ML062420346
ML062420346 | |
Person / Time | |
---|---|
Site: | Salem, Hope Creek |
Issue date: | 05/28/2004 |
From: | - No Known Affiliation |
To: | Office of Nuclear Reactor Regulation |
References | |
FOIA/PA-2005-0194 | |
Download: ML062420346 (44) | |
Text
Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning is to establish the preliminary significance of Issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were Identified during Interviews conducted to assess this allegation.
LEGEND S -Specific Incident QG- General GMLC -General Management I Leadership I Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure Issue Root PERCEIVED LACK OF FREEDOM TO RAISE SAFETY CONCERNS TO PSEG MANAGEMENT Tsse ause* The plant lost the Core Monitoring System and CRIDS ... the NCO, CRS, and STA concurred that the correct action was to reduce power to the pre-uprate level until the CMS was fixed ... OS overrode and directed that the operators not reduce power, the interviewee stated that he wrote a notification describing the Issue and the procedures that were violated.
Later, the OS approached him and tried to get him to "change [his] whole process' and revise the notification written related S NCD to failure to reduce power following loss of the CMS and CRIDS ... he spent a lot ofiti e shing to get the Issue resolved ... eventually, "...my thought process was that I havi nd I have a house, and. I say'I guess it's not going anywhere anyway, what's the pling it any further?'
So I stopped.'o 1/07/04, p. 44 -47, 50, 51, 54, 55* "I've had an OS stand up at a meeting and say 'you f$1#@r' ... I called him on a lie about actions... when your manager [gets that] upset, the guy who writes your appraisal
... when you work for G GMLC people who dolike you, [you] have a fear of [reprisal]" 0 11/07/03, (#2) p. 10* "[I left .cause] --- I felt like there was no future for me there [HC] because I was the one that G GMLC spoke up 2ofter they really don't care for that.'o 0/29/03, p. 8 0 Discusses cheating that occurred during Initial qualification training for non-licensed Nuclear Equipment Operators (NEOs). "The qualification process for NEOs should have taken about 18 months. ... Part of the process of their [management]
managing Information was that if you G GMLC spoke up ... they would not support you on getting qualified." It took him almost two years to qualify.o .10/29/03, p. 12 -43* Response by the Individuals accused of cheating tdifter an exam ".-. you can't rat out a Union brother or they can pres charges against you at reunlon ... If you want your time here to be G GMLC normal ...
or your life's going to be miserable." o 1 10/29/03, p. 21 Discussifonout a valve mis-alignment coverup with related to a mechanical vacuum pump water seal during a plant startup: '... the operator who started the [water seal] pumps did not open the make up water [isolation valve] ... one [pump] tripped on low water level and the other one was real dose to tripping ... He [a co-worker who un-Isolated the mis-postioned valve] Insisted that I say It that way [that the 2 of them went down to check why the pump tripped and that they kicked the make-up tank, In effect, freeing up a sticky float switch] or I was not go t t G GMLC help [completing my NEO qualification]" ... the NEO (Interviewee_
InformeG ut he was not aware of any action taken by.. "NoMafly [the operators In the control room will say] 'go write a notification'
... [howl.'er], nobody said anything about writing a notification
[the supposedly stuck float In the seal water supply tank] ... I could have[written a notification, but then] I would have had to deal with even more peer pressure ...basically, you can't do anything that might get someone in trouble" o 10/29/03, p. 73 -82* -The retai-ation is so pervasive, no one will talk." G GMLC o -M 10/29/03, p. 97 With respe"E to the SCWE at Hope Creek: *.. they have an excellent procedure.
They have an excellent policy; and they don't enforce it ... Management
... [was] not supportive.
.... G GLC[Management]
would not tell you not to [write a notification], but then I had notifications they'd close an hour later. ... They felt like I was a crybaby." Ifnrm -. J If10/ /03, p. 129 7C Ic-fiV%9W6SbWn Bins lbrowlfls Page 1 of 45 Updated: 5/28/0e Txk Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning is to establish the preliminary significance of issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were identified during interviews conducted to assess this allegation.
LEGEND S -Specific Incident G -General.GMLC -General Management
/ Leadership
/ Communication NCD- Non-Conservative Decision Making FIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure PERCEIVED LACK OF FREEDOM TO RAISE SAFETY CONCERNS TO PSEG MANAGEMENT Issue Root]ýe Cause* ... we have ayýeryapthetic work environment
... they're in a hurry to get the Job done.' .G GMLC o .10/29/03, p. 133"IHope Creek has ... an unhealthy safety consdous work environment." G GMLC 0 jj V/29/03, p. 133 S Management Is perceived as responding negatively when Issues are raised (types of 'negative' responses:
inequitable distribution of work, negative performance appraisals, withholding of pay G GMLC raises, etc.)0 ji-- v[01jljiw22103, (#1) p. 20, 23 & 47I 0 -,[1/07103, p. 26 -31 0 ..."1/06/03, p. 47 & 48 Expresses lack of confidence in the notification process ... "if I write something up, I should have P GMLC confidence that It works through the process and I really don't" 0o 11/06/03, (#2) p. 14.%... every time I try to bring something up [to management, 1] have to pound it Into their head you have to almost shame them Into doing something and write them up so many times or reinforce that you have to do this or email their boss or email them and cc their boss to force their end to do the right thing. They tend to take it personal and make my life difficult And other G GMLC people see that, and therefore, it Intimidates them from putting themselves In the same position I'm In. That's the point I feel Is the safety aspect, that people dont want to get Involved.
It's easier just to stay out of it because there wont be any retaliation.'
o :11/06/03, (#2) p. 23 & 24 6 Brings Issues to management on behalf of someone else ... 'a lot of people come to me with their Issues ...-I'd say, 'did you do anything?'
[then that person says] 'Well,'no, I'm not going to do G GMLC anythihg about It. I dont want to write It up, I don't want to be the one who did that' So, I'm the one who does that ... they don't want to be me" o 11/06/03, (#2) p. 26 & 27* difficulties with particular managers after raising numerous iisu nd how his schedule was changed which affected him by losing ~'4 ours of overtime.
It G GMLC appears he was singled out.0 11/06/03, (#2) p. 33 -41, 48 & 49* .. they beat him Into the ground ... used to wan~t to do the right thing ... said he's tired o-stanTing up In the meetings alone ... when you're the lone wolf out there and it's going to affect G GMLC your [willingness to] raise [issues]" o 11/06/03, (#2) p. 77* "Operators say 'I'm not going to tell management about that ... Why should I bring It up If they're G GMLC not going to do anything about it' that kind of attitude" o J11/07/03, (#2) p. 15 & 16* Environment Ileved-to be Intentionally cumbersome to discourage the Identification and P GMLC resolution of IssuesI o 10/22/03, (#1) p. 20* Stated he was reluctant to use the Employee Concerns Program because he was not sure that they could protect his Identity.
Someone from the ECP told him that based on the Issue he raises, It G GMLC wouldnt be hard for management to figure out who had initiated the complaint.
o , , 1/07/04, p. 134 & 135 Updated: 5/28/04i N, S:\SaIem-HC SCWEMBlnning By Bins Only.wpd Page 2 of 45 Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning is to establish the preliminary significance of Issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were Identified during interviews conducted to assess this allegation.
LEGEND S -I Specific Incident G -General GMLC- General Management I Leadership/
Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure PERCEIVED LACK OF FREEDOM TO RAISE SAFETY CONCERNS TO PSEG MANAGEMENT Issue Root ipe. Cause a The safety culture at Salem reflects managers, and to a lesser degree peers, looking down on people that raise Issues. Interviewee believes that Shift Managers take direction from above that they are not comfortable with because they have to. The Interviewee also thinks that his particular Shift Manager has had his job threatened forbacking up the NEOs and therefore was taken off shift for several weeks to get 'reprogrammed.".
This Shift Manager has stated on several G GMLC occasions that his crew g ts hm in troublega the time. The Interviewee believes the problem resides with a couple o OM the currentlneral Manage"fnew position), and iretoo at is no longer on-site. Belle's on specific operator Is harassedly his supervisors
... "ei'y hound him hard" ... because he raises issues.o I[0O/29/03, p. 54 -59* Stated Atfihe-idn`t think there were any long-term negative impacts on his career from raising safety issues. "Not lately, anyway. As a matter of fact, lately everybody that I work with has a good workfng relationship.
During the time t was raising concerns to the NRC resident Inspector I G GMLC didnay hear anything [negative]
directly.r Sfated that he may have been treated differentwy by managentp he raised concerns w(although not overtly)o 10//03, p. 10 -63"We bhring prncesLs or we say we have a concesr ... Buteweter Ihat you knew aboutn It before G GMLC not 11/07/03, (t2) p. 11 Comfeosa e with abmiy to raise oncernsll m e to koeep w ng tem.in thatsion , at (but not G GMLC always the wayou want It) ... other personnel feel the same wayn g o JI M 1/21/04, p. 12 & 13 M anag Is pe~reive~d as responding negatively when Issues are raised (types of 'negative' responses:
Inequitable distribution of Work, negative performance appraisals, withholding of pay G GMLC ra -isesi, etc.) ..,_" 0 10/23/03, p. 62 -63""M" level hasn't chne.I neve'r had a with backing dlown from anything whether I got pressure or not. I never felt pressured.
But whether I had gotten any pressure or G GMLC not, I would continue to raise Issues.w_i._-: ght now,11ho wa c~nlsome of the notific-'-lons that I have written have ca-used him a lot of pain.
etaG GMLC message through my shift manager to tell me to keep writing them. In that situation, at least with him, he has encourage me.ff 0 1/22/04, p. 109j* DlscussesCRS's reluctance to. bring up issues due to fear of retaliation.
"'He was basically talking about the political ramifications if he wrote It up. He knew that if I brought up the concern there wouldn't be any. As a union guy, there wouldn't be any effects on me. Whereas if he brought it up and actually put the problem out in writing, there are certain things they could do to him.' Also G GMLC gives example of a CRS who used to raise Issues and no longer raises as many. "I think he got hammered from his evaluations.
I think he's gone a few years without a pay raise. That got to the point where it's starting to hit home. It's starting to hit his wallet. He's starting to tone it down a bit." 0 1/22/04, p. 63 -68 SASalem-HC SCWEkInning By Bins Only.wpd Page 3 of 45 Updated: 5/28M04 Binning Of SalenmHope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning Is to establish the preliminary significance of issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were identified during Interviews conducted to assess this allegation.
LEGEND S -Specific Incident G- General GMLC -General Management
/ Leadership
/ Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure PERCEIVED LACK OF FREEDOM TO RAISE SAFETY CONCERNS TO PSEG MANAGEMENT Issue Root TyeCause* '... there have been people who have come to me and said ... 'I have this problem ... do you want to lead up this cause'...
I would ... [they have had] a fear of the possibility that the supervisor being mad, and taking some kind of retribution at some point ... look at it ... if I feel that It is valid, G GMLC which normally I would ... I would either write the notification, or bring it up to a supervisor, and then write the notification
... [wouldn't]
call It frequent, but It has happened" o J @ 10/26/03, p. 7 & 8" "I think people do Identify problems ... they bring them up ... they write notifications if there is a G GMLC safety Issue ... [however,]
a weakness [is] the experience level of some of our supervision" o .10/26/03, p. 50* n r aes the TARP team leader (CI can't believe you're even thinking about shutting down ewfi"_eunt.u Just need to be getting some $&%I# air compressors in here, and keep the units on line") in front of-the rest of the TARP team ... "He lit off on me like a Roman candle ... didn't change my course of action ... when he came out in the hallway, I said ... I'm going to run this the G GMLC way, as a nuclear professional Ive been trained to run [It] ... or you can get somebody else to do it' -o f 212/03, p. 14 -27* 'i... I probably have received negative ... performance appraisals as a result of the way I vocalize concerns ... not that I raise those concerns but the way I raise them ... my performance appraisal last year led to pretty much a zero pay raise for the year ... [not challenged]
- .. it's ... a catch-22 G GMLC If it says rightin [the] appraisal that [I'm] argumentative
... [contentious, I cant be contentious about myperformance appraisal]
... I mildly voiced my disappointment and went on" o 11#IW12/31/03, p. 134 -140 Recounts-the Interaction betweei 2511P~fad members of Operat;Lons managp.tnent about the number of irculating Water Pumps required for start-up ._he a d were favoring waiting until more Crc Water pumps were available
.. ca se of frustration, and I left [to oversee/push the return of h= arc Pump] s really the decision-maker" ...he categorized the input fron i o be a fi pers-ua ive aargument" -the availability of any number of circulators a-ov-e-e a l mum required maid the decision a S NCD management decision NOT a safety decision ".. h i pcertainly applied pressure ... the term_'holdin the plant hostage' was used, which pfirase for ops isn't being reasonable iift2Rationbe e he9did, I -"P he wasbeing listened to ..... here may have been a sense of resure being applie lb ut he beleves s leaning in the same direction (allowing the startup with <4 drcu ators)o 6 ý 12/ 16/03, p. 37 -53* On people subjected to forms of retaliation
... %A-adership coac., people were In for her ... she had the ear of senior management
... if you didn' have the rihgttaitude
... yo Lwouldn't be a shfit manager for very long ... she never threatened my job specifically
... [throug heard that] she basically said ... %you guys tow the line or IIl get somebody who will ... it was behaving G GMLC in accordance with their [vision] ... had nothing to do with conservative vs. non-conservative operations
... I certainly wouldn't have bad-mouthed senior management in front of her ... it could be career-ending" o t lOW 12/16/03, p. 126- 130* Discussei-iffficulties'In raising concerns with the fomh. tevee stated: "...there was a lot of discussion about the san10 11sas G GMLC So Ill say maybe there was some reluctance to go to him se of the pa -e ,ersaton might take." o 3/09/04, p. 30 & 31 S.%Salem-HC SCWEMinnlng By Bins Only.wpd Page 4 of 45 Updated: 5/28104
' Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning Is to establish the preliminary significance of issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were Identified during Interviews conducted to assess this allegation.
LEGEND S -Specific Incident G -General GMLC -General Management/I Leadership
/ Communication NCD -Non-Conservative Decision Making PIR- Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure Issue Root PERCEIVED LACK OF FREEDOM TO RAISE SAFETY CONCERNS TO PSEG MANAGEMENT Issy Cause SX.AA. as and he wo I at to his advantage, I'd say, and you know, almost as a prese e. He'-probably
-what,. 11 /r so? It wasn't uncommon that, for example, if I was In a meetingand he was coming In, that, you know, he would pump and slap G GMLC you on the back harder than most people would...So I can see how people could take that, Interpret that as, you know, someone trying to influence them by his presence." o ] .3/09/04, p. 150* "... with some types of verbal responses
... people were decreased in value ... (and therefore may be] reluctant to speak... when a person is yelled at, screamed at, belittled
... they would feel reluctant to say anything after awhile ... In the 1998, 1999 time frame ... I think that the people ... G GMLC are broken in spirit [because of their treatment and are not] Inclined to bring anything up ... there[were] VPs, superintendents, [and] managers, all levels that had that style ... I think that style was expected ..., Innmdation tactics" o p. 15 -19* With respect to the NRC's January 2 8 1 letter to PSEG and the Interviewee's statement that he was surprised by the assertion that people may not be bringing up reactor safety concerns:
the interviewee believes that people could have been Intimidated from bringing up other concerns but G GMLC not reactor safety concerns ... "reactor safety Is [the] prime mission. There's no choice. You have to bring it up ... [so the working environment should not have had an impact] we had so many avenues to bring that type of Issue up ... don't have to go ... up through the management chain" o M2/13/04, p. 38* "I'm not aware of any time where I thought that there was an environment where employees didn't have that freedom [to raise safety concerns].
And none of them ever expressed to me that they [felt they did not have] the freedom to ... express themselves." He went on the mention that G GMLC significantly more concerns are raised by NCOs and equipment operators, who are "more passionate" about their Issues than the supervisors.
o ,2/20/04, p. 15 & 16* " somet-ki'mI'mi not sure that the CRSs are as free to express what their opinions are because G GMLC they're a member of the management team."G o 2120/04, p. 21* When discussing an Issue where the plant computer was lost, the Interv athe CRS originally wanted to lower power. He changed his position after the SI convinced him to maintain power. "Perhaps he wasn't comfortable witht,"- is goes eck to S NCD whether the CRSs are free to bring up concerns, right? Perhaps he wasn't comfortable with the order and he didn't want to give it, but he felt that that's what I expected and he didn't feel free to express IVt.o _F2/20/04, p. 33* The Interviewee stated that he and others might be unwilling to raise concerns because management was unwilling to listen to them. "... part of the reason I might be reluctant to raise a concern is because I don't believe that the management that I have was willing to listen and G FIR understand the concem that I had." He said that this was most evident when it comes to fixing non-Tech.
Spec. equipment problems (he gave the example of a safety-related control room chiller that has been broken/degraded for the an extended period of time).o /20/04, p. 60 -62* When asked If he feared reprisal for his comments during the 01 interview and PSEG SCWE review, the interviewee stated, "Do I have concerns that there might be repercussions?
Yes. Did I have G GMLC concerns then? Yes." o li 2/20/04, p. 125 -127 S:ASalem-HC SCWEYBInnlng By Bins Only.wpd Page 5 of 45 Updated: M8/04 i Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning Is to establish the preliminary significance of issues that have been raised from a Salem/Hope Creek allegation (fail 2003) or that were identified during Interviews conducted to assess this allegation.
S -Specific Incident G -General GMLC -General Management I Leadership
/ Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure Issue Root PERCEIVED LACK OF FREEDOM TO RAISE SAFETY CONCERNS TO PSEG MANAGEMENT
]~ Cause a The interviewee expressed concerns over the effectiveness of the SCWE review done by PSEG. In particular, he was concerned that because of the way the questions were set up/worded, there may not be corroboration for many of the Issues, and they would subsequently be Ignored by G PIR PSEG. "[I was concerned that the] company attorneys were going to In the end boil it down to there's no e videncetherefore there's no Issue." o .. /20/04, p. 128 -131 When asked if he was awareof anyone afraid to come forward for fear of reprisal, the interviewee stated that raising concerns can cause the perception that an employee Is not "with the program... I mean, if I express some concern and I'm perceived as not being with the program, Is anybody going to come back and fire me? No. Are they going to demote me? Not likely ... However, do I think that there's a possibility that as a result of It I wouldnt be considered for future promotions?
Absolutely I think that's true. I would not be considered for future promotions." 0 2/X0104. n- 171 -174 G GMLC 0 em S:%Salem-HC By Bins Only.wpd Page 6 of 45 Updated: S28104 Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning is to establish the preliminary significance of Issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were identified during interviews conducted to assess this allegation.
LEGEND S- Specific Incident G- General GMLC -General Management
/ Leadership/
Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE- Excessive Production Emphasis ESP -Excessive Schedule Pressure PERCEIVED LACK OF FREEDOM TO RAISE SAFETY CONCERNS TO PSEG MANAGEMENT Issue Loot Ivp Cause 0 Discussed the push to sta rt up Hope Creek following the stuck BPV Issue..* "went beyond questioning and challenging.
It was more like Interrogation
... I was there when we were trying to dose that valve ... listened to it, and it was coming up against a hard mechanical stop, and they knew there erm .,. did considerable testing ...' Monday ... the valve did go dosed ... I was aske hy we couldn't just restart the unit [because it was not a safety related S NCD yalve and n fi_ e time] ... a lot of discussion, challenging, and consternation
'was challenginin]
an Intimidating manner ... to me the questioning was out of-I 2... you do thatonce or twice, and those individuals aren't going to speak up again ... a number of Instances where... Individuals basically clammed up"'o 10/09/03, p. 29 41 The following comments were made In reference to one specific senior manager"His engagement in understanding what we are doing was relatively high (p. 12 canbr"ery blunt and he can be very asserting but that was his management style (p. 16) ... I think that his methodology
... may have caused the rest of the people more discomfort (p. 17) ... I think he wanted to understand what we were doing [after the BPV went dosed) with'the asset (p. 20) ...the way he talks to people ... I see It now as potentially challenging and stifling (p. 28) .,. [It never came to mind before] ... what Impact they [Senior Management]
have on a safety conscious Work environment (p. 48 & 49) .., his loud challenging voice and the woids that he Used ... could vei G GMLC easily train you to keep your mouth shut (p. 49) ... I didn't think it [a meeting office to discuss the decision to cool down and repair the BPV or not, caused a our delay in cooling down'the plant] was-a good meeting ... I cant tell you I wasn't sweating and challenged during that meeting. I was. (p. 49) ... that Is the kind of thing onduct at the meeting] that can be stifling ... for people to speak up and IdenA7issues
.. I think that his management style would be counter to what we want to achieve here with our safety conscious wok ent (p. 50) ... I dont think he directed me to do anything" (p. 71) ... The forme rl ad a management style that had a stifling effect. (p. 75)o -ý /02/04, p. 12 -75'IL o "... I wai-oini deial about the Issue [a damaged safety conscious work environment]
as much as other people in the organization
... [if we were to be] branded [within] the Industry [as having a] chilling atmosphere
... those words strike fear In me that an organization would have a chilling effect on its emio~yees when they dont address Issuesm 0 /02104. n. 116 -Ila G GMLC I I would say [that the atmosphere for raising concerns at the site Is] neutral, depending upon the concern. Some are addressed expeditiously and some are not." Equipment Issues are handled G GMLC better than personnel or procedural Issues.0 2/27/04, P. 9 & 10 S:\Salem-HC SCWEWInnIng By Sins Only.wpd Page 7 of 45 Updated: M123/04 J Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning is to establish the preliminary significance of Issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were identified during interviews conducted to assess this allegation.
LEGEND S -1 Specific Incident G -General GMLC -General Management I Leadership
/ Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure PERCEIVED LACK OF FREEDOM TO RAISE SAFETY CONCERNS TO PSEG MANAGEMENT Tssue Root lrType Cause 0 Stated that he was not aware of any Issues that, once raised to the management level, were not acted on. However, he did state that, in some cases, Issues that were raised may not have been handled in a timely manner, In particular g discussing one example of this, the Interviewee stated, "... [the fact that he ] kept after [the issue] tells me he felt G PIR comfortable coming forward. He just was not comfortW with the ... rate at which things were being performed
... at the time he was very emotional with regard to what he felt was a lack of concern with his Issue." o I1Jl12/2/0 4 , p. 9- 11, 1 5* The Interviewee stated that some of the former senior managers, particular, promoted an environment that discouraged people from raising concerns. "In the past, I've been In meetings where I felt some of my senior management team were out of line with regard to the G GMLC way they spoke to Individuals
... If an Individual is [subjected to] a verbal attack like that, how often or how free does he feel going in there and telling this guy something is wrong because he knows that's not what he Wants to hear." o 2/12/04, p. 19 -20"I had [a good working] relationship wlt 11-ncl ... w ed for [them] directly over the years ... could pretty much rai onv ...F r tord a, with, no [I could not raise G GMLC Issues cc) 1`6~y o 2/13/04, p. 21 S .Belleves people are more comfortable bringing up Issues to all levels of management G GMLC o ..ý 12/17/03, p. 8, 19 -27* 'Workers that work for me generally will ... raise concerns, questions about ... Industrial, G GMLC radIologIcal ad nudear safety"'o 2/2/04, p. 10 0 'aI have never been i-n a situation where I have'recommended, for Instance, that something should G GMLC be dedared inoperable, and I've had somebody above me override that decision." o 2//04, p. 39* SM Meetrr-wi]gi
-' basically said, 'Bullshit.
That's not the way you approach G GMLC o 2/2/04, p. 87 0 'I dont see any differences in people's ability or how they bring Issues to the table ... I get Issues brought up to me by my equipment operators, by the NCOs, and ... if I don't give them satisfactory results, they continue on [to bring the Issue up to those higher In the management G GMLC chain" o 12/16/03, p. 6-7 S "'I've never had an Issue with personally raising a safety concern" G GMLC o 11/16/04, p. 8 CNY S:\Salem-HC SCWEYBlnning By Bins Only.wpd Page 8 of 45 Updated: SM/204 J Bihning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning Is to establish the preliminary significance of Issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were Identified during interviews conducted to assess this allegation.
LEGEND S -Specific Incident G- General GMLC -General Management
/ Leadership
/ Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure Issue Root PERCEIVED LACK OF FREEDOM TO RAISE SAFETY CONCERNS TO PSEG MANAGEMENT Issu Cause 0 When asked If he was surprised that the SCWE was being investigated at Salem & Hope Creek .he replied: "Very much so ... if you would have approached me a couple of years ago, I would not have been too surprised.
The environment
... was very negative ... people didn't value one another very well ... not all that friendly ... opposed to change ... any kind of discussion
... would [be taken] very personall.
sve tye of direction
... late 1990s ... that's been a primaryobjective o % F m e ... to try to Improve the culture and the G GMLC atmosphere
...'yes I'iff gdr-a"whole lot of Indicators
... all were telling us ...on a macro level that it [the work environment]
was becoming more generous ... people Interacted more professionally
... that came out loud and dear in the last Gallup Poll survey we did in the fourth quarter of 2002" o .! 10/0 6/0 3 , (#f.) p. 4,- 6* Discussing the decision to eliminat n Harvin' sitionJtes that the decislon was based solely on the results they were getting for-te money:7kte-ffiey giving us what we think we are paying for and, if not, we make the hard decision of whether or not we continue that or don't G GMLC continue It and [we didn't view] this person ... that much differently than GAP:nternational
... did not continue their services in 2003 either" .0 Z14/04, (#2) p. 63.r 6 The interviewers played a recorded conversation i'nade by~~mrn Haq'vini etween~ilff nd m her. On the recording, she discusses a conversation she hawitsuly beore her termination:
1I talked to him about what I am doing over here, a out all of e Issues, how scared people are. They think we are making bad nudear safety dldIons. He saildI t t unch of bullshit and then he picks up the phone after I leave nd call"and saysI want her out of here. What oes that tell you?" ... f'esponse: "L had a serse'that what she did talk to out wthb ... is that some of the cultural Issues were continuing to occur in[her] mindi.. i and I Ififfonversations gbout cultural Issues as not being nuclear safely Issues but beng performance Issues that the management team was working ... to Improve ... she G GMLC told me on a regular Is what kinds of conversations and content ... that she had expressed cultural es and said [they were] not nuclear safety [related]
and she thought [they were).. I said 'llt being fully engaged In doing his-leade
-Is not a nudear safety Is"e ... that Is a standards Issue ... an accountability Issue wVti nd with his supervisors'
... [she was unable to give me any specific event or equi .sue that was a nuclear safety concern improperly dealt with] ... It was just a feeling that she had because of ...emotions of people she was Interacting with" o 3/25/04, (#3) p. 234 -236 0 In dlscussng the decision to eliminateymn Harvin's on, the Interviewee states: "I knew of nothing or any kind of influence that would suggest n any way that this position elimination or G GMLC decision that her time was up was the result of some sort of response to Information she was providing that was In a nuclear safely space." o 0 3/25/04, (#3) p. 351 0 'Management people are fearful of raising Issues for their jobs, because ... [they don't] know who's next to go [in the next round of layoffs] ... fear of bringing Issues to their leaders In fear of G GMLC retribution for their jobs ... that's not conducive to [a] safely conscious work environment" o & -" 11/13/03, p. 56 -63* A PSEG supervisor told an employee "If you bring that up as a safety Issue, I'm going to disdpline you"... went Immediately "up the chain of command" ... a high level manager was Initially G GMLC contacted and took no action ... at a higher level word got sent back %down the chain of command" to admonish the supervisor for making that statement o 11/13/03, p. 45 -52 t Zj SASalem-H0 SCWENBinnlng By Bins Only.wpd Page 9 of 45 Updated: 6/2R/04 Binnine Of Salenm/ove Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning Is to establish the preliminary significance of Issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were Identified during Interviews conducted to assess this allegation.
LEGEND S -Specific Incident G -General GMLC- General Management
/ Leadership/
Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis[ 'ESP -Excessive Schedule Pressure PERCEIVED LACK OF FREEDOM TO RAISE SAFETY CONCERNS TO PSEG MANAGEMENT Issue Root SCause* Several people are not willing to continue to bring these Issues (falsification of records -premature closeout of corrective maintenance work packages) up again for fear of losing their jobs ... "They have [raised] these Issues before and they [have been] pushed and there's nobody backing them G GMLC up, telling them it's wrong to (prematurely]
dose the packages ... They're afraid that If they don't do It thearejgoing to lose their Jobs" o 1/27/04, (# 1) p. 13* An individual raised an Issue about service water valves being installed Incorrectly (therefore would not operate as designed) and was told not to write a notification about It. Maintenance management finally agreed to the writing of a notification only after the individual got Operations and QA personnel
!nvolved in his chain of command.o 1/27/04, (#1) p. 15" 'Nobody believes In the employee concerns program there ... [as a result of the Inability to G GMLC maintain confidentiality as well as the Inadequacy of results]" o 1/27/04, (#1) p. 18* "One Salem supervisor, ~ lwas terminated for [doing the same sort of things that past and current maintenance superintendents have endorsed/promoted/ordered
... things like] not G GMLC having correct paper work ... missing steps, signatures, sign offs, [etc.]'o 1/27/04, (#1) p. 29* "Bringing up Issues ... the recirc pump ... the diesels ... [Inaccurate]
procedures
... the [broken]work management process ... the [inaccuracy]
of work orders and spare parts [resufted In my G GMLC being viewed a 'non-team player' and therefore attributed to my leaving]" o /27/04, (#2) p. 60* The indiv duial had a concern which somebody took that to mean that he was positioning himself G GMLC (with a 'protecie lawsuit')
during the time of the reorganization.
o 1/27/04, (#2) p. 66 Several people were raised concerns or pushed issues lost their jobs also. G GMLC o 1/27/04, (#2) p. 69 -74 0 "[In] my opinion, the [corrective]
actions are Ineffective and added to the human performance and p PIR the chilling effect that you're seeing." o 1/27104, (#2) p. 78 & 79* Identified an Issue where Hope Creek experienced an unexplained power Increase during the shutdown following the stuck Bypass Valve. While not personally Involved In the Issue, the Interviewee stated that the crew didn't readily Inform management or write a notification.
He S NCD Implied that this may be due to plant cultural Issues" -specifically people were afraid of the repercussions of informing management.
o 1/22/04, p. 41 -51"When you cant the people In charge, It doesn't make a difference whether it's a safety Issue... a family Issue ... a compensation Issue ... an 'oh, by the way" Issue ... you are not going to G GMLC speak up" .., , o ý 2/26/04, (#1) p. 55* Discusses the removal of ' and how he would challenge the system. "Personally I G GMLC think he got forced out b uis=e-ey didn't want that challenge anymore.G L o 2/26/04, (#1) p. 70 a "It seems like people got cut off at the knees for not fully [toeing the company line] every minute G GMLC of every day." I I!$ASalem-HC SCWENBInnIng By Bins Only.wpd Page 10 of145 Updated: 5/28/04 1ýu Bifining Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning is to establish the preliminary significance of issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were identified during Interviews conducted to assess this allegation.
LEGEND S -Specific Incident G- General GMLC -General Management
/ Leadership
/ Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure PERCEIVED LACK OF FREEDOM TO RAISE SAFETY CONCERNS TO PSEG MANAGEMENT Issue Root U Cause o ý! 2/26/04, (#1) p. 95* Discusses the reorganization In the fall of 2003. IndMdual feels that he was displaced from his position partly due to raising an Issue concerning resources for performing a PM during a Nuclear Review Board (NRB) meeting. About one month after the meeting the individual was rotated..."People know me. They know what I stand for and everything right? So they say "Gee, look at G GMLC him. He opened his mouth and got chopped off at the knees." (p.105 line 21) The environment Is set so people would be less willing to raise concerns ... "It sets up an atmosphere where people think twice before they even say something
..." (p. 107 line 8)o 2/26/04, (#1) p. 102 -107 S:ASalem-HC SCWEkBlnnlng By Bins Only.wpd Page 11 of 45 Updated: 5/28/04 Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning Is to establish the preliminary significance of issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were identified during Interviews conducted to assess this allegation.
LEGEND S -Specific Incident G -General GMLC -General Management/
Leadership
/ Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure PRODUCTION OVER SAFETY ISSUES Issue Root Tvye Caus__.e* An cl. ose a Main Feedwater Pump Steam Isolation Valve wi0out authorizatioon niro e onro oom ... This was contrary to the Operating shift's Intentto take the Main turbine offline to address a 20 foot steam plume from the affected valve ... Could be S EPE considered a violation of the Conduct of Operations procedure which prohibits operation of equipment without the operating shift's knowledge/permission j o- 0 /23/03, p. 56- 58 o , ffi11/7/03, p. 14 & 15* The 24 Steam Generator Feed Regulating Valve (FRV), 24BF19, failed to respond ... The NCOs, and at least one Senior Reactor Operator (SRO), on shift believed the valve was mechanically bound ... Management didn't want to declare the valve mechanically bound and therefore S NCD Inoperable because that would require a Umiting Condition for Operation (LCO) 3.0.3. shutdown Management elected to pursue a controls failure ... Shutdown delayed for about 36 hours4.166667e-4 days <br />0.01 hours <br />5.952381e-5 weeks <br />1.3698e-5 months <br /> o 10/23/03, p. 7 -29 o0 in1-h,11/7/03, p. 16 & 17 o = 4 11/6/03, p. 49- 53* With respect to pressure to get done: Is there something about the tagging process at Hope Creek to make some challenges to do the right thing? ... You're always In a hurry....
they said no G ESP time pressure ... but then they're paging, are you done yet?" o 10/29/03, p. 64* The operations department operates outside of established processes (I.e. cleaning condenser waterboxes) because of a 'Just fix it and get the unit(s) back up to full power' mentality
... ArriGaP used a metal bar to pry a Circulating Water Pump breaker into its cubicle In facilitation of a raF G return of the pump to support return to full power o ý ý'10/22/03, (#1) p. 25 -31, 33 -37* Overheard a member of Operations Management saying that he did not receive a raise at the end of 2003 after numerous Instances of voicing an opinion In contrast to the 'production mentality'
... G GMLC Its built Into their'cormpensation package o a n -!0/22/03, (#1) p. 23 & 47* Made an emergent change to the plant startup procedure to remove the restriction that the steam dumps be operated in automatic
... Conducted emergent training to extra NCOs and required them S EPE ev control Reactor temperature and pressure (which affects reactivity)
In manual Instead of fiS E the asstem to rpere In automatic as designed o ! 1o/230/3, p. 41- 48 0 Identifie d the Hope Creek Issue where procedures called for certain acitions (possibly Including reducing power) for increased off-gas system flow, but rather than take those actions, Engineering evaluated the condition to allow continued operation.
Stated that they were running for "a long S NCD time" with elevated off-gas flow before the situation was resolved.
The concern was more focused on actions that require supervisor concurrence, rather than Immediate actions.0 1/07/04, p. 18 -20, 26 0 Discussed an Issue where, while raising power, the plant lost the Core Monitoring System and CRPDS. Those systems were required to operate at post-uprate power. The NCO, CRS, and STA concurred that the correct action was to reduce power to the pre-uprate level until the CMS was fixed. The OS entered the CR and overrode their decision.
The Interviewee stated that S NCD Engineering later did an evaluation to prove they hadn't violated their power limit. '...I got told not to do something that was conservative decision-making." The procedure was later revised to direct reducing power (p. 52). Said he felt that he needed permission to take a conservative action (not consistent with their previous training) (p. 67). 1 (\J SASaIem-HC SCWEV31nning By Sins Only.wpd Page 12 of 45 Updated: 6/28104 Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning is to establish the preliminary significance of issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were Identified during interviews conducted to assess this allegation.
LEGEND S- Specific Incident G- General GMLC -General Management
/ Leadership I Communication NCD- Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure PRODUCTION OVER SAFETY ISSUES Issue Root Type~ Cause o Kretzer, T., 1/07/04, p. 32 -44, 52, 67* Discusses the Salem Unit I Feed Regulating Valve (BF19) equipment problem that occurred In mid October 2003 that required a plant shutdown.
The valve appeared to be stuck and the Interviewee Indicated that no actions were taken for many hours, Induding entering Tech. Spec. 3.0.3 and sending someone to attempt to free up the valve to figure out that the valve was mechanically stuck (said the situation was hokey -it took way longer than It should have In his opinion), The S NCD sticking of the valve appears to be a recurring plant equipment problem In which the normal response by plant operators is to send a maintenance person to free up the valve (spraying on lubricant'and striking valve components with a mallet). The failure of the valve results in entry Into TS 3.0.3 which would require a plant shutdown.o .10/29/03, p. 12- 17 Feed Pump steam admission (MS 42) valve bonnet steam leak which should have required a plant shutdown to close the valve (operators would not go near valve se leak was so bad and they couldn't determine where the leak was coming from -p. 20). An nd the Work Control Supervisor went to valve, without operators, and shut the valve (W=Dut consideration for the S EPE need of a steam rescue should conditions worsen). The thought process that went into the decision to dose the valve and the manner In which It was done Was a "megawatt mentality." (Interviewee only has second hand knowledge of issue)o ý 10/29/03, p. 28 -34* Salem grassing event In March 03 -Unit 2 was taken. off and Unit 1 50% power. The Interviewee thought that the Shift Manager was getting pressure from above him to keep the units on-line S EPE because he looked uncomfortable 0 10/29/03, p. 43 -46* -Main Steam Isolation Valves (MSIVs) were opened late during the startup following the 'hurricane-S EPE salting' shutdown.o .10/23/03, p. 32 -40* Steam leak ... hours and hours spent trying to figure out how to keep the unit alive; group bus S EPE experiencing shorts from the condensed steam; waited until the place couldn't be safely shutdown o M J'"1, 11/07/03, (#2) p. 23 & 24* They have had NEOs operating the components required to synchronize and load the Emergency S PIR Diesel Generators (EDGs) rather than fixing the problem causing the proceduralized workaround o M 10/22/03, p. 13 a Continual problems with switchgear room ventilation resulting In high differential pressures across doors could Impact accessibility to safety-related component areas In the event of a fire or other S PIR transient/event o .. 10/22/03, p. 17 & 18* Multiple EDG governor replacements without finding and fixing the root cause of the failure ... S PIR engineering has been more Involved in this lately 0 -10/22/03, p. 20 o Boric Acid Transfer Pump boron-leakage (resulting In bolt corrosion)
Identified by NEOs long before S PIR (4/5 years) it became an 'Industry Issue' and management did nothing o l 10/22/03, p. 23 0 'Taking the easy/cheapest way out' -(1) Multiple Boric Acid Transfer Pump boron-corroded bolt replacements and (2) Multiple Charging Pump cooler cleanings expected during the 'grassing S PIR season' versus modification o ,10/22/03, p. 24 -26 SASaIem-HC; SCWE\Binning By Bins Only.wpd Page 13 of 45 Updated: WSW Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning Is to establish the preliminary significance of issues that have been raised from a Salem/H-Iope Creek allegation (fall 2003) or that were identified during Interviews conducted to assess this allegation.
LEGEND S -Specific Incident G4- General GMLC -General Management I Leadership
/ Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure Issue Reot PRODUCTION OVER SAFETY ISSUES Issu Rause.Typ Cause* Starting surveillances just before end of shift causing a hastened/lower quality turnover S GMLC 0 _]JJJW1/6/03, p. 26, 27, 2 S Performing the 24 hour2.777778e-4 days <br />0.00667 hours <br />3.968254e-5 weeks <br />9.132e-6 months <br /> EDG surveillance just prior to beginning EDG overhauls only gives confidence that it would have worked In the past and should work for the next day or less. Taking S NCD the EDG apart for the overhaul negates the test that was just completed.
o 11/07/03, (#2) p. 18 Performing a service water surveillance test that Involves flow measurements supporting S PIR operability that did not take Into account leakage past a boundary valve.o 11/07/03, (#2) p. 20 & 21 Dropped license because he felt the OS's were hesitant to take conservative action because It would affect their pay. Wanted to operate @ 98% to ensure they were not exceeding 100% when we lost CMS computer and had to rely on nuclear Instruments which can have 5% error ... OS not willing to do that and felt OS treated them differently after that ... Discusses safety aspects of Instrument operation
... Management Issues orders that If you lose CSM, reduce power by 26 NCD vindicating alleger ... New rules issued that reduced authority of NCO to make operation decisions believed related to INPO like other plants for consistency making reactor operators feel like no longer in charge. Other similar problems, but 2% Issue was worst nightmare 0 1/21/04, p. 15- 32* Above tie d supervisor, pay, bonuses based on power production.
Since deregulation, pay based G EPE on reactor power performance.
o WU 1/21/04, p. 51, 53 -59 Produ Ip re is excessive G EPE o 101 /21/04, p. 99* BF-19s using a sledge hammer to operate ... 'the mentality is don't shut down, stall, do whatever S EPE you can to fix It without shutting down." o 11/07/03, (#2) p. 26* The 24 Steam Generator Feed Regulating Valve (FRV), 24BF19, failed to respond ... The NCOs, and at least one Senior Reactor Operator (SRO), on shift believed the valve was mechanically bound ... Management didn't want to declare the valve mechanically bound and therefore S NCD inoperable because that would require a Umiting Condition for Operation (LCO) 3.0.3. shutdown ...Management elected to pursue a controls failure ... Shutdown delayed for about 36 hours4.166667e-4 days <br />0.01 hours <br />5.952381e-5 weeks <br />1.3698e-5 months <br /> o 10/23/03, p. 6 -11* Recounts the Issue surrounding elevated off-gas levels at Hope Creek ... procedure said 'do not operate above 75 scfm' yet gave no direction on actions to take If above 75 scfm ... the 75 scfm limit was also mentioned as a design basis In the FSAR (Final Safety Analysis Report) ... NCOs wanted to shut down ... a TARP team was developed to evaluate options ... PSEG essentially S NCD'engineered It away' saying that 75 scfm was the design for each unit In a dual unit site and since Hope Creek Unit 2 was never built, the Hope Creek site could actually go as high as 150 scfrn with some compensatory actions ... "the only time that I felt [that we didn't shut the plant down when required]
was with the [elevated]
off-gas'o 10/26/03, p. 9 -21, 26 -29 Updated: 5/28/04 S:%Salem-HC By Bins Only.wpd Page 14 of 45 Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning Is to establish the preliminary significance of issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were Identified during Interviews conducted to assess this allegation.
LEGEND S -Specific incident G -General GMLC -General Management
/ Leadership
/ Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure Issue Root PRODUCTION OVER SAFETY ISSUES ue R Type Cause* Discussed the excessive EDG exhaust leakage issue ... the company Industrial safety personnel had not tested for all possible harmful gases being emitted from the diesel ... "there is an LCO time limit, and they wanted to clear it up. so that we [could] keep the plant running ... that is part of the S EPE business ... there is certainly schedule pressure and production pressure to keep the plant making electricity, because It Is a business" ... 3 people got sick (one nearly passed out In his car on the way home and went to the hospital to get check out)o 0/26/03, p. 22 -24, 32 -40* Discusses an issehere management knew about an EHC leak prior to startup that resulted in having to scram the Reactor seven days later. Also describes initial scram (due to a hurricane 9/03) as preventable and a result of not making repairs to an In-feed breaker that had a known S EPE degraded condition for over a year.o t'i EW 1/22/0 4 , p. 37 -4 2* "Yes, we hear about safety all the time...But a lot of the times I think Ws safety is number one as long as It doesn't Impact schedule, If it doesn't Impact generation.
If something has to give, it G EPE tends to be on safety. That's the impression that most of us have.'o. 1/22/04, p. 74 , In tly e ars, it was ... run it until it ksand somebody shuts you down ... [with]if] it's broken, let's fix it ... [I don't think i wanted to be [effective at fixing-hIngs. It's cheaper to run. It's easy to run. 'Hey, Ill explain why it broke later' ... production over G EPE all else" 0 1-il , 1/15/04, p. 25 .* A lot of cost pressures to keep the units operating contributes to the shift In safe operating G EPE phillosophy away from one of "safety first" o 1/15/04, p. 101 & 102 0 Off-Gas flow Just took pu past th..SAR limits. Engineering given time to evaluate the Issue vice taking action (i.e S/D). 0"lli ll~nterpretation of the correct action to take would have been to S NCD S/D the unit and searchTor the cause. Turned out to be a condenser leak o " 15/04, p. 103 -109" Recent decision not reduce power to remove a reactor feed pump from service that had high vibration, as directed in the procedure, exemplifies management's emphasis of production over safety. The decision was made to allow engineering an opportunity to evaluate the condition prior S NCD to taking action In accordance with the procedure. (The plant would have had to go down to 95% power to take the pump out and evaluate/fix IL)o 1/15/04, p. 113 & 114 S 'I've seen In the last year or two a [greater]
emphasis on engineering evaluation
... I get the G EPE Impression that they [managers]
are driven In the direction that would maintain the plant running.o 1 1/15/04, p. 127 Discusses i------e've action process. "Based on some of the other things I have seen, there's probably not going to be a resolution to It. You almost get apathetic to where you feel you are wasting your time ..... Once you put in a notification to try and go through and track, all the P PIR numbers change...Then you find out that basically your notification got dosed out with no corrective action, no activity taken. So you get frustrated.'
o 1/22/04, p. 104 -105 L S:ýSalem-HC SCWE\Binning By Bins OnIy.wpd Page 15 of 45 Updated: 6/28/M4 Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning Is to establish the preliminary significance of Issues that have been raised from a Salem/I-lope Creek allegation (fall 2003) or that were Identified during Interviews conducted to assess this allegation.
LEGEND S -Specific Incident G -General G6MLC -General Management
/ Leadership/
Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure PRODUCTION OVER SAFETY ISSUES Issue Root Type Cause I erates the TARP team leader (CI can't believe you're even thinking about shutting down the unit. You just need to be getting some $&%I# air compressors In here, and keep the units on line") In front of the rest of the TARP team ... "He lit off on me like a Roman candle ... didn't change my course of action ... when he came out in the hallway, I said ... I'm going to run this the G GMLC way, as a nudear professional I've been trained to run [it] ... or you can get somebody else to do o 12/2/03, p. 14 -27.* An l sed a Main Feedwater Pump Steam Isolation Valve without authorization from the Con--IT1room.
This was contrary to the Operating shift's intent to take the Main turbine offline to S EPE address a 20 foot steam plume from the affected valve.0 p. 84 -92 (considers the fallout from this to be the result of a perso~nal vendetta againstý ýl o J ý 12/31/03, p. 101 -132 (also believes that the fallout from this to be the result of._a personal vendetta by Union personnel againal61.&i
- Discussion a 00oýsolatlngi the steam leak ... "that was brought up immediaeasn example of non--co-n-servative derision making ... I think It was more a case where wud not have sent somebody else Into the position to Isolate the steam leak ... i seeilas e kind of at he would be hesitant to send other people and take risks he wouldW flmiself take ant. the on duty shift manager] had looked at It and thought he was just going to shut the opan down ... walked away after looking at the lea sa Ing, 'no It's too big ... we'rejUst going to have to shut down and Isolate the other mains' .IW.. looks at It, says ... 'let me see If I can S EPE get to the valve' ... [he is able to get to the valve], Ioo1 around, doesn't see anybody, and Isolates It." ... the steam was affecting components In the area like secondary switch gear (of which ded ower the Reactor Coolant Pumps) ... It was air Ia steam plume ... he talked ut it later... "the gist of it was that h felt he could safely get to the va kehe was thinking the way to stabilize the 7an an o stop this condition Is to close the valve" o -12/16/03, p. 67 -77* Salem. startup In progress with generator complications causing delays greater than a week ... Site management directs pursuit of bringing the plant up as far as possible to make up for the lost time... vacuum was established and the plant was heated up to about 100# with the turbine &generator uncoupled and using a special substance to seal the turbine glands (gland sealing steam not In service and using a packing/stuffing material to prevent air In-leakage allowing e lishment of vacuum conditions In the main condenser)
... senior managemen was pushing to perform reactor power physics testing 11 direct o S NCD i n arguing for the conservative approach 'I erased hisi .whiteboard a aseaid]lt me work from the augmented Inspection team backwa Ps' ... Rgo to remove decay heat from the plant ... with two systems [in manual] not in the normal configuration
... because[someone doesn't] control the system right, you cool down a little bit ... [cause] the reactor to go more critical ... or super critical ... go up into the power range and have a reactivity event ... talked about verbally to me at my appraisal
... that stand for safety cost me In my career at PSEG" o ..12/2/03, p. 27 -43 o 0i , 12/16/03, p. 85 -90 ("... no I wasn't comfortable with It)* Startup after a failed pressurizer spray valve & subsequent reactor trip was directed without understanding the cause of the trip ... "Typically, e understanding of that whole thing would have occurred before the plant would start up.l was applying significant pressure .EPE to get the unit started back up, and later admi to the f"actt he started the reactor up with really no understanding of what occurred at the event ... then a whole bunch of new learnings came out the next week after the root cause was done" SASaIem-HC SCWE\Blnning By Sins Only.wpd Page 16 of 45 Updated: 5/2804 Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning is to establish the preliminary significance of issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were identified during interviews conducted to assess this allegation.
LEGEND S -Specific Incident G- General GMLC- General Management/
Leadership
/ Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure PRODUCTION OVER SAFETY ISSUES Issue Root Tye Cause o 7 2/2/03, p. 77- 82* March 20-0 stuck Bypass Valve (BPV) Issue: Was very "uncomfortable" with the way the problem was handled ... The shutdown to fix a Reactor Redrc Pump seal ... during startup following the outage ... they synched the generator to the grid, raised load on the turbine and one of the BPVs did not go full dosed as expected -.. some troubleshooting Friday night Into Saturday morning ... 'When we went through it (stuck B/P valve problem) I was very uncomfortable with It... (Reducing pressure while critical) had not been done at Hope Creek before ... There was a lot of frustration in that training...in those couple of hours Saturday night ... So there was a certain amount of time pressure to achieve this thing (fix B/P valve problem) Sunday night ... It wasnt a S NCD validation and it should have been...still hashing things out..weren't sure which way we were to go ... So the time pressure...was that we had to get through lt...relieve the other crew at midnight I said 'Unless we can come to some consensus as to what we are doing...find someone else to take the watch' ... I don't think that thing would happen agaln...had a plan not fully baked ... We felt we had responded the way we were trained and we did a good job ... I'm sur e IN lFet the same...this thing was scheduled for Sunday.. .we needed to do what we could ...!WInk It had anything to do'with production, absolutely not" 0 I L 1/16/04, p. 42 -86 March 2003 stuck Bypass Valve (BPV) Issue: The shutdown to fix a Reactor Reclrc Pump seal... during startup following the outage ... they synched the generator to the grid, raised load on the turbine and one of the BPVs did not go full closed as expected ... some troubleshooting Friday night irito Saturday 0rmoinm '"determined that it looked like theivalve may mechanically bound".. Saturda';. ...... ..1- eaIvni act in Ihs place ... "dedslons were made -t1hut u;hnit down and place It Ina condition(bareavacuum)
[to repair the valve]" ... shutdown and repair plan developed Saturday and Sunday (including new procedures, training, SORC on Sunday night, etc.) while S NCD maintaining the unit at '-20% power ... shutdown commenced Sunday night ... early Monday morning they tripped the main turbine and the valve went fullclosed
... 'seemed to fix Itself ...questions were raised [around day by fi.... do we need to continue shutting [cooling]
down to fix the valve given a e-va e -... the "cidown was delayed ... "the length of time that was taken to make what ... seemed like a very black and white decision... caused some angst" o i, 9/25/03, p. 40 -56 0 Discussed the pusi to start up Hope Creek following the stuck BPV Issue ... "I was there when we were trying to dose that valve ... listened to it, and it was coming up against a hard mechanical stop, and they knew there was m ... did considerable testing ... Monday ... the valve did go dosed ... I was asked we couldn't just restart the unit [because It was not a S NCD safety related valve and was o ng l ne at the time] ... a lot of discussion, challenging, and consternation M.o 10/09/03, p. 29 41 0 "We were not goin the unit up until we understood what the problem was with the BP valve ... I think he needed the data to support [and explain the reasoning for not restarting the u e PV In question]
to corporate
... [I did not, at any time, get the Impression tha as pressuring for the start up] ... what surprised me was that .eh_discussion]
... uti zed 4 hours4.62963e-5 days <br />0.00111 hours <br />6.613757e-6 weeks <br />1.522e-6 months <br /> of ... critical path time ... It was clear to me that he had to provide an explanation of what we were doing to the unit to corporate PSEG ... don't S NCD remember where the notion of starting the plant back up came from ... but someone did [vocalize it], and It really caught me Q u .. [You can re and have someone else start the unit up] ... I did say that [toM ... [whe- canvassed the group], I don't remember anyone saying a" e uld start up ... everybody was aligned with that viewpoint (to shutdown)
... I don't know If that was based on the strength of my justification" SASalern-HC SCWMEinning By Sins Onlympid Page 17 of 45 Updated: W/28104 Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning is to establish the preliminary significance of Issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were Identified during Interviews conducted to assess this allegation.
LEGEND S- Specific Incident G -General GMLC -General Management/
Leadership I Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure PRODUCTION OVER SAFETY ISSUES Issue Root Type, Cause o 3/02/04, p. 7, 14, 22, 23, 56, 66 & 68* "... I waisomifortable that the [diesel with extensive exhaust leaks] was operable and would perform Its Intended function ... and I didn't think [it] had risen [to a level requiring us to] shut the S EPE facility down ... in hindsight
... [remaining at power without correcting the condition of the diesel]was not a good decision" o 4 T13/02/04, p; 37 & 38* "The two times that I remember being In challenging situations
[i.e. uncomfortable with the position being advocated for the company, were] the [stuck] bypass valve and the diesel [with the S GMLC excessive exhaust leak]" 0oý 3/02/04, p. 44* There were no examples showing where senior operations management l'challenged the G GMLC ,operators to be more conservative.
o -.. 3/02/04, p. 46 The previous senior operations manager was the decision maker in the process (i.e. making day-to-day decisions on what to do with the plant) ... "that is not the place for [the] decision making to take place" ... the new senior management style Is one that makes the Shift Managers the decision makers ... "[current senior operations management]
never tells me what to do ... he asks what am I going to do ... [then] did you think about this ... did you think about that ... [I factor his G GMLC questions] [and then let him know what, if any, changes I've made to my plan] ...I don'tt thiwasgoing to make me start up [during the stuck BPV Issue] ... the position I k-was so dly Justified
... I threw my job behind it to support my conviction
... I was not going to start the unit up as [a] senior licensed Individual at Hope Creek" o , 3/02/04, p. 70 & 72* New seo7irations management Is operating in a more safety conscious conservative manner"the current organization gives you the wherewithal to make a decision and make comparisons
... it Is OK to come down 5% and take the Bravo feed pump out and then figure out [If] you have a problem ... it Is easier to make the 'gray' decisions
[now] because to is G GMLC not. -ro lem [any more] because you almost don't have to do It ...conversations are gentle but probing ... made a significant
[pos-ye]/-mpa ieeks o Fh/02/04, p. 76 -81.The follo;in-gref'ate to operating Hope Creek at off gas flows greater than "procedurally allowed":
S NCD o "What we did was rationalize
[that because everything was operating correctly at the moment, we were justified In giving] engineering time to tell us [that It was Indeed okay]" o "It took us two days to change the procedure
... to operate above 75 CFM ... not the way to do business" o "... we would rationalize our decisions to provide justification that we were comfortable with ... that is not the kind of procedural use ... message [we want to send to] the operators" o mI believe solid! that we have gotten away from that behavior mode"-_1IN W../02/04, p. 98 -105 o The work groups that havethe most Issues are those people with jobs dosest to "production" (p. G EPE 120)., 3/02/04, p. 120 Updated: 5/28104 S:ASalem-HC SCWEBlnning By Bins Only.wpd Page 18 of 45
.Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning is to establish the preliminary significance of issues that have been raised from a Salem/iHope Creek allegation (fall 2003) or that were Identified during interviews conducted to assess this allegation.
LEGEND S -Specific Incident G -General GMLC -General Management I Leadership
/ Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure PRODUCTION OVER SAFETY ISSUES Issue Root Type Cause* Discussed the issue where the plant computer was lost, removing the primary indication of reactor power. The 1RO was "very vocal about the r lIn to lower power because his most accurate indication of power was gone.k Th who was the shift manager at the time, S NCD decided to keep the plant at Its current powerLffv Wn other, less accurate indications of power. The RO went away from the situation upset that a non-conservative decision had been made.o0 12/20/04, p. 18 -28"The interviewee stated that he believes the plant is moving In a direction toward making more conservative decisions.
He gave the example of a steam leak from the turbine in late 2003 where the decision was made to shut down the plant rather than try to fix the leak on-line. "I dont know G NCD that we've had a similar decision to make in the past, but I'm not sure that in the past we would have made the same decision." o ý 2/20/04, p. 51 & 52 ConcemIng operability calls, the Interviewee discussed an issue where a crew Identified a jacket water leak on one of the Emergency Diesel Generators (EDGs). The leak was in excess of the limit given In a past operability evaluation, so the EDG was declared inoperable.
Management feedback was that before a component Is declared Inoperable "we needed to make sure that we fully engage the rest of the organization to figure stead of just saying it's Inoperable." This feedback was fro n This clearly put pressure on S ND the SMs to assume a component Is operable untilere s exten 'e proof that it was inoperable.
The interviewee discussed the Impact of the above feedback.
He stated that recently he had to make an operability call on a degraded rod block monitor. "And based on the jacket water incident okay, I shouldnt make that decision myself. I ought to havy engineeL e Iand make the evaluation for me." The SM later received feedback from th :that the RBM should have been declared Inoperable sooner.o JJ§NW2/20/04, p. 74- 86 Dudng maintenance on a 500 kV breaker In the switchyard, the load dispatcher contacted the control room to reduce rea C oad So br.d stability concerns.
After the crew began lowering power, tha im = .Called from the switchyard and directed the crew to stop lowering par ae b1re'wVuld be restored soon. The interviewee G EPE felt this was Inappropriate, because "the trainlng [I] received in the past [emphasized that] when the electric system operator gives me direction, I'm to follow that direction because the electric system operator Is trying to protect the integrity of the grid." 0 2/20/04, p. 95 -97 The Interviewee discusses an Issue where the plant was In a T.S. Action Statement that required them to be In hot shutdown within six hours (relate olthe EDG Jacket Wr leak). The crew was about to commence shutting down, when the&Ln i pushed them to keep the unit at current power and continue to try to-fx tie- 9W.
was concerned that he would ot have enouh ti&e the unit If they were delayed. "I was In a room w1 thi JI Wi n _ asi trying to [convince]
me [that shutting down] S NCD was and [thati I't ,e to e the plant yet when my control room crew was saying we need to move the plant so we can get to where we need to go, meet the tech spec and not liengourselves by making a mistake by having too much time pressure ..." He also stated theI ! actually attempted to delay and district him from taldng the actions he felt were appropria 0o p. 101 -104 S:NSalem-HC SCWE\Einnlng By Bins Only.wpd Page 19 of 45 Updated: 6/28/04 Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning Is to establish the preliminary significance of Issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were identified during Interviews conducted to assess this allegation.
I S -Specific Incident G -General GMLC -General Management I Leadership
/ Communication NCD -Non-Conservative Decision Making PIn- Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP- Excessive Schedule Pressure PRODUCTION OVER SAFETY ISSUES Issue Root Type Cause 0 Following the stuck open BPVhe peratin gcrew was attempting to depressurize the plant so the valve could be repaired, wh called the control room and directed the shift manager t.-top the depressur2z-a..
e interviewee stated that he was Informed that order came fron0through
.The Interviewee felt there was often pressure from S EPE senior man ement, w o may not a ftiunderstanding of the situation, to keep the plant at power.0 2-120104, p. 113- 117* Outage management wrote a notification listing the concerns that operations management was making overly conservative decisions costing the company productivity.
The interviewee mentioned that the Shift Managers at the time took exception to this message. The Interviewee G EPE noted that it certainly seemed unusual that the corrective action process was used in this venue.(Spring 2002 time frame)o 1/22/04, p. 43 -53 ushed for a procedure change after a diesel generator service water test nVicated ananndm W-n flow-rate.
The procedure change was Intended to remove the requirement for a given flow rate during, a periodic flush of piping. The Issue was resolved apparently when. valve s ired. The Interviewee had stated he was uncomfortable at the time with th N Ive pushing in that direction at the time because he felt the push was to find gnore an apparent problem with the system.o 1/22/04, p. 106* Thr interviewee categorized production pressure as excessi tiW. and he felt that he had less decision making authority than he had at a previous Job at He did Indicate, G GMLC however, that the difference could be related to the change away fr t rate~based regulatory model days.o /2!2/04, p. 126* "I say that when I became shift manager [in 2001] we were very [lethargic].
In other words, we allowed a lot of things not to be fixed. We accepted them ... Over the last 12 to 18 G PIR months, at least, specifically the last six months that mind set is rapidly becoming history with regard ýtx the plant, bringing up concerns, and those type of things." o !I M 2/12/04, p. 16* Discusses concems that were raised during a startup at the end of RFO-11, where the #3.V I osd~Ie e g crew had concerns with continuing the startup. "We called thi n and we were basically overruled.
He said, "I want the unit synTEd ... I fetw eded Wi out what I would consider good engineering Justification
... the unit [was] S EPE synched properly [to thejut Inddent] ... they gave us justification later but I found out it was [merely a]
/12/04, p. 19 -20 o 2/12/04, p.26 -37* The interviewee Tscussed an Issue where off-gas flow rate Increased above the licensee's administrative limits due to a leak, but the unit was not shutdown. "What I remember on my shift was [that] the NCOs were a little bit concerned.
They didn't feel the [engineering) evaluation was complete ..PN _e1masicalIy felt that we were keeping the unit online to make money." o 2/12/04, p. 66 -68* DiscussseU-the licensee's actions related to Increased drywell floor drain leakage. As with the off-gas flow Increase, the licensee exceeded their administrative limit but rather than shut the unit S EPE down, they raised the limit. "We kept raising that value when we had [a know] Issue with the Recirc [týleak].
We kept raising It and raising it when we might shut the unit down." 0 .JJJRW /12/04, p. 73 -75 S OSlmH CEBnlgB isOl~p ae2c4 pae:5214\(SASaIem-HC SCWE\BInnIng By Sins Only.wpd Page 20 of 45 Updated: 6/28/04 4J Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning Is to establish the preliminary significance of Issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were Identified during Interviews conducted to assess this allegation.
LEGEND S- Specific Incident G- General GMLC- General Management
/ Leadership
/ Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis' ESP -Excessive Schedule Pressure PRODUCTION OVER SAFETY ISSUES Issue Root Type Cause"We're also In this competitive business to make money. If you owned this business, would you[require someone] to go in there twice a shift and monitor something or would you shut the unit off to fix it? The decision is sometimes based on economics, but if safety comes Into play, the G EPE decision should always be conservative
[indcluding taking the] unit off line if you have to, to fix [the problem]." o 2/12/04, p. 108 & 109 The Interviewee stated that following Identification of a 150 drop per minute jacket water leak from one of the EDGs, he declared the EDG Inoperable (based on a past evaluation that gave a limit of 150 dpm for operability).
He stated that his decision to dedare the EDG inoperable was critidzed by his management because he didn't get engineering involved to re-analyze the allowed leak rate. The Interviewee used this as an example to show that engineering will at times generate S EPE any number you want to prevent the plant from having to be shutdown.
This Is also an example of where upper management's expectation is tosut e ta piece of equipment Is operable until engineerin9 pines In and proves that It's Inoperable.
o M 92/12/04, p. 75 -79* The Intervi pla nitscusses problems with a positionnwheparts for work. The plant has a policy of not keeping spare partss(even critical parts) at the plant, and Instead ordering them when they break. 'I can take you In the control room right now and show you two extremely
[important S GIVLC degraded pieces of equipment]
that if wecould get spare parts we could fix them but we donw have the parts yet. We had a battery room duct heater that burned up on us. We had to manufacture a brand new one. That's taken weeks and weeks and weeks." o 3/0912/04, p. 118 & 119* Upper managem wh non-conservatively delayed (while awaiting s engineering evaluation) the start ofwa Technical Speafication required shutdown at Hope Creek due to an Inoperable Diesel S NCED Generator.
o /09/25/03, p. 62 -88 Concern that thffp/a'nt operators were In a position where If operability~of a piece of equipment w*s In question, It was assumed operable until proven Inoperable, The Interviewee stated that, G NCD while this Wasn af.c pisae y Iu re a utre being pushed that Way.o 12/3109304, p. 685 & 136 0 Discussed an issue where the shif manager had to convince senior plant management to shut the plaSnt down to correct arching and sparking In the switchyard.
The shift manager ddnmt feel he was getting any support In the decision makiing process because it: Involving taking the plantS EP offiine.0 L 164 -168 0 Senior ranagendticdzed for the tripping unit during, degrading condition (grassing);
S ML message can affect. safety, culr-e-l " fulture, decisions on shift S GL 0 12/31/03, p. 68 -71* Service Water underground leak was accepted and sworked-around" far longer than most of the Operations personnel thought was appropriate
... questionable operability
... non-conservative S PIR approach to operations o 12/31/03, p. 18 -35* "... after il-s management change-out, the questions were more along the lines of production pretty much at all costs ... 'What can we do?' 'Is there a way around this requirement?'...
G EPE
- o o --- 12/2/03, P. 4 -6 I Updated: 5/28/04 S:VSalem-HC SCWEkBinning By Bins Only.wpd Page 21 of 45 Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning Is to establish the preliminary significance of issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were Identified during Interviews conducted to assess this allegation.
LEGEND S -Specific Incident G -General GMLC -General Management
/ Leadership I Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure PRODUCTION OVER SAFETY ISSUES 6 , S S 7-1 I.... if your looking at promoting conservative decision making " operating these places safely, I would have expected senior management would have [embraced the concept of not restarting Hope Creek] until we completely understood what the problems and issues were" G NCD o0, 10/09/03, p. 38 Sr zed SM for calling SW loop inop (failed ST, check valve eventually replaced in the inohtwlB5ut consulting licensing) getting consensus; but the SW was clearly Inoperable.
Early S GMLC 2002 o ~ 12/31/03, p. 56 -60* lefeided SM against a complaint from Training Dept when unit was kept online after loss o-6f-r-ars.
Although SM still believes that keeping unit online was the correct decision in this EPE specific case ... created a. perception that senior management will always support decisions that keep plants online.o ] W '-12/31/03, p 69 -72 Recounts the S -valve Issue that was delaying continuation of a startup following a refut needed to conduct some testing to determine which set of valves was leaking..had taken the position to NOT perform the testing ... 'we're goipW to figure out a way enIneer It away [and the real force behind the decision]
I believe it wasFWMf!M
.. I suspNCD talked to him and expressed his opinion on the matter...
Ioug7h we werelaying with somethin a could turn Into a tech spec.violation
- Alya. cally said he was making the d~.ision .. er wasa representative of his at was my opinion ... he reflected the.Irves as typically a representative of the senior management" 0 12/16/03, p. 54 -66, 119 -121, 140, 141 Discusses the stuck BF-19 (Steam Generator Feed Regulating Valve) Issue ... it happened on night shift and he was the Shift manager for day shift ... believed that night shift was mistaken In thinking that It was a controller problem ... "[around 3pm] we've done what we can do to confirm or deny it's a control problem. It really appears that there is something preventing this valv from S NCD dosing ... The time of discovery Is now. We're calling this Inoperable
... [we got to a pre-determined point in the troubleshooting procedure where It would more definitively Indicate that the problem was valve-related NOT controls-related and then declared the valve inoperable]
... we started sh wown ...o p. 101-116 Speaking of the situation where operators have continually
'managed" a problem with oil level fluctuations In a safety-related control room chiller for at least 18 months and repairs are PIR scheduled for Oct 2004 (8 more months) -"...It has frustrated a lot of operators.
Do I think the decision Is the right decision to manage this equipment?
Yes, I do." t I Updated: 5128/04 SASaIem-HC By Bins Only.wpd Page 22 of45 Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning Is to establish the preliminary significance of issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were identified during interviews conducted to assess this allegation.
LEGEND S -Specific Incident G- General GMLC -General Management I Leadership
/ Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure PRODUCTION OVER SAFETY ISSUES Issue Root" " 2"e: Cause 0 /04, p. 56= Relaying second/third hand Information that previou V 1.promoted a non- .Nkia conservative approach toward operability determinations "Gee, w to my Interview witlmw G NCD and, boy, this is what he said about operability determinations.
And that doesn't seem right- t e -M -"2/2104, p. 63* Recounted ho relay" -rabIlity determination philosophy at a'Sh1tf Manager's meeting -"it sou to me as gh we -the approach was G NCD one of ... justifying why something was operable versus determining that it is operable.
And there's a big difference between those things." o 2/2/04, p. 86-8* Fall 2003, High vibration alarm on reactor feed pump, SM directed remaining at full power based on verbal Input from engineering, in violation of alarm procedure
-"I've got engineering, through NCD several communications, saying we don't believe this pump Is In jeopardy.
Yet I still have a procedure that has hese words in it, and this is presenting a challenge for the shift." o /12104, p. 107 o "lll' 1/16/04, p. 127* "the point is that ratlheii tan ... doing the hit on the head, you know, you guys were bad and didn't follow procedure, the approach has been, what can we as operators do better, or do G GMLC differentl doff this type of situation through the way we monitor the equipment?" o JJ1 L W[ /2/04, p. 116* Recoungteidanincident where the RO's probably think that a Production-Over-Safety decision was made upon-the loss of some rod position and other Indications
... RD reported that multiple rods were Indicating that they were drifting in ... all other indications APRMs, LPRMs, Turbine 1" stage S EPE pressure, etc. were indicating that the rods were not actually moving ... the majority of RO's on shift wanted to back down in power while the electronic failure was being Investigated
... shift-manager and control.rom supervisor o0 '16/04, p. 112 -116* '... we had said we were goln to ait for five circulators:
let's wait, let's get the fifth circulator back, and start the plant up [was] asking us to do ing that ... is different than what our [SORC] plan was .., it was n" unus hone call, th~ through the shift manager ... S EPE discussing how to change the plan ..
[sta p four circulators]
was ... that was his decision toma, and there was contention about that." o 1 ,3h10/04, p. 16- 31* EDG Jacket Water leak event -shutdown action. statement
-technical adequacy of the operability determination was OK but the Shift manager at the time was unhappy with the condition of the S NCD EDG and the amount of help provided on them on the mid shift.o .4 2/05/04, p. 33-46, 92-93, 104* an event with the off-gas system and a procedure that stated "Do not operate above 75 SCFM" and Indicated that it was philosophically okay to evaluate the design basis of the limit contained in the procedure and stay at full power instead of reducing power to get within the procedural limit.0 o2/05/04, p. 101 -103 FýUpdated: 5/281044"7 SA.Salem-HC SCWEY3innIng By Bins Only.wpd Page 23 of 45 Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning is to establih the preliminary significance of issues that have been raised from a Salern/Hope Creek allegation (fall 2003) or that were identified during interviews conducted to assess this allegation.
LEGEND S -Specific Incident G -General GMLC -General Management
/ Leadership I Communication NCD -Non-Conservative Decision Making FIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure PRODUCTION OVER SAFETY ISSUES Issue Root Type Cause S Individual perceives the current senior management Improving equipment reliability
... focusing the organization on fixing things right the first time ... [during the last outage] "what I saw in the last outage that we did was that ..... there was a lot more emphasis on fixing the plant as opposed to G GMLC can we start up now and fix It In the next refuel outage and avoid .... extending our forced outage time".0 Y05/04, p. 67 & 68 1 think we were focused on safety ... fixing the plant ... team work" G GMLC 0 111fl 2/13/04, p. 18 l Interviewee believes there was never a situation where there was a concern that was elevated and G GMLC didn't get handle apropriately
... '[no 'concerns with safe plant operation)
It Is In my backyard" G GL 0/13/04, p. 21 & 22* "I would say that the safety conscious work environment and the Importance of pladng nuclear safety and Industrial safety and radiological safety over production, that has always ... been G GMLC dearly communicated, and I would say communicated on a regular basis, too" o 2/05104, p. 122* "I can't fik ....of any -any specific circumstance where the final decision was, in my opinion, the G GMLC wrong decision." o 111!" &/2/04, p. 53 4 "I have never been in a situation where I have recommended, for instance, that something should G GMLC be declared inoperable, and I've had somebody above me override that decision." o --2 p. 39 When asked whether she thought putting up with an exhaust leak on the emergency diesel for an entire operating cycle, Induding a 3 to 4 week refueling outage, was a case of production over S EPE safety, she stated, "No. No, I did not." 0 p. 35 never ave I felt that I was being coerced or directed to operate the plant In what I thought G NCD was an unsafe manner" o 12/31/03, p. 14* Spring of 2003, crew experienced extremely heavy grassing and manually tripped Salem Unit 2.The crew was "iralsed" for taking the conservative action ... "applauded and recognized for talding S NCD AA !o n] ... Got a trip to the Blue Rocks game or something for the whole crew ... from o IW 2/31/03, p. 36 & 37* "It's to F~e that with these forced outages ... Is really upper management saying 'Hey, let's get this stuff fixed. We're not going to settle for this stuff anymore'...
we're fixing other things too G GMLC... going to cold shutdown ... going into the drywell ... [addressing) the root causes ... so [these failures don't] happen again ... fixing it dght" o 1WINR 1 1/16104, p. 19_::;0 -* Taped conversation between/ft Harvin to the 4 hour4.62963e-5 days <br />0.00111 hours <br />6.613757e-6 weeks <br />1.522e-6 months <br /> debate over shutting down 1:6-"W the turdSineb---yass vac1- -it.You don't understand the economics of the decision to turn the plant off andx th alve" ... S EPE continued, saying "the fact that we were even there means we don't come from saf ...-fefered to Hope Creek as ... dangerous" and u... yes, I meant that from a nuclear safety standpoint" o ,0/06/03, (#1) p. 83, 96, 97, 103 & 104 S:\Saiem-HC SCWEMBInning By Bins Only.wpd Page 24 of 45 Updated: 5/2M/04 Binning Of Salemfllope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning is to establish the preliminary significance of issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were Identified during Interviews conducted to assess this allegation.
LEGEND S -ý Specific Incident G -General GMLC -General Management I Leade.rship
/ Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure PRODUCTION OVER SAFETY ISSUES Issue Root* Says that following deregulation, it became more difficult to obtain funding and that they have had to put In more effort to prove that any expense is necessary.
Says it can be easier to obtain G GMLC funding for projects if the cost is spread out ... "moire toward stretching things out, making it go a little longer and willing to take a little more risk." 0 ý ý ý0/06/03, (#1) p. 16 -19=) He t-ht the pressure of deregulation would effect operators and their conservatism."I'd have no reason to believe that If the situation required something to be done, they [operators]
G GMLC;would *d oa , r lht reasons."f o 1 0/06/03, W#) p. 21 0 as &ually never judgmental and simply [espoused]
the position of I expect you o what's ght, go do it and if we have problems with that, well have discussions
[about it] G GMLC later, but shut down the plant If that's what you (have] to do." 0 110/06/03, (#1) p. 33* Following an outage for repairs on a turbine bypass valve at Hope Creek, PSEG senior management made a point of Informing the lrinde.g how much the outage (which ran S EPE longer than projected) cost the company. ated that he did not take this as criticism for the decision to shut down, bult raer "ec-ucation." o .10/06/03, (#1) p. 41 -45 S 0. 'ta Ng over a "The only changes I saw was ... more elTTion. We're getting far ucatlon on wha ppening in the market What Is the G GMLC market doing? What's the market expecting from us? What's Wall Street demanding from us and how do we plinto that picture?" o -10/06/03, (#1) p. 63* The interviewee discussed the decision-making following the stuck open BPV erTor not to take the plant to cold shutdown).
He stated that Operations, In particular the may have been left out of the loop in the dedsion-making process. He stated when he learned this, he called the meeting between managers to decide on a course of action. He also S GMLC stated that in spite of other people's assertion that the meeting was over three hours long, it was actually only:around 45 minutes.0 3/24/04, (#2) p. 102 -105* The interviewee stated that during the meeting to decide on whether or not to cool down the plant following the stuck open BPV, he took the position of arguing for plant startup to stimulate discussion and make sure everyone knew their position "... it is my job -I need to make sure it is dear to you [that] it is my job to ask questions from every possible front Why is It the right S NCD thing? Why Is it the wrong thing? Why Is it okay to start up? Why is it not okay to start up?" However, when asked if he pushed operations to start up the unit or if the meeting was longer than 45 minutes, the interviewee stated "that isn't true at all." o ]M 3/24/04, (#2) p. 106 -111, 121* The interviewe a during the stuck BPV problem, he discussed the Issue with PSEG management but feno undue pressure from him to keep the unit operating. "You could translate at -avig to cal is] ... being held [accountable]
to be prudent with the S EPE company's resources, but it is not ntability that I am afraid of or that ... I [don't] cringe because I have to answer to somebody" o /I " " /24/04, (#2) p. 145 & 146 S:%Salemr-HC SCWE\BinnIng By Bins Only.wpd Page 25 of 45 Updated: W8/04 Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning Is to establish the preliminary significance of issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were Identified during interviews conducted to assess this allegation.
LEGEND S -Specific Incident G- General GMLC -General Management/
Leadership
/ Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure PRODUCTION OVER SAFETY ISSUES 1 Cause a The interviewee gave another example of where he argued to keep the unit shutdown In spite of Operations pushing to start the unit back up. The example Involved a problem with the seal purge lines to the Recirc pumps. In relation to the issue, the Interviewee stated: "We are going to fix the S NCD equipment and if we are going to stay down longer, we are going to stay down longer and we stayed down another day and a half to go fix those things under complete disagreement with some of the operators, Including some of the people that reported directly to me." o ,3/24/04, (#2) p. 149 -151 0 Stated that the root cause of the Issues surrounding the decision making following the stuck BPV were related to lack of communication between Ops and the rest of the organization.
He stated that following the event a thorough root cause evaluation was conducted to determine where they S GMLC had shortcomings.
He said they looked at "both the technical aspects, the decision making aspects, command ang control aspects and cultural aspects." o 13/25/04, (#3) p. 172 -174, 182 0 The interviewee gve an example (related to a problem with a Recirc pump seal) where he was alone In arguing that the plant should be shut down. He dted this as an example of an Issue Where he was arguing for plant shut down (as opposed to the BPV Issue). "We had a difference in philosophy between my management team and myself In that concept [the risk significance of a G NCD potential seal purge system failure] ... In the previous week we fixed the Redrc seal and stayed down two additional days to resolve the seal purge system and I will tell you that I was alone in that dedsign making as well.'o 3/25/04, (#3) p. 187* 1 q forced outage, the Interviewee prepared a presentation on the plant's performance for , ,t me know that he was not happy about some of our performance and he told#e the con-se ces of some of our performance issues in financial terms." He stated several G EPE other times throughout the Interview tha ll nd others in PSEG senior management let Salem/HC rma na ersow the financial Importance of keeping the plants running.o ý ý 3/25/04, (#3) p. .189, 196 & 197 0 'You asked m-elfbiabnne put pressure on me to say you have to do something and bring this plant back. I would say no ... The only pressure that there was was self-imposed pressure by me and G EPE the people around me.'o 3/25/04, (#3) p. 296 0 Following an Issue W"iere heIa tw.s brought to full power with an Incorrect valve lineup (not caught by the operators), met with plant personnel (Salem and Hope Creek) and told them that they dont have e to make changes in plant power (except In the case of an Imminent significant concern requiring the operators to take Immediate actions).
In other cases, G GMLC he expected a management review to be conducqgd1I think they [the SROs] took that as a challenge to their manhood because they heardJJ ay that they are not In charge of the plant and there was the prception potentially that tfIt 6ouldn't exercise their license responsibilites' o ' 3/25/04, (#3) p. 359 -363* April 7th, 1994 -had both feed pumps In manual and both Feed Regulating Valves (FRVs: BF-19s) S NCD in manual and still keeping the unit on o 10/22/03, p. 10* Nuclear safety Issues are handled immediately G GMLC o 10/23/03, No Transcript
-From the Investigator's summary of notes taken.urtlng the interview I 4 AýUpdated: 5128104 S:\Salem-HC SCWE\Binnlng By Bins Only.wpd Page 26 of 45
.Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning is to establish the preliminary significance of issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were Identified during interviews conducted to assess this allegation.
LEGEND S -Specific Incident G -General GMLC -General Management I Leadership I Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure PRODUCTION OVER SAFETY ISSUES Issue Root Te Cause* Discusses safety concerns raised during turbine building chiller maintenance
... "I think ... the financial pressures and limitations with the contractor may have, for the moment, outweighed S GMLC some of e ýsafe aspects of the job." o ,2/26/04, (#1) p. 188 -191* "I will tell you that there were valves ... that were not Installed correctly
... Operations accepted S PIR[these S3 valves] though they were Installed Incorrectly and wouldn't operate as designed" 0 1/27/04, (#1) p. 15* With respect to the Hope Creek "B" Recirc Pump Issue (tolerance
/ alignment problem that manifested itself via high vibration that was 'corrected' by machining and repositioning the vibration Indication equipment effectively
'masking' the problem), a level 1 notification with a root cause was initiated.
The recommendation (from site engineering, maintenance, and FlowServe
-S PIR an external vendor) was to do maintenance on the pump Internals during the next refueling outage to resolve the Issue. Management viewed this as a business decision rather than a safety issue and corrective actions were scheduled beyond the next refueling outage.o 1 1/27/04, (#2) p. 2 -5 The SaiemV 6nf 1turbo charger" failed because PMs Were not done ... 'two people*...
manager and superintendent
[that signed deferrals for the Pins for] ... almost three years ... [and a deferral S PIR required]
operations or engineering concurrence" o 1/27/04, (#2) p. 20 -22"WhenI first got there the [stack of] PM deferrals
... was unbelievably huge ....Just [couldnt]support [the PM work] with all the corrective maintenance
... [the PM program started to Improve] P PIR about a -year andI V Aago'o 1/27/04, (#2) p. 22 & 23 The practice of adding new notifications to existing work packages creates the potential for Items to be overlooked and Inadequately planned. One diesel work package had over 30 notifications attached to it ... "that's how half the stuff gets missed .. [which results in the work order add-ons P PIR not getting] prjedi panned" o (#2) p. 43 -48 Discusses an issue ated to testing of the SJ-12 valve. Says he felt the plant was not In compliance with Technical Specification
('.S.) requirements for zero leakage pa be.e and that required testing was not performed.
He also stated that pressure came fo to S NCD continue on without conducting the testing.o 22/04, p. 25 -31 Discussed the Issue wher erced an extended debate on whether or not to complete the shutdown & c down o Hope Creek following the stuck BPV. Most or all other plant personnel felt the decision to shutdown & cool down should have been straightforward.
'I S GMLC felt that his i'i approach was on the edge ... I did not feel that he went over the edge, but he ddpus to the edge." o 0 ./- /22/04, p. 61 & 62 Updated: 5128104 S:\SaIem-HC SCWEWBinning By Bins Only.wpd Page 27 of 45 Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning Is to establish the preliminary significance of Issues that have been raised from a Salem/Hope Creek allegation (lall 2003) or that were identified during Interviews conducted to assess this allegation.
LEGEND S -Specific Incident G- General GMLC -General Management
/ Leadership I Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure Issue RODt SCHEDULE PRESSURE ISSUES ss u seo Type Cause a During the recent Salem Unit 2 outage, a SW valve was stroked to allow system fill prior to setting S ESP the torque and limit switches ... This was done to save time on the outage schedule 0 i i o 1/7/03, p. 7 -9* "Procedures aren't a hundred percent right now ... you don't see any gain In correcting a problem,[you] see gain In getting the work done. Post-job briefs are pretty much non-existent
... the drive to get the schedule done, to meet the schedule ... I mean, that's the number one thing ... you say S ESP safety Is the number one priority ... you can't, If you did everything totally 100% or as safe as you could, you wouldn't be In business." o 0. 11/06/03, (#2) p. 24 & 25* Attempted to start the 22 Auxiliary Feed Pump on a dead bus. Crew lost focus of the evolutions and failed to restore the 2B bus before the pump start attempt ... "it was the pressure to get S ESP something done ... it seems like they were going out of the schedule to get something back." o -11/06/03, (#2) p. 69 -74* Reckless pursuit of pessurization of Service Water piping during a Bay #4 restoration following an S ElP outage 0 11/6/03, p. 40- 46* Some problem repair delayed (putting things off) because of time or cost of reduction of power G EPE level.o 1/21/04, p. 62 S Deferral of 5 or 1 yr. inspection Interval for bolts for at least one outage, possibly two (Summer 2001 or 2002, but possibly Fall 2003).. Halfway through the 18-month cycle'they found a lot of boron a.nd degraded bolts. Operability determination was required to see If the bolts holding the RHR heat exchanger head were good enough to hold while bolts were replaced one at a time.Deferral of Inspection was due to wanting to hold outage schedule to 19 days. Bolting condition S PIR could have been found during the outage If the Inspection was conducted.
Interviewee was unaware If the Inspection was a spedfic NRC ISI or IST requirement or If the deferral was NRC approved or not. But, he. was aware that the responsible engineer was angry about the inspection being deferred, about the identification of wastage on some bolts and about the removal of the Inspection from the outage schedule.0 10/29/03, p. 34 -40* Operatioin-sana'gement exerted pressure to bypass Interlocks to allow transmission switchyard operations to continue to restore grid reliability
... the Interlocks were not bypassed ... mbut there S EPE was certainly a lot of [pressure exerted] to try to get them to bypass the Interlocks" o 10/26/04, p. 44- 49 0 Outage pressure Issue. "I think time ran a little short on the I&C work....they tried to do both of them at the same time and ended up getting an automatic Initiation of SLCS. Now, because there was portions of It that were Isolated, we ended up firing the squib valve which had to be replaced S ESP and we also broke a section of pipe." 0 1/22/04, p. 17* Discusses outage scheduling. "Well, they actually look at it like we want a 16 day outage or we want an 18 day outage....It seems like the outage duration is set ahead of time. And then you G ESP have to an malthe work fit In." o IOI /22/04, p. 43-45 Updated: 5/28/04 S:ASalem-HC SCWE\Blnning By Bins Only.wpd Page 28 of 45 Binning Of SalemfHope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning is to establish the preliminary significance of Issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were Identified during interviews conducted to assess this allegation.
LEGEND S- Specific Incident G- General GMLC -General Management
/ Leadership
! Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure SCHEDULE PRESSURE ISSUES Issue Root Cse"Ter [hlave] been start-ups where th -h the , and t ivu d alt be standing in the ekvfthe contrtroomi the shi anagert'soffice.
We' G ES used to call them the Sopranos.
It seemed like every time these guys would come In, they would start push. ,d on the CRS.'o Jiý J 1/22/04, p. 71 DiscusseB-a startup with 4 of 6 Orc Water pumps available; he thought there was about a 50/50 split among those on the call, but he was the Shift Manager, agreed with the startup, was not pressured Into It did ncons/der It a safety issue ... discussed that h belle the argument S EPE betweer] n " got pretty heated, so much so that. left the conference call a t o n e p o' t " o 12/16/03, p. 18- 39"... after this management change-out
[1997/1998 time frame], the questions were more along the lines of production pretty much at all costs ... 'What can we do?"'Is there a way around this G EPE requirement?'
... consistent
... shockingm o 12/2/0 3 , p. 4- 6 During de-epmiient of the procedure to shutdown the unit with a stuck open BPV, there was no separate verification/validation step for the procedure (as you would normally expect to see). E Instead the crew that was going to be performing the evolution completed a combination practice run and vedfication/validation In the simulator.
o "ý .2/12/04, p. 63 -65* "But. I ha-einever had the sense that It was production over -over repairs. I think there's an G -IR Inefficiency in our ability to define and implement repairs.'o " d/2/04, p. 60* Discussing effects of deregulation on staff perceptions that market forces require quicker repairs -"It was a matter of getting folks educated and talking to the .PJM. And all the right answers came G ESP back. You know, you guys, we're not In a grid emergency.
Take the time that you need.o 2/2/04, p. 138 0 Discusses an Issue related to stroke time testing the reactor head vents In preparation for startup and problems with the test procedure.
The creww a difiulty with preformrng the test as required by the procedure, and a senior managei entered the control room and pushed for making an on-the-spot procedure chan- to allow completion of the test (not allowed S ESP by plant Instructions).
The Interviewee stated the senior manager's goal was to continue the plant startup.o /S .,09/04, p. 32 -43, 45 0 Discusseanother test procedure associated with measuring leakage back from the RCS to the Boron Injection Tank (through check valves). Suspected flashing In the lines prevented quantifying the leak rate. Test performance was not a T.S. requirement, but there Is a T.S. leak limit. "Then there was some discussion about re-DeorrmanScUe test, and how we were going S NCD to do the test. And there was some reluctance on part in our discussions then to even perform the test, that we weren't requ-red [by T.S.] to e test, that It was a performance test Jrequired by plant procedures, but not T.S.]." o, 3/09/04, p. 47 -55, 60.(",/S:Salem-HC SCWEYBlnning By Bins Only.wpd Page 29 of 45 Updated: 5/28/04 Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning is to establish the preliminary significance of Issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were Identified during Interviews conducted to assess this allegation.
LEGEND S -Specific Incident G -General GMLC -General Management
/ Leadership
/ Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure SCHEDULE PRESSURE ISSUES Issue Root ui ause During dilution to the reactor coolant system for startup, the samples did not agree with the calculations.
Outage management believed that the operating shift should continue diluting and stay within the schedule while operations management wanted to discontinue the dilution process S ESP until they could determine why there was a discrepancy.
Delaying the dilution activity was the right thing to do in the Interviewee's opinion because It was a reactivity Issue. Ultimately, they understood the problem and fixed the discrepancies prior to continuing.
(2001 time frame)o 1/22/04, p. 39 There was no emphasis by management to lower the corrective maintenance backlog 'haphazardly' just to get the numbers down ... s(the] directive was its not fixed until it works per design ... G NCD driven Into us. It's not fixed until it works'on demand for the operator ... we had plenty of resources" o 2/13/04, p. 30 (p. 10 -11) Says that management put no unnecessary schedule pressure on people. However, during many assessments following events or problems, those responsible daim they felt pressure, but were unable to state why they felt that way. 'The general outcome I found from many people G ESP when we'd have events .. they thought they were under some sort of pressure in order to get something done. We asked well, where did it come from? Well, Its what I thought. Did someone tell you that? Well, not exactly. Well, did they or didn't they? No, [they did not]." o iif 10/06/03, (#1) p. 63 The Interviewee discussed some of his interactioon ith PSEG managementi Stated that In the past he'd had Interactions wher as disappointed that fh-s epctatllns weren't met: "It was the fact that we would make mitments and we wouldn't be able to fulfill them and that is what he was saying. Why is it so difficult for you and others to be able to tell me one G GMLC thing and then you can't deliver on It?" He stated that these types of questions covered various commitments, including startup dates, budget targets, and project end dates. However, he also stated that he d cdnt feel the pressure was unwarranted, and he only saw those types of questions if they. had "fumbled the ball" and the situation was preventable.
0 jKJ J 3124/04, (#2) p. 1,58 & 159 0 In discussing the effect of deregulation, the interviewee states, "Rt puts more focus on that efficiency and how that can Influence the outcome of not the plan but the outcome of the G GMLC company." He also sid that'he doesn't believe that: safety decisions are made based on cost.o 3/25104, (#3) p. 198 & 199, In a tape recorded conversation w mn Harvli 1'he interviewee discusses the effect of deregulation: "The very thing that it was intendeclo do was to be a rival entity and it ends up causing people to make a poor decision because of economics and it ends up being economically G GMLC not viable anymore." He went on to state that Issues with safety related components still get resolved, but other things require more justification and sometimes are not fixed.o 3/25/04, (#3) p. 305 -308* Service water valve destruction during premature motor operator actuation during system fill ...scheduling pressure to get the header filled ... someone in the Outage Group made the decision ... S ESP done to save time on the outage schedule.o VNIW 11/13/03, p. 42" 'There Is no one from the management side, even union labor force, that wants to say 'I'm the G E reason thejob got held up'" 0 &0/22/03, p. 22 Updated: 5111 S:\Salem-HC SCWELBinnlng By Bins Only.wpd Page 31 of 45 Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning is to establish the preliminary significance of Issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were Identified during Interviews conducted to assess this allegation.
LEGEND S -Specific Incident G -General GMLC -General Management I Leadership
/ Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure SCHEDULE PRESSURE ISSUES Issue Root_. Cause* Since September of 2003, work packages were b o iPlJ rkbei.2o tor.e Itog. -_told i S ESP.o ose out work packages on more thanone: occasion.0 1/27/04, (#1) p. 9 -11* The Hope Creek"B" riecrc. pump had a tolerance
/ alignment problem that manifested Itself via high vibration that was 'corrected' by machining and repositioning the vibration Indication equipment effectively'masking' the problem. The condition Is still believed to have not been properly addressed.(!.e.
correcting the root cause of the mis-alignment) to date.o -fi 1/27104, (#1) p. 38 -62 There was "great pressure to get the work backlog down, just get it killed, just get the work done" G ESP o '1/27/04, (#2) p. 51* Discusses reluctance to aggressively work issues ... "We've gotten to the point where everybody is so afraid of gettingtheir heads chopped off at anything, well, you want to be foolproof" ... "People G GMLC aren't going to get back In the game If they think they are going to get hatcheted first time they make a mistake." o 2/26/04, (#1) p. 147 -150 0 "We are always In-a reactionary mode." G GMLC o /126/04, (#1) p. 165 Updated: 5/28/04 S:.Walem-HC SCWEBlnnlng By Bins Only.wpd Page 32 of 45 Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning Is to establish the preliminary significance of issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were Identified during Interviews conducted to assess this allegation.
LEGEND S -Specific Incident G -General GMLC -General Management/
Leadership
/ Communication NCD -Non-Conservative Decision Making FIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure LABOR -MANAGEMENT ISSUES Issue Root yrpe Cause* firen becaus anted to show the union that management is running the station a=not the union ... as reinstated after arbitration S GMLC o 1 10/23/03, p. 71- 74* Issued iagout for the 2B EDG that included a tag for the control power to the 2A EDG by mistake ... NEOs discovered the error ... Issue raised to supervision and the discrepancy was S GMLC corrected
... A notification was generated but not believed to adequately address the level of concern ... Made a Level 3 ... Supervision was viewed as not taking ownership 0 -1/7/03, p. 10 -14 0 General sense of non-conservative decision making due to production emphasis G GMLC 0 02/3 p. 7* 'Work Environment' Surveys -They conduct surveys and interpret the results to justify whatever they (mgt.) want ... Have not seen a lot of correction come from the surveys ... Management G GMLC hasn't listened to wat union members have said before o 0/22/03, (#1) p. 8 & 43 o 4ý ý 10/22/03, p. 29* In the last 1.5 years, there has been an escalating battle between workers and management interviewee thinks it started when INPO gave PSEG a three ratings. Management will not take accountability for deficient processes like work controls -an absolutely horrendous process that results In 1 7% wrench time. The Issues with work control has been an ongoing problem for years and they cant seem to get a handle on It. Also, there Is a concern by workers that there Is mismanagement in not fixing broken primary system equipment
... For Instance, the Salem Unit 2 G PIR (fall 2003) outage schedule had the 'scoped' primary system work completing in 28 days and the secondary work completing in 42 days while numerous pieces of primary plant equipment were documented with deficiencies
... Management's answers to the questions raised by workers (in reference to the Issue of inactive/minimal primary system work scope) did not seem credible..."We wanted to make sure we could do these shorter outages" 0 10/29/03, p. 62 -69* NEOs concern about being heard. It's the screaming and yelling, the tit-for-tat stuff that is all adding up into "white noise". NEOs are concerned about how do you make sure that what really needs to be heard gets" heard and continue to believe that their attempts to continue to be heard are still being treated by management as white noise. Most NEOs feel they are white noise- -except for a few that are good at jumping up and down. About a year ago the management and union held fairly regular scheduled meetings and were doing ok for awhile, but in the last 6-months things have gotten really bad. No sense In doing them because they are not productive
-not G GMLC getting anything done. The current situation is that NEOs believe there are some Issues with the plant as well as some Issues with the workforce.
Basically the workforce doesn't trust the management at all ... In anything (running the plant nor dealing with personnel Issues between the company and union). While this environment may be making some people uncomfortable about raising nuclear safety or personal safety Issues, he believes that those who tend to raise Issues will continue to do so.o .0/29/03, p. 73- 77* '... I destriffO with my Immediate supervision
.., there's no need to go any higher because of the change ... I don't have a whole lot of respect for anybody higher than my supervision anymore I have been lied to a lot. I've brought up various Issues that have seen brick walls ... has gotten G GMLC better ... still a lot of guys ... will cut corners [on industrial safety] ... I have lost a lot of confidence in the upper management
..." 0 10WI/22/03, p. 32 & 33 -I:J U Updated: 5/28104 SASalem-HC SCWEMBinnlng By Bins Only.wpd Page 33 of 45 Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning is to establish the preliminary significance of issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were Identified during interviews conducted to assess this allegation.
LEGEND 1 5 -I Specific incident I G -I General I GMLC -I General Management
/ Leadership
/ Communication NCD -Non-Conservative Decision Making 1 'PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure LABOR -MANAGEMENT ISSUES Issue Root.. .Type Caus. e* Members of mana errement doing union employee work .losing a Feed Water Pump Steam Isolatio valve sing a metal bar to pry a Circuaf ngWater Pump breaker into its cubicle anpulra Pressurizer valve ... Ops Supervisor manipulating an instrument nitrogen sy pmep ursue ctroller o 0/22/03, (#1) p. 25 -31 o " 0/23/03, p. 55, 56 -58, 59, 60 -65* With respect to retribution: "Did you catch any heat for bringing that issue to [management's]
attention?
Oh yes. ... I was confronted in the Ready Room by the person I was supposed ... to S GMLC work with that evening ... I was told that he was not going to work with me, he did not feel comfortable with me ... If he messed up, I would rat him out." o .10/29/03, p. 60* Discussion about equipment being out of the correct position during a second verification for an equipment tag-out: "... I was given a list ... to verify that It was in the procedural correct position.I found It In the Incorrect position because it had a red tag on it. ... the expectation amongst S GMLC my peers was to call and get support on the way to cover it up. Because a per Is ointo get, a significant rift. ... I called the supervisor
... the guy who got in trouble we on some kind of probation
..." o 1 10/29/03, p. 54* Once dedsions or FIssues are raised above the level of the CRS/NCO, the results and basis are not conveyed to the person that Identified the concern. %I swear I can't figure out, once it leaves the G GMLC NCO, the CRS, once it goes above that level, I have no Idea who makes decisions on what's Important and what Isn't." S1/07/04, p.13&14* "I think PSEG as a whole thinks of me no more than they think.of a stapler. And when the stapler breaks, theyll throw it away In a heartbeat and not think anything of It. It has a lot to do with G GMLC local management." o /"N ]07/04, p. 105 -* '... [the situation betweewi -"d Shift Managers was viewed as 'us against them'] ... I don' t o::uri-F'e.
eanagement team that was there before the previous regime was very well liked and very well respected
... something occurred [during the G GMLC previous regime] where the trust level went south" 0 .1/21/04, p. 48 & 49* People skills and technology skills lacking In many supervisors, need more experienced people (not Just young people) who can jump In for unusual operations problems.
Arbitrary assignment of lead G GMLC personnel.
o 1/21/04, p. 74 -95 fired because anted to show the union that management is running S GMLC-tion ah o h non.-The reinstated after arbitration.
0 10/23/03,*
- p. 59 -62* Discusses management of Pl's. %It's like my RCIC system Is- not looking good for the maintenance rule. So I want to do as little outage time on that as I can to bring my maintenance rule time, my G NCD outage time down and get me back Into a nice looking figure. So they are managing the Indicator S Instead e performance of It.'0 p. 78 -81 s I -m ... h ~ a impressed me so far" 'S GMLC o"R., 1/15/04, p. 24 SASalsm-HC SCWEVElInning By Sins Only.wpd Page 34 of 45 Updated: W/28/04 Binning Of Salem/Hope Creek SCW E Issues (SORTED BY BINS ONLY)The objective of this binning Is to establish the preliminary significance of Issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were identified during Interviews conducted to assess this allegation.
LEGEND S- Specific Incident G -General GMLC -General Management
/ Leadership I Communication NCD -Non-Conservative Decision Making PIR- Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis"_ ESP -Excessive Schedule Pressure LABOR -MANAGEMENT ISSUES Issue Root ype Cause 0 Some SRO supervisors have expressed that "they need to keep [certain union people] in the union because they [the union guys] are people that do bring up concerns ... because [the supervisors]
have to be careful of what they say ... [union members] are not intimidated
... they [are protected G GMLC from adverse consequences]." Management people who express concerns are viewed as not being"team players." o 1di /15/04, p. 164 -168* "... any event that occurred In the plant....
sght ... take your best shot at doing the right thing, but if It wasn't exactly w anted ... very abrupt and scream and yell... berate Individuals
... In front of the management
'... particularly harsh ... would that have G GMLC affected me In raising a concern? No, but could It have affected somebody else? Yes ... if you ...kept your head down, you got less of a chance of getting your head knocked off ... any viewpoint a different viewpoint especially" o h111- '12/2/03, p. 83 -85 0 "But, the evolutionýo ultimately making the decision to run the [emergency diesel] engine, to declare It operable, with operators wearing self contained breathing apparatus, did cause some -S NCD some very, very significant rifts between different parts of the organization." o /204, p. 35 S %..J..ra...a.ted.to of my class In mechanical MgMeerin have NW.. Do. I feel that I was heard bymy management team at the end? A§SOLUTELY NOT. G GMLC They cotilLqregwhat opinion I had an nuclear power and nudear safety'.0 = 12/2/03, p. 106 " 0 The inteFv ewie was the shift manager Involved in the cooldown following the stuck open BPV. He said that he was told at 1600 to report to the simulator in two hours with two NCOs, a CRS, and an STA. He said that the verification/validation of the procedure had not been done and was combined with the crew practice run. The Interviewee stated that at the time, his crew expressed S EPE concerns that they were being rushed Into the procedure.
He went on to say that he felt there was no one in Operations management With whom he could discuss the concern. "I dont believe it would have been supported to put the evolution at risk In order to rigorously adhere to [our]process." O. 2/20/04, p. 139 -147 4 The InMrvrwee was asked to be the test engineer for the startup following RFO 11. tje was asked at 0800 to have the IPTE paperwork ready for the evolution at 1100. 'And I talked týiw,--IS M 'nd said I'm not going to be ad dyI 1100. I said I cant follow the process and meet S EPE T'-p~a% of It and be ready by 1100. I told him "We need to be ready by 1100. That's when the evolution is going to happen. The Interviewee pointed out that the startup had been planned for a!on time, and there was "no effort prior to that morning to get It ready." o 2/20/04, P. 155 & 156* The Interviewee discusses another Instance where.ut pressure on the operators to mov r. han they felt comfortable.
The opera we Waeparing to roll the main turbine, and tol ey would be ready by 0900. "And h aid you need to be ready to roll at S ESP 07A... [even though] we were telling him this is how" long [takes If done] within the balance of the procedures and standards that we have." o j§JW /20/04, p. 157* In spite of past problems with management rushing operating crews, the Interviewee states that "'I think if I were to say that this is what It takes for me to do a job In accordance with the standards G ESP I believe the new management team would be supportive of me taking the time I needed to do it safely the first time." ulC&'Gelem-1-11C SCWEBlnnlng By Sins Only.wpd Page 35 of 45 Updated: W8104 Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning is to establish the preliminary significance of Issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were identified during interviews conducted to assess this allegation.
LEGEND S -Specific Incident G- General GMLC- General Management I Leadership
/ Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure LABOR -MANAGEMENT ISSUES Issue Root Type Cause 0 2/20/04, p. 164* Identified Issues where union personnel refused to enter Items into the corrective action program because "it was not in their job specifications." He identified that In some cases people may be G GMLC reluctant to use the corrective action program because of lack of familiarity with the system (they don't know how to enter Issues).o ýl3/09/04, p. 23 -25* Followin a siriulator session whIe.tt Interviewee an iýJan'were both obsern told the J ink (T-sh u re the CRS'(in spite o the fact that the indivlduar-pessed the scenario).
sis was that "the NCO looked more professional than the CRS -nothing to do withie g performance, it was all based S GMLC on appearance...lt looked like it ad ben awhile since he's had a halrcut...and his dothes didn't look like they'd been ironed." ccused the Interviewee of 'being a mouse" for not wanting to fire the CRS.o, 3/09/04, p. 121 & 122* During another discussion withpthe Interviewee stated that".. directed me once again to fire somebody.
He di nrt ca ho, 'Just fire somebody,'
to crea-e a uming platform." S GMLC The focus was on firing someone from management (rather than union) to help Increase leadershi In Ops.o 3/09/04, p. 1231- 126* "..,I see that w ONi J.coming back as thA as probably one of the major changes, Is that I cn see andl can sense that the -nd or tie relationship between bargaining G GMLC unit personnel and management personnel is improving...v 0o 3/09/04, p. 174* '... the perception at the plant ... equipment operators, the technicians, the union personnel, that G GMLC senior management just gives lip service to safety because of the way operations are conducted" o f 12/31/03, p. 14* For a timeiunide there was more of a .ro fit's p" push from Sr mgt than, 'prove it's operable'.
Prompte to meet wit ý didn't get the G NCD message. Nqowunder new mgt, it seems to be going back to 'e oth- a' -" o i2/31/03, p. 53 -61 Apparent communication problem between management and labor -"So there's a frustration where somebody repeatedly tags the same piece of equipment
[diesel jacket water pump] several G PIR times to fix what one would think would be an easy thing to fix." o /2/04, p. 45 Describil
-'I have never had any reason to question his integrity.
He was one of the most operational savvy people I have ever known. You know, he just had- he had a strong plant Instinct." "He was very effective at getting things done, getting people to do things. But as S GMLC far as understanding how to operate a power plant, he -he really did not have that operator -that Instnct on how to safety operate a power plant'" 0 A " 2/2/04, p. 89 Believesi"- -th relationship between management and the equipment operators has been deteriorating for the last couple of years and has gotten even worse In the last 6 or 8 months ... G GMLC anlmosl Ilght ofWhidngs and people coming back to work o 2/16/03, p. 9 & 10"there are situations where operators
...[have to] babysit certain equipment because we have not G PIR been able to schedule a window to do the necessary repairs on it." I lu S.VSalern-HC SCWESlnning By Sins Only.wpd Page 36 of 45 Updated: 5/28104 Binning Of SalenffHope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning is to establish the preliminary significance of issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were Identified during Interviews conducted to assess this allegation.
LEGEND S -Specific Incident .G -General GMLC- jGeneral Management
/ Leadership
/ Communication NCD -Non-Conservative Decision Making PIR"- Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis.ESP -Excessive Schedule Pressure LABOR -MANAGEMENT ISSUES Type o__aus o 2/2/04, p. 54* Related an Instance where work sequence was appropriate but reasoning not communicated from outage management to workers -"I think there's [still] a gap between ... the union workers ... S GMLC 0 /2/04, p. 149, 1S0-._I.* Statea U ,=L LO I. zLUCK open BPV power excursion that took place during the shutdown caused "a lot of damage (to union] -management relations when it was all said and done." He also stated that the RO who was on shift that night wasn't in the training for the shutdown, and was disqualified following the event. He Implied that the whole evolution was not well planned or thought out ..."It was obvious to me at the time that there was a fundamental knowledge breakdown with regard to taking pressure down with the bypass valves." S12/04, p. 56 -58 6 The int-rvewee mentioned some union concerns related to wearing SCBAs when running one of the EDGs due to exhaust leaks. sIt was hard to convince various people within the bargaining unit that we were concerned about their safety. We were going to fix the diesel ... No, we didn't make them go In with SCBAs. Yes, site protection had data. that supported that the environment S GMLC wouldn't kill you, those type of things...
The outfall was [that] management doesn't care about personal safety ..." The Interviewee stated that this issue caused a lot of concern among union membershi and ledershIp.
effectively communicating his discussions with Eny a"e a-e- ctfed-so-e people In that they did not believe he would pursue their concerns appropriately.
The Indicated that the hlft Manager may have felt an aversion since that time to dealing with t S NO but he did not believe he would be affected In continuing to bring up safety issues.(Summe201 e frame)operability decisions even though heantN U ~ iene script covered a few Instancesthe Interviewee felt this had been the case. The Interviewee did not Indicate that he believed any of the issues would be current safety issues. When the above concern was taken to a G GMLc* nmeeting between the Shift oanagers and Senior Operations banagement
... addressing the feeling that there was Inappropnrate Intervention of senior management In operability calls, the senior management said the shift managers as acting like victims.v The interview~ee did not completely a inicaionof pertioal ecison akig pwerbeig sbvered y snio maageent-he talks abot ein i te cntol oo o seerl ccaios t "ak sue hatth aproritederisions G GMLE were being made In those control rooms!o 10/09/03, p. 40* *.. some people In management think that [industrial) safety Is being used as a weapon ... by the G GM union" G 1 S.'XSalem-HC SCW'BlnnlnIg By Bins Only.wpd Page 37 of 45 Updated: 512EM Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning is to establish the preliminary significance of Issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were identified during Interviews conducted to assess this allegation.
LEGEND S -Specific Incident G -General GMLC -General Management
/ Leadership
/ Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure LABOR -MANAGEMENT ISSUES Issue Root Tvipe Cause o 12/16/03, p. 10* -... example where I think that ... unethically, (industrial]
safety was used to create an advantage... a feedwater leak [low-level contaminated waterl] _ng to get the leak Isolated ... everyone was soaked by the end of the day ... [theame forward and requested that some members be allowed to leave early with pay] ... I said 'Well, this isn't a night we can do that. We S GMLC need to keep working'...
[after that exchange]
there became a safety Issue ... health effects of the water ... it only became an Issue after I tell the guys to go back to work ... when queried about the safety Issue, the workers deny that It came from them and say "the union told us not to do itV o m 12/16/03, p. 12 -15 o Workers bring up Tsues (industrial safety related) In order to delay work and cause problems ... 'I just feel that [the safety Issues] were used as political weapons as opposed to trying to make sure G GMLC the job was safe'o r12/16/03, p.-17 -2 0 0 Discussion about time while on duty performing Investigations of Issues S GMLC brought to him by other member instead of doing his assigned tasks.0- 2/16/03, p. 23 -32* 'Well, firing _probably was the biggest Incendiary device ... I'd categorize it as an S GMLC Integrity Issue more at anything else. But It was about a fitness for duty thingS G o 12/16/03, p. 34* "..-a number of them [union workers] come up and say 'Well, as long as S GMLC position, I don't see things getting. better" o '- 12/16/03, p. 147% '..- a lot of management have been abusive and unkind ... [there have been] days like 'Black Friday' ... [1997 time frame] .. [they] came in and let a whole bunch of people go [without]
S GMLC warning ..Jut escorted off site by security'o. 2/13/04, p. 18* 1 think our problem was more productivity and labor Issues ... I did a study [and found that]direct work was down around 12% wrench time ... Issued a number of PMs ... was unbearable
... G GMLC that were not necessary' o .2/13/04, p. 30 & 31* "... the relationshiip (between labor and management]
was poor ... a lot of turmoil ... [caused by the way they treated people] ... the biggest problem was how people felt about coming to work G GMLC each day" o 2/13/04, p. 31 -36* Discusses issues with the corrective action program. "The biggest weakness I've seen is not a failure to Identify an Issue. It's to properly document the Issue." Stated that people were reluctant P PIR to write notifications (CRs) and would routinely discuss Issues with supervisors before entering It Into the action program.o jj i j 3/09/04, p. 19- 22, 27* Information from the previous licensee Investigation Into the EDG exhaust leak Issue found that management was split on considering employee refusal to work In the diesel room as Insubordination.
Although tIn e ee did not recollect it, 2J.ue us information documents that he had discussions w it p bout'Insubordination' supportlng It) ... "Trying S GMLC to accomplish something a hammer Is never the dght waytb do It ..1 telling someone to do somethi becauseg .i1.be Insubordinate
.;. is not a win-win situation
... that clearly Indicates that we had a conversation of Insubordination with employees" U SAOSalem-HC SCWEVaInning By Bins Only.wpd Page 38 of 45 Updatede SP2111104 I
Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning Is to establish the preliminary significance of Issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were identified during interviews conducted to assess this allegation.
LEGEND S -Specific Incident G -General GMLC -General Management
/ Leadership
/ Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP- Excessive Schedule Pressure LABOR -MANAGEMENT ISSUES Issue Root Type Cause 0 ..W ,3/02/04,, p. 40 -48* "To be engaged in that type of [justifying why the unit should stay shutdown and S GMLC continue to. cooled down with as abnormalff GL 0 ,I3102104, p. 54 0 The Intervlewed discusses conflicts between labor and management following a series of human performance issues (including an injury, several LCO entries, and a scram). The Interviewee made a presentation to the maintenance department attribu s robiems to carelessness and 'threatening to fire five or six of the people Involved.
=and I were under a great deal of pressure from the as any time you take five orsx GLC Union employees that are five, ten, or fifteen years with the company and are telling the Union that these potential five or six people may not have employment, that has a tendency of creating a lot of contentiousnes in the air." o I, K3/24/04, (#2) p. 87 -89* Followin hrreat" to fire the Union employees responsible for the Issues addressed above, th&'as s 1ificant divisiveness between the Union and management
... "the Union pulled out of all involvement type of things that you typically would see,-writing tags, partidpating In outage planning, recruitment initiatives, anything like that, the Union's position at that point was S GMLC we are no longer a participant in anything other than just doing our job classification until these Issues are resolved..
o 3/24/04, (#2) p. 94.* Discussed the Issue where a, solated a steam leak to prevent the unit from being shut down. "One of e .had said that the work practice and Implementation by a senior manager W.completely inappropriate." The Union's S GMLC concern was that management was 0-i'on work and that the work was done unsafely.o 25104, (#3) p. 380 & 381* Effects of a lingering--ear or reprisal/termination exists due to several people having stories like the following:
A manager came to a supervisor with an employee who was being removed from engineering and requested that the superviqor use him In his scheduler group. The Individual was performing well when the manager came back to the supervisor and requested that he tell the IndMdual that his position was being eliminated when the positions were actually being expanded.
G GMLC When the supervisor refused to submit the letter to the Individual because the supervisor believed it "was not true," the manager gave the supervisor a letter to the same effect. (Summary:
THE PROCESS AT PSEG IS TO MOVE UNDESIRABLE PEOPLE AROUND, THEN ELIMINATE THEIR POSITIONS TO "GET RID OF THEM." ALSO- ANY DEFIANCE OF SUPERIORS IS GROUNDS FOR 0 IN/M 1/12/03, p. 131 -135* Supervisors'
& Managers' jobs were threatened if they failed to reduce the corrective maintenance S GMLC backlog, overtime, lost-time accidents, safety Incidents, and human performance inddents.o.1/27/04.
(#1) p. 12 4 '... I get the impress on that [workers]
really don't care anymore. They're fed up with the five-year management teams coming In shaking up the world, changing polides and philosophies, and [the G GMLC workers] feel as though they're not listened to ... [across the board]" o 11/13/03, p. 5* Threats ai used against an individual for responding to a request by a shift manager S GMLC o p. 10 -14= .e----Updated: 5I28104'Y S:Salern-HC SCWELBNinning By Bins Only.wpd Page 39 of 45 Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning is to establish the preliminary significance of Issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were identified during Interviews conducted to assess this allegation.
LEGEND S -Specific Incident G -General GMLC- General Management
/ Leadership I Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure LABOR -MANAGEMENT ISSUES Issue Root I Cause* Indication of the disorganization within management
-An individual had, simultaneously, 2 supervisors, 3 other people who give him direction
... Another person (whom he had never received any direction from) gave him his annual performance review (the written evaluation of which w ttýeny,le person being evaluated) 0 11/13/03, p. 30 & 31* Example of a "self-censorship" effect given of Radiation Protection personnel not Including Information necessary for changes to the Off-Site Dose Calculation Manual (ODCM) because of S GMLC their percp Lion of being "beaten 6p" at the Site Operations Review Committee (SORC).0 j 1 1/ 12/03, p. 211 Discusse6sunpa-vertime "They will tell you to get your butt in here to do something but I don't S GMLC think they appreciate it at allr o 2/26/04, (#1) p. 53 & 54 41 1 usqed WfTEutdown to repair bypass valve and the 'Monday Morning Quarter Backing' o 1" think our operations staff right now In some aspects are afraid to almost operairW S GMLC the plant-because of some of these types of Issues.'o (#1) p. 126 -128 0 They Indicated that surveys (Gallup & internal), done from 2000 through 2002, showed a"downturn" In results and that the downturn was attributable to "union Issues during the period" G GMLC (includin2 the termination of an employee)0o 10/14/03, p. 2 (of investigator summary of interview)
- There has been a lot of talk about improvement following recent management changes, however, G GMLC the effects have not been seen in the field with respect to equipment Issues.O 10/23/03, No Transcript
-From the Investigator's summary of notes taken I d.ngh e interview Updated: 08/04 S:VSalem-HC SCWEBlnnlng By Bins Only.wpd Page 40 olf45 Binning Of Salent/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning Is to establish the preliminary significance of issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were Identified during interviews conducted to assess this allegation.
LEGEND S -Specific Incident G -General GMLC- General Management/
Leadership/
Communication NCD- Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure Issue Root INDUSTRIAL SAFETY ISSUES Tsse Raut..... .Type &us_._e 0 An mbed to an elevated Main Feedwater Pump Steam Isolation Valve without authorization from or n- of the Control Room to dose it to isolate a 20 foot steam plume EPE o ._10/23/03, p.- 56 -58* Discussion about EDG manifold leaks and an unsafe atmosphere:
"... it was an unsafe work environment
... from an Industrial safety standpoint
...' the concern was raised and nothing was done until several other iterations of NEOs going out to the EDG room while the EDG was running S NCD and getting sick from the exhaust fumes ... only then did the station management pay attention and take actions to rotect the workers (or at least address the concerns)0o ... 10/29/03, p. 124'* sed a mk l bar to pry a Circulating Water Pump breaker Into its energized cubicle S EPE o 10/22/03, (#1) p. 25 -31, 33 -37 o /J)23/03, p.59 & 60* Had to threatn 5-IS4A involvement to affect resolution on a fan with exposed fan blades S GMLC 0 , 10/22/03, (#1) p. 18* Feed Pump steam admission (MS 42) valve bonnet leak -efforts to dose valve were done without proper consideration for steam rescue should conditions deteriorate as part of valve manipulation.
S_ EPE (Interviewee only has second hand knowledge of Issue)o .AFA 0/29/03, p. 28 -34* While a malntenirace supervisor racked a breaker In, electrical safety precautions and approved methods were not used ... 'took a [pry bar], pried the switch In the cubide with no fire retardant S EPE clothing ... and It [the breaker] went right in." o J 11/06/03, (#2) p. 46* Discussed the excessive EDG exhaust leakage Issue .... the company Industrial safety personnel had not tested for all possible harmful gases being emitted from the diesel ... "there Is an LCO time limit, and they wanted to clear it up so that.we [could] keep the plant running ... that Is part of the S EPE business .... there Is certainly schedule pressure and production pressure to keep the plant making electricity, because It Is a business" ... 3 people got sick (one nearly passed out In his car on the way home and went to the hospital to get check out)o 1i1K 10/26/03, p. 22- 24, 32 -40* " Operations management exerted pressure to bypass Interlocks to allow transmission switchyard operations to continue to restore grid reliability
... the Interlocks were not bypassed ... "but there S EPE was certainly a lot of [pressure exerted] to try to get them to bypass the Interlocks" o 7ý 10/26/03, p. 44 -4* The situation With the CO leak In the Hope CreekB'1'Diesel room 'was handled very poorly ... we dropped one guy. He came out and threw up, fell down. And before the guy got to the hospital, they started running it again ... a couple of weeks later ... ran it again, one of the supervisors
[observing the run locally, passed out driving home In his car and originally attributed It to the EDG] ... [then] later on ... [claimed that It] could have been ... working nights ... blah, blah, blah" S GMLC... After they had two (one potential) industrial safety Inddents they required workers to were SCUBA during runs. It was fixed for months. Length of time may have been based on production (72 hour8.333333e-4 days <br />0.02 hours <br />1.190476e-4 weeks <br />2.7396e-5 months <br /> LCO not met and S/D action statement)
... Seems to have been many safety meetings, lots of discussion and precautions taking while the leak was active (i.e. scuba and CO monitoring during ýeventually fix It within a 36 hour4.166667e-4 days <br />0.01 hours <br />5.952381e-5 weeks <br />1.3698e-5 months <br /> window (on-line)o 1/15/04, p. 8 -19 Updated: 5128/04 S:\Salem-HC SCWE\Blnnlng By Bins Only.wpd Page 41 of 45 Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning is to establish the preliminary significance of Issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were Identified during Interviews conducted to assess this allegation.
LEGEND S -Specific Incident G -General GMLC -General Management I Leadership I Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure INDUSTRIAL SAFETY ISSUES Issue Root Tye _Cause* Reactor Feed Pump turbine inlet valve steam leak ... 'Big steam leak. Going to have to shut the unit down. You need to come in ... got into the plant and was told ... everything's fine. We got the valve shut ... lagging blown all the way across the turbine building ... I've seen steam leaks that scared me that threw a lot less stuff around ... 20 [to] 30 ft. steam plume ... never a TARP report... TARP didn't exist ... operators had said that the decision was ade to shut the unit down ...s na er ang preparations to shut the unit down ...* went to talk to thr S EPE dimbed the ladder and shut the valve e NEOs had said thdywould not s bec "-view It as unsafe/life-threatening
... the response I got [after confronting the 1111was totally unacceptable.
It was ... 'so what' ..." Site guidance dlctates that management iidividuals are not supposed to operate equipment
... NIn an emergency, it's allowable, but the way this unfolded, It really wasn't like an emergency' o -2/2/03, p. 48 -56* During the recent Salem Unit 2 outage, a SW valve was stroked to allow system fill prior to setting the torque and limit switches.
This was done to save time on the outage schedule.
The valve S ESP destroyed itself when stroked remotely.
Could have caused serious personnel injury If someone had been In te vcinity at the time of the failure.o '2/23/03, p. 37 -39* Incident ("-2000 time frame) where there was a complete loss of station air during scheduled maintenance.
Temporary backup diesel air compressors were placed In service but only maintained the air header pressure at ,-89# which very near the ,-85# or -87# level requiring a manual reactor trip per Abnormal Operating procedures.
The V. diesel compressor was shut down In an S NCD attempt to refuel It but the header pressure degraded too quickly. The decision was made (before the management team was consulted) to refuel the compressors while running with the Fire Company Ing as a precaution o 2/2/03, p. 9 -12* Discusses an Industrial safety Issue brought up by an operator.
There Is steel plating In the service water Intake area that operators have to walk on. The operator was concerned that, because of the corrosive environment, the steel plating may have lost thickness and not be safe to walk on. I S PIR The Interviewee restricted access to deck plate until It was evaluated.
He felt this was a conservative decision, but the only feedback he received was that he should have contacted other members of plant organization.
o _/-20/04, p. 218 & 219 a '... some people In management think that [industrial]
safety Is being used as a weapon ... by the G GMLC union" o p. 10 0 '... example where I think that ... unethically, [Industrial]
safety was used to create an advantage a feedwater leak [low-level ater , trying to get the leak Isolated ... everyone was soaked by the end of the day ... [th in l lcame forward and requested that some members be allowed to leave early with pay] ... I said 'Well, this isn't a night we can do that. We S GMLC need to keep working' ... [after that exchange]
there became a safety Issue ... health effects of the water ... It only became an Issue after I tell the guys to go back to work" ... when queried about the safetylIssue, thp workers deny that It came from them and say 'the union told us not to do it" o M M 1"12/16/03, p. 12- 15 0 Worke'?brbng up issues (industrial safety related) in order to" delay work and cause problems ... "I Just feel that [the safety issues] were used as political weapons as opposed to trying to make sure G GMLC the job was safe" o 12/16/03, p. 17 -20 S:SaemHCSCE~nnngByBis n~~pdPae 2 f 5 pdte: 1210 D~S:ýSalem-HC SCWEMInnIng By Bins Only.wpd Page 42 of 45 Updated- 5128104 k 1 4 Binning Of SalenimHope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning Is to establish the preliminary significance of Issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were Identified during interviews conducted to assess this allegation.
LEGEND S- SpecIfc Incident G- General GMLC- General Management
/ Leadership
/ Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive.
Production Emphasis ESP -Excessive Schedule Pressure INDUSTRIAL SAFETY ISSUES Issue Reot , .Twpe Cause a "But, the evolution of ultimately making the decision to run the [emergency diesel] engine, to declare It operable, with operators wearing self contained breathing apparatus, did cause some -S NCD some very, very significant rifts between different parts of the organization." o .2/2/04, p. 35* ... everything was iafety. Safety is number one' G GMLC.0o J12/13/04, p. 14* With respect to a personnel safety concern In 2003, associated with some valve work and multiple S PIn Injuries or near misses ... "I had no Issue with the resolution of the concern or how It was handled" o 2/13/04, p. 22 & 23* Discusses industrial safety concerns felt by equipment operators.
Says that "... they were very concerned about some of the plant material condition and chemistry and In some of the systems G GMLC that they had to take rounds on that there were too many things that kept them from being able to do the job effectively and, quite frankly, they thought they could get hurt physically." o 10/06/03, (#1) p. 13 & 14* The following relate to the issue of diesel exhaust fumes in the "B" Diesel Generator Room: S GMLC o 'What Is it I need to do for you to feel comfortable and safe?' ... In the "B" Diesel Generator Room o 0 ... the safety department
[said the atmosphere In the EDG room had] not reached any threshold that jeopardized
... health and safety ... the bargaining unit said we don't care,[the fumes are] making us ill" o 'was before we utilized the safety Issues resolution process ... [which has become] a very effective way to resolve those Issues"-W 3/02/04, p. 37 -48 4 The Interviewee discusses an Incident In early 2000 where'a worker was almost killed In an accident While moving a service water sluice gate with a large tool (and using a garbage can as a prop), the worker fell and the tool hit him In the head. The paging system In the service water structure had recently been fixed following a period where It had routinely failed to function.
He was able to use the paging system to call for help, but If he hadn't, 'everybody pretty much agrees he wouldn't have made It." According to the Interviewee, "that made us understand that our safety, our-personal safety was not where It needed to be so we took a giant step forward there with regard to Individual personal safety on the job." o = 011, I 2/12/04,-p.
9, 100 & 101* The Interviewee mentioned some union concerns related to wearing SCBAs when running one of the EDGs due to exhaust leaks. "It was hard to convince various people within the bargaining unit that we were concerned about their safety. We were going to fix the diesel ... No, we didnt make S GMLC them go In with SCBAs. Yes, site protection had data that supported that the environment wouldnt kill you, those type of things ... The outfali was [that] management doesn't care about personajlsaety
..." o v/12/04, p. 96 & 97 0 Safety Is the number one priority In the plant. I believe that G GMLC o /16/04, p. 18* A building operator got hurt two years ago and the other operators said "We're not going to put up G GMLC with this stuff." Since that time it has become a more safety conscious work environment o 1/16/04, p. 22 U, S:\Salem-HC SCWEIBinnlng By Bins Only.wpd Page 43of 45 Updated: 5/2V/04 Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning Is to establish the preliminary significance of Issues that have been raised from a Salem/Hope Creek allegation (fall 2003) or that were Identified during interviews conducted to assess this allegation.
LEGEND S -Specific Incident G -General GMLC -General Management
/ Leadership I Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure Issue Root INDUSTRIAL SAFETY ISSUES y Cause 0 The 'B' diesel was leaking carbon monoxide for several months. The situation was getting progressively worse with each surveillance test they did. It got to a point where the Safety S GMLC Department told the Operations department that If the next diesel surveillance, scheduled for March 2003, was going to require that the equipment operators be in SCBAs.o0 10/06/03, (#1) p. 32 -36* Discussing the leaking manifold on the 'B' diesel ... 'It's like keeping your car running and In the garage" o _L. 1/07/04, (#2) p. 66* ThtJgiyi/ewee discusses some on the Union's concerns about Industrial safety Issues related to th4 .isolating a steam leak In the feed system. 'That was one theme and it had to do with the use o a ders and fall protection and that kind of stuff and the Information that I had heard was that the work was done off the ladder without proper fall protection and there was some S GMLC shimmying on the pipe to get to this particular valve. Whether that is true or untrue, I don't know.That is just what I've heard and so that was viewed as setting the wrong example or the wrong standard for Industrial safety.w 0 325/04, (#3) p. 382 4 Restart pressure exerted to fix a valve by flashlight vs. correcting the lighting deficiency
... the S GMLC si'uatioi was eventually resolved by using temporary lighting o 10/21/03, p. 53 -60, 64 -65* During the recent Salem Unit 2.outage, a SW valve was stroked to allow system fill prior to setting the'torque and limit switches.
This was done to save time on the outage schedule.
The valve destroyed Itself when stroked remotely.
Could have caused serious personnel Injury If someone S ESP had been In the vidnity at the time of the failure.0 11/13/03, p. 42* Managements de-eimiphasls of Industrial safety Is evident in the backlog of "'400 Industrial safety S PIR notifications In the Corrective Action Program (CAP) ... some small ... some huge o 10/23/03, No Transcript
-From the Investigator's summary of notes taken durng the interview* ,Funding for safety Is fixed and limited ... Industrial safety Issues are prioritized and not addressed as quickly as nudear safety concerns ... personal safety Issues do not get addressed as quickly as S GMLC operability Issues o 10/23/03, No Transcript
-From the Investigator's summary of notes taken&iriTiig1nterview
- With respect to the EDG with a leaky exhaust creating an unacceptable breathing atmosphere In the EDG room, the interviewee perceived that _ f ,as only concerned about the Technical S GMLC the OSHA requirements.
o 111 10/23/03, No Transcript
-From the Investigator's summary of notes taken during e interview* =.mmernmade (b.thend operators at that time indicated that he cons dere-fiefusal to work on the EDG ( ecause of any Industrial safety concerns) to S GMLC".insubrdination.
o in OW 10/23/03, No Transcript
-From the investigator's summary of notes taken during the interview* Supervisors'
& Managers' jobs were threatened if they failed to reduce the corrective maintenance backlog, overtime, lost-time accidents, safety Incidents, and human performance Incidents.
S GMLC/\)P S:~Salem-HC SCWE~Binning By Bins Only.wpd Page 44 of 45 Updated: 5/28/04 S:%Salem-HC SCWE\Blnning By Sins Only.wpd Page 44 of 45 Updated: =8104
.O o C Binning Of Salem/Hope Creek SCWE Issues (SORTED BY BINS ONLY)The objective of this binning is to establish the preliminary significance of Issues that have been raised from a Saleml-ope Creek allegation (fall 2003) or that were Identified during Interviews conducted to assess this allegation.
LEGEND S -Specific Incident G -General GMLC -General Management/I Leadership
/ Communication NCD -Non-Conservative Decision Making PIR -Problem Identification
& Resolution Deficiency EPE -Excessive Production Emphasis ESP -Excessive Schedule Pressure INDUSTRIAL SAFETY ISSUES Issue Root Fy Cause o O/27/04, (#1) p. 12* Discussed human performance Issues In which errors of omission existed where work activities and their associated tagging activities were not tied together.
This presented a significant risk of personnel Injury and the Identifying maintenance individuals were afraid to report the errors for fear of retaliation
... "we're going to get In trouble, that's all that ever happens" o /27/04, (#2) p. 80 -85 S:ASalem-HC SCWEBinning By Bins Only.wpd Page 45 of 45 Updated: BMBI04