ML17332A547

LER 94-014-00:on 941225,discovered That TS Surveillance 4.11.2.1.2 Gland Seal Exhaust Weekly Gaseous Effluent Grab Sample Not Completed for 941217-25.Caused by Personnel Error.Surveillance Schedule Sheet modified.W/950124 Ltr

ML17332A547
Person / Time
Site:	Cook
Issue date:	01/24/1995
From:	Blind A, Dennis Morey INDIANA MICHIGAN POWER CO. (FORMERLY INDIANA & MICHIG
To:	NRC OFFICE OF INFORMATION RESOURCES MANAGEMENT (IRM)
References
LER-94-014, LER-94-14, NUDOCS 9502020100
Download: ML17332A547 (6)

Text

RID RITY (ACCELERATED RIDS PROCI'.SSliGi REGULATORY INFORMATION DISTRIBUTION SYSTEM (RIDS)ACCESSION NBR:9502020100 DOC-DATE: 95/01/24 NOTARIZED-NO DOCKET.N FACIL:50-315 Donald C.Cook Nuclear Power Plant, Unit 1, Indiana M 05000315 AUTH.NAME AUTHOR AFFILIATION MOREY,D.O.

Indiana Michigan Power Co.(formerly Indiana&Michigan Ele BLIND,A.A.

Indiana Michigan Power Co.(formerly Indiana&Michigan Ele RECIP.NAME RECIPIENT AFFILIATION

SUBJECT:

LER 94-014-00:on 941225,discovered that TS surveillance 4.11.2.1.2 gland seal exhaust weekly gaseous effluent grab sample not completed for 941217-25.Caused by personnel error.Surveillance schedule sheet modified.W/950124 ltr.DISTRIBUTION CODE: IE22T COPIES RECEIVED:LTR g ENCL i SIZE: TITLE: 50.73/50.9 Licensee Event Report (LER), Incident Rpt, etc.NOTES RECIPIENT ID CODE/NAME PD3-1 PD INTERNAL: AEOD/SPD jRAB F/IZ CENTE@02 NRR/DE/EELB NRR/DISP/PIPB NRR/DRCH/HHFB NRR/DRCH/HOLB NRR/DSSA/SPLB RES/DSIR/EIB EXTERNAL: L ST LOBBY WARD NOAC MURPHY,G.A 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 1 1 RECIPIENT ID CODE/NAME HICKMAN,J AEOD/SPD/RRAB NRR/DE/ECGB NRR/DE/EMEB NRR/DOPS/OECB NRR/DRCH/HICB NRR/DRSS/PRPB NRR/DSSA/SRXB RGN3 FILE 01 LI TCO BRYCE P J H NOAC POORE,W.NUDOCS FULL TXT COPIES LTTR ENCL 1 1 1 1 1 1 1 1 1 1 1 1 2 2 1 1 1 1 2 2 1 1 1 1 i'OTE TO ALL"Rl DS" RECIPIENTS:

PLEASE HELP l'S TO RE DL'CE iVASTE.'Oi I AC'I"I HE DOCL'iIEi T CONTROL DESk.ROOXI Pl-3" (EXT.5%.2083)TO I Llilli:KTE i'OI.'lI%ANIL PROil DISTR I Dl'TIOi LISTS I:OR DOCI.'ill X'I'S Yol.')Oi'"I i I.:I:.D'ULL TEXT CONVERSION REQUIRED TOTAL NUMBER OF COPIES REQUIRED: LTTR 26 ENCL 26

Indiana Michigan Power Company Cook Nuclear Plant~One Cook Place Bridgman, Ml 49106 616 465 5901 INDIANA NICHIGAN POWER January 24, 1994 United States Nuclear Regulatory Commission Document Control Desk Rockville, Maryland 20852 Operating Licenses DPR-58 Docket No.50-315 Document Control Manager: In accordance with the criteria established by 10 CFR 50.73 entitled ice see Eve t e ort S stem the following report is being submitted:

94-014-00 Sincerely, A.A.Blind Plant Manager/sb Attachment c J.B.Martin, Region III E.E.Fitzpatrick P.A.Barrett R.F.Kroeger M.A.Bailey-Ft.Wayne NRC Resident Inspector J.B.Hickman-NRC J.R.Padgett G.Charnoff, Esq.D.Hahn INPO S.J.Brewer 9502020100 950i24 PDR ADOCK 050003i5 S PDR NRC FORM 366 (5 921.NUCLEAR REGULATORY COMMISSION t APPROVED BY OMB NO.315~104 EXPIRES 5/31/95 LICENSEE EVENT REPORT (LER)(See reverse for required number of digits/characters for each block)ESTIMATED BURDEN PER RESPONSE TO COMPLY WITH THIS INFORMATION COLLECTION REOUEST: 50.0 HRS.FORWARD COMMENTS REGARDING BURDEN ESTIMATE TO THE tNFORMATION AND RECORDS MANAGEMENT BRANCH IMNBB TTI4)~U.S.NUCLEAR REGULATORY COMMISSION, WASHINGTON, DC 205550001~AND TO THE PAPERWORK REDUCTION PRCUECT (31500104), OFRCE OF MANAGEMENT AND BUDGET.WASHlNGTON, OC 20503.FACILITY NAME (I)Cook Nuclear Plant-Unit 1 DOCKET NUMBER (2)osooo PAOE (3}10F 3 TITLE (4)Weekly Gaseous Grab Sample Not Taken Due to Personnel Error EVENT DATE 5 LER NUMBER 6 REPORT NUMBER 7 OTHER FACILITIES INVOLVED 8 MONTH 12 DAY YEAR 25 94 SEOUENTIAL NUMBER 94-O14 REvlsroN NUMBER 00 MONTH DAY 01 24 95 FACIUTY NAME Cook Unit 2 FACIUTY NAME DOCKET NUMBER 05000 316 DOCKET NUMBER 05000 OPERATING MODE (9)20.402(b)20.405(c)50.73(a)(2)(iv)73.71(b)THIS REPORT IS SUBMITTED PURSUA NT TO THE REQUIREMENTS OF 10 CFR 5: Check one or more 11 POWER LEVEL (10)100 20.405(a)(1)(i)Fa 20.405(a)(l](lt) 20.405(a)(1)(lii)20.405(a)(1)(iv)20.405(a)(1)(v) 50.36(c)(1)50.36(c)(2)Z S0.73(a)(2)(l) 50.73(a)(2)(ii) 50.73(a)(2)(iii)50.73(a)(2)(v)50.73(a)(2)(vii)50.73(a)(2)(viii)(A)50.73(a)(2)(viii)(8)50.73(a)(2)(lt)73.71(c)OTHER (Speoty In Abstract below and In TexL NRC Form 366A)LICENSEE CONTACT FOR THIS LER 12 NAME D.0.Morey, Chemistry Superintendent TELEPHONE NUMBER (Include Area Code)616/465-5901 X2502 COMPLETE ONE LINE FOR EACH COMPONENT FAILURE DESCRIBED IN THIS REPORT 13 CAUSE SYSTEM COMPONENT MANUFACTURER REPORTABLE TO NPRDS CAUSE SYSTEM COMPONENT MANUFACTURER REPORTABLE TO NPRDS SUPPLEMENTAL REPORT EXPECTED 14 YES (tt yes.complete EXPECTED SUBMISSION DATE)No ABSTRACT (Limit to 1400 spaces.i.e., approximately 15 single-spaced typewritten lines)(16)EXPECTED MONTH OAY YEAR SUBMISSION DATE (15)On January 6, 1995 it was discovered that Technical Specification surveillance 4.11.2.1.2 for Units One and Two Gland Seal Exhaust weekly gaseous effluent grab sample was not completed for the period of December 17 through December 25, 1994.As the sampling requirement was not met, this event is reportable under 10CFR50.73(a)

(2)(i)(B), as a condition prohibited by Technical Specifications.

Technical Specification 4.11.2.1.2 requires a monthly surveillance on the Gland Seal Exhaust for particulate, iodine and tritium in addition to the weekly gaseous grab sample.The individual involved mistakenly marked the line item for the gaseous sample as nNot Applicable" (N/A)on the Nuclear Test, Schedule system, believing the item was the monthly surveillance for particulate, iodine and tritium which had been completed the previous week.This event is attributable to personnel error.Weaknesses in the Nuclear Test Schedule system schedule form and its use were identified during the investigation.

These weakness have been addressed.

During the month of December 1994, no abnormal operational activities occurred that would have caused an alteration in the normal nuclide composition of either units'land Seal Exhaust effluent.A review of the gaseous samples obtained before and after this event indicated no unusual nuclides present.It was concluded that the missed surveillance created no safety hazard, nor was the health and safety of the public jeopardized at any time.NRC FORM 366 r5 921 NRC FORM355A (I i (SSS)U.S.NUCLEAR REGULATORY COMMISSION LICENSEE EVENT REPORT (LER)TEXT CONTINUATION t APPROVED 0MB NO.3150010i EXP I R ES,'i/30/02 ESTIMATED BURDEN PKR RESPONSE TO COMPLY WTH THIS INFORMATION COLLECTION REQUEST: 500 HRS.FORWARD COMMENTS REGARDING BURDEN ESTIMATE TO THE RECORDS AND REPORTS MANAGEMENT BRANCH (F430), U.S.NUCLEAR REGULATORY COMMISSION.

WASHINGTON.

DC 20555.AND TO THE PAPERWORK REDUCTION PROJECT 13150010il.

OFF ICK OF MANAGEMENT AND BUDGET, WASHINGTON, DC 20503.FACILITY NAME ((I Cook Nuclear Plant Unit 1 DOCKET NUMBER (2)YEAR LER NUMBER (5)seaveNNAI.

NVM EII Rev(sloN~NVMee/I PACK (3)TEXT///moro totcoit roeor/od.Vto oddroooo/HRC Form 355A'I/I)))0 5 0 0 0 315 94 014 0 0 0 2 0F 0 3 Conditions Prior to Occurrence Unit One in Mode 1 at 100 percent power;Unit Two in Mode One at 68 percent power.Descri tion of Event On January 6, 1995 it was discovered that Technical Specification surveillance 4.11.2.1.2 for Units One and Two Gland Seal Exhaust weekly gaseous effluent grab sample was not completed for the period of December 17 through December 25, 1994.Technical Specification Table 4.11-2(C)requires the grab sample to be taken on a weekly basis.Surveillance requirements are tracked using the Nuclear Tracking System (NTS)surveillance tracking system.As each line item representing a surveillance requirement is completed, the responsible individual"signs offH (initials) the form.In addition to the weekly gaseous grab sample, Technical Specif ication 4.11.2.1.2, Table 4.11-2(C)requires a monthly surveillance on the Gland Seal Exhaust for particulate, iodine and tritium.The involved individual was aware that this monthly surveillance had been completed the previous week.On December 23, 1994, when the weekly gaseous grab sample was due, the individual mistakenly marked the line item for the gaseous sample as RNot Applicable" (N/A)on the NTS f orm, believing that the line item represented the monthly surveillance for particulate, iodine and tritium.Cause of Event Thi..v.nt is attributable to personnel error.The knowledge that the monthly surveillance had been completed the previous week resulted in the responsible individual exhibiting a lack of attention to detail.The individual failed to read the NTS form carefully, and subsequently marked the form incorrectly.

An important contributing factor to this error was the ambiguity of the NTS schedule form for Chemistry.

The format failed to clearly define surveillance frequencies and the Technical Specification require(Rent which the sampling fulfilled.

In addition, the form contained tasks unrelated to Technical Specification surveillance requirements.

Also contributing to this event was the lack of timely review of the completed surveillances for the period in question.Supervisory personnel were not available to review the completed paperwork prior to the expiration of the grace period for the surveillance.

NRC Forot 358A (585)

NRC FORM 35SA (549)U.S.NUCLEAR REGULATORY COMMISSION LICENSEE EVENT REPORT (LER)TEXT CONTINUATION I APPROVED 0MB NO.3)50410S EKPIRESl s/30/92 ESTIMATED BURDEN PER RESPONSE TO COMPLY WTH THIS INFORMATION COLLECTION REQUEST: 508)HRS.FORWARD COMMENTS REGARDING BURDEN ESTIMATE TO THE RECORDS AND REPORTS MANAGEMENT BRANCH IP430).U.S.NUCLEAR REGULATORY COMMISSION, WASHINGTON, DC 20555, AND TO THE PAPERWORK REDUCTION PROJECT 131504104).

OFFICE OF MANAGEMENT ANO BUDGET, WASHINGTON.DC 20503.FACILITY NAME (1)Cook Nuclear Plant Unit 1 DOCKET NUMBER (2)LER NUMBER (5)YEAR (Trs>SEOUSNTIAL

@>AEYISION IIUMSSII S.O IIUM SII PAGE (3)TGCT/II more ssrsse ls ss)O/red, use eddr)ioosl llRC Form 3SSA's/(I))o 5 o o o 315 9 4 014 0 0 0 30F 0 3 Anal sis of Event This event is being reported in accordance with 10CFR50.73(a)(2)(i)(B) as operation prohibited by the plant's Technical Specifications.

Technical Specification 4.11.2.1 Table 4.11-2(C)requires the Gland Seal Exhaust gaseous effluent to be sampled and analyzed on a weekly basis.During the month of December 1994, no abnormal operational activities occurred that would have caused an alteration in the normal nuclide composition of either units'land Seal Exhaust effluent.A review of the gaseous samples obtained before and after this event indicated no unusual nuclides present.In addition, the result of the sample analyses for particulate, iodine and tritium were reviewed for the periods prior to and after the missed gaseous sample, and no unusual nuclides were present.It was concluded that the missed surveillance created no safety hazard, nor was the health and safety of the public jeopardized at any time.Corrective Action The NTS surveillance schedule sheet has been modified using human factor principles.

Previously, the form had contained entries both for Technical Specification required surveillances and administrative tasks.To lessen the potential for confusion, the administrative tasks have been removed and the NTS schedule form now contains only Technical Specification required surveillances.

The format has also been revised to organize the information for the required surveillances in a consistent and obvious manner.The Chemistry Department has established a policy concerning the use of"N/A" which makes it clear that its use is no longer acceptable on the NTS surveillance schedule form.The procedure governing the use of NTS has been revised to reflect this clarification.

Staff briefings on the procedure changes have been completed.

Personnel resources have been reallocated to be available on a timely basis to review finished surveillances for completeness and accuracy.Previous Similar Events 315/94-012 316/93-010 316/93-002 315/92-013 316/91-003 Failed Com onent Identification None NRC Form 3SSA (549)