip modules.
The Maintenance Human Performance Committee will develop a summary of the lessons learned from this event to be presented to the Maintenance Departments of ANO-1 and ANO-2. The summary is expected to be completed by December 21, 1998.
E. Safety Significance The EFZC and EFW systems performed as designed after the inadvertent actuation signal was initiated. However, since the OTSGs were at normal operating levels and pressure, no EFW flow was initiated and no plant perturbation resulted from this event., Therefore, this condition is considered to be of low safety significance.
F. Basis For Reportability This condition is reportable pursuant to 10CFR50.73(a) (2) (iv) as an actuation of an Engineered Safety Feature (ESF).
It was also reported to the NRC Operations Center at 1336 on September 23, 1998, in accordance with 10CFR50.72(b) (2)(ii) .
G. Additional Information There have been no previous similar LERs submitted by ANO regarding the inadvertent actuation of an ESF as a result of inadequate self-checking by Maintenance personnel.
Energy Industry Identification System (EIZS) codes are identified in the text as [XX] .
NRC FOHN 366A (5-92)
