05000293/FIN-2016002-01
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Finding | |
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Title | Inadequate Review of Vendor Documents Results in Shear Pin Failure |
Description | A Green self-revealing finding was identified for the inadequate design verification of the travelling screens system in accordance with EN-DC-149, Acceptance of Vendor Documents. Specifically, Entergy replaced travelling screens C and D during the May 2015 refueling outage, but did not identify that the installed shear pins did not meet the plant design during engineering reviews of the modification. This caused the shear pins in the C and D traveling screens to prematurely fail during a large seaweed intrusion event on May 5, 2016, which lead to a 50 percent rapid reduction in power. Entergy installed the modified shear pin assembly into the C and D travelling screens per the plant design and restored the screens to service on May 6, 2016. The finding was entered into the corrective action program (CAP) as CR-2016-3202. This finding is more than minor because it is associated with the Initiating Events cornerstone attribute of Design Control and affected the cornerstone objective of limiting the likelihood of events that upset plant stability and challenge critical safety functions during shutdown as well as power operations. Specifically the failure of the C and D travelling screens shear pins resulted in an unplanned 50 percent reduction in power. In accordance with IMC 0609.04, Initial Characterization of Findings, and Exhibit 1 of IMC 0609, Appendix A, The Significance Determination Process for Findings At-Power, the inspectors determined that this finding was of very low safety significance (Green) because the finding did not cause a reactor trip and the loss of mitigation equipment relied upon to transition the plant from the onset of the trip to a stable shutdown condition. The inspectors determined that the finding had a cross-cutting aspect in Human Performance, Avoid Complacency, because Entergy did not recognize and plan for the possibility of mistakes, latent issues, and inherent risk. Specifically, Entergy did not identify that vendor supplied documentation and part numbers did not match Entergys updated documentation. |
Site: | Pilgrim |
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Report | IR 05000293/2016002 Section 4OA3 |
Date counted | Jun 30, 2016 (2016Q2) |
Type: | Finding: Green |
cornerstone | Initiating Events |
Identified by: | Self-revealing |
Inspection Procedure: | IP 71153 |
Inspectors (proximate) | A Burritt B Dionne B Pinson E Carfang J Pfingstein S Elkhiamy S Galbreath S Horvitz |
CCA | H.12, Avoid Complacency |
INPO aspect | QA.4 |
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Finding - Pilgrim - IR 05000293/2016002 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Finding List (Pilgrim) @ 2016Q2
Self-Identified List (Pilgrim)
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