05000334/FIN-2012005-01
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Finding | |
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| Title | Failure to Use a Procedure to Operate a CVCS Valve |
| Description | A self revealing, Green NCV of Technical Specification 5.4.1 Procedures, was identified for FENOCs failure to use a procedure when operating chemical volume and control system (CVCS) valve 2CHS-FCV122 during troubleshooting, as required by the regulatory guide (RG) 1.33 Quality Assurance Program Requirements . Specifically, when an operator discovered that the valve positioner main feedback arm was sheared, the operator inadvertently manipulated the valve without guidance from a procedure or problem solving plan. The inspectors determined that failing to use a procedure when operating 2CHS-FCV122 during troubleshooting was a performance deficiency within FENOCs ability to foresee and correct which contributed to over-pressurizing the reactor coolant system RCS during solid plant operations. This finding is more than minor because it is associated with the human performance attribute of the initiating events cornerstone and adversely impacted the cornerstone objective to limit the likelihood of events that upset plant stability and challenge critical safety functions during shutdown. Specifically, the operators failure to use a procedure when operating 2CHS-FCV122 during troubleshooting led to over-pressurization of the reactor coolant system. The inspectors evaluated the finding using PWR Refueling Operation: RCS level > 23 or PWR Shutdown Operation with Time to Boil > 2 hours2.314815e-5 days <br />5.555556e-4 hours <br />3.306878e-6 weeks <br />7.61e-7 months <br /> and Inventory in the Pressurizer Checklist 4 of Attachment 1 to Appendix G of IMC 0609. Because no loss of control occurred and no checklist attributes were adversely impacted, a Phase 2 quantitative assessment was not required. Therefore, the inspectors determined the finding to be of very low safety significance. This finding has a cross-cutting aspect in the area of Human Performance, Work Practices, because FENOC personnel failed to use human error prevention techniques during troubleshooting of 2CHS-FCV122, and proceeded in the face of uncertainty after identifying the broken positioned feedback arm. |
| Site: | Beaver Valley |
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| Report | IR 05000334/2012005 Section 1R20 |
| Date counted | Dec 31, 2012 (2012Q4) |
| Type: | NCV: Green |
| cornerstone | Initiating Events |
| Identified by: | Self-revealing |
| Inspection Procedure: | IP 71111.2 |
| Inspectors (proximate) | D Spindler G Hunegs S Barber |
| CCA | H.12, Avoid Complacency |
| INPO aspect | QA.4 |
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Finding - Beaver Valley - IR 05000334/2012005 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Finding List (Beaver Valley) @ 2012Q4
Self-Identified List (Beaver Valley)
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