ML17335A764

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

ML17335A764
Person / Time
Site:	Arkansas Nuclear
Issue date:	10/22/1998
From:	Scheide R, Vandergrift J ENTERGY OPERATIONS, INC.
To:	NRC OFFICE OF INFORMATION RESOURCES MANAGEMENT (IRM)
References
1CAN109801, LER-98-004-04, LER-98-4-4, NUDOCS 9810280011
Download: ML17335A764 (6)

Text

CATEGORY ly REGULATORY INFORMATION DISTRIBUTION SYSTEM (RIDS)ACCESSION NBR:9810280011 DOC.DATE: 98/10/22 NOTARIZED:

NO FACIL:50-313 Arkansas Nuclear One, Unit 1, Arkansas Power E Light AUTH"NAME,'UTHOR AFFILIATION SCHEIDE,R.H.

Entergy Operations, Inc.VANDERGRIFT,J.

Entergy Operations, Inc.RECIP.NAME RECIPIENT AFFILIATION DOCKET 05000313

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&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: A.RECIPIENT ID CODE/NAME PD4-1PD'NTERNAL: ACRS AEOD/SPD/RRAB NRR/DE/ECGB NRR/DE/EMEB NRR/DRCH/HOHB NRR/DRPM/PECB RES/DET/EIB EXTERNAL: L ST LOBBY WARD NOAC POORE,W.NRC PDR COPIES LTTR ENCL 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 RECIPIENT ID CODE/NAME HILTON,N AEOD SPD RAB NRR/DE/EELB NRR/DRCH/HICB NRR/DRCH/HQMB NRR/DSSA/SPLB RGN4 FILE 01 LITCO BRYCE,J H NOAC QUEENER,DS NUDOCS FULL TXT COPIES LTTR ENCL 1 1 2 2 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 1 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 lOCFR50.73(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 ADGCK 05000SiS S 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 of Nuclear Power Operations 700 Galleria Parkway Atlanta, GA 30339-5957 (5-92)LZCEMSEE EVENT REPORT (LER)APPROVED SY (BIB NO.3150-0104 EXP IRES 5/31/95 ESTIHATED BURDEN PER RESPONSE TO CNIPLY llITH THIS INFORHATIOH COLLECTION REQUEST: 50.0 HRS.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)Arkansas Nuclear One-Unit 1 DOCKET NQIBER (2)05000313 PAGE (3)1 of 3 TITLE (4)Inadvertent Actuation Of The Emergency Feeduater System During Surveillance Testing As A Result Of Persanef Error HONTH DAY YEAR EVENT DATE 5)LER NNSER (6 SEQUENTIAL NQIBER REVISION NQIBER REPORT DATE (7)OTHER FACILITIES INVOLVED (8)DOCKET NQIBER FACILITY MANE YEAR HONTH DAY 00 10 22 98 OPERATING HOOE (9)POUER LEVEL (10)THIS REPORT IS SUSHITTED PURSUANT 20.402(b)20.405(a)(1)(f) 20.405(a)(1)(ll) 20.405(a)(1)(I f l)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)(f I)50.73(a)(2)(l 1 I)X 50.73(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)

TO THE REQUIREMENTS OF 10 CFR: (Check one or more)(11)73.71 b 73.71(c)OTHER Specffy ln Abstract Befou and fn Text LICENSEE CONTACT FOR THIS LER (12)NAHE Richard H.Scheide, Nuclear Safety and Llcensfng Specialist TELEPHONE NQIBER (Include Area Code)501.858.4618 COHPLETE ONE LINE FOR EACH C(SIPONENT FAILURE DESCRIBED IN THIS REPORT (13)CAUSE SYSTEH CNIPONENT HAMUFACTURER REPORTABLE TO NPRDS CAUSE SYSTEH COHPONENT HAMUFACTURER REPORTABLE TO NPRDS SUPPLEHENTAL REPORT EXPECTED (14)YES (If yes, coapfete EXPECTED SUBHISSION DATE)X EXPECTED SUSHI SS I ON DATE (15)HONTH DAY 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)

(5-92)LICENSEE EVENT REPORT (LER)TEXT CONTINUATION APPROVED SY NNI NO.3150 0104 EXPIRES 5/31/95 ESTIHATED BURDEN PER RESPONSE TO CNIPLY HITH THIS INFORHATION COLLECTION REQUEST: 50.0 NRS.FORMARD CNNIENTS REGARDING BURDEN ESTIHATE TO THE INFORHATION AND RECORDS HANAGEHENT BRANCH (HNBB 7714), U.S.NUCLEAR REGULATORY COBIISSIONg NASHINGTON, DC 20555-0001, AND TO THE PAPERNDRK REDUCTION PROJECT (3150-0104), OFFICE OF HANAGEHENT AND BLNGET MASHINGTON DC 20503.FACILITY NAHE (1)Arkanaaa Nuclear One-Unit 1 DOCKET IRBSER (2)05000313 98 LER NNBER (6)SEQUENTIAL NNBER REVISION NNBER PAGE (3)2OF3 TEXT (17)Plant Status B.At the time this event occurred, Arkansas Nuclear One Unit 1 (ANO-1)was operating in steady-state conditions at 100 percent power.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.

If only two EFIC channels are initiated, it 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)LZCBMSBB BVENT REPORT (LER)TEXT CONTINUATION APPROVED BT (NB NO.150.01 EXPIRES 5/31/95 EST INATED BURDEN PER RESPONSE TO CNIPLY MITH THI S INFORHAT ION COLLECTION REQUEST

50.0 HRS.FORMARD CQNENTS REGARDING BURDEN EST IHATE TO THE INFORNAT I ON AND RECORDS HANAGENENT BRANCH (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)Arkansas Nuciear One-Unit 1 DOCKET NIMBER (2)05000313 LER NMBER (6)SEQUENTIAL NSIBER REVISION NWBER PAGE (3)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)