05000382/FIN-2009005-03
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Finding | |
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Title | Failure to Update Drawings after Design Change |
Description | A self-revealing Green noncited violation of 10 CFR Part 50, Appendix B, Criterion V, was identified for the licensees failure to prescribe an activity affecting quality by documented instructions, procedures, or drawings appropriate to the circumstance. Specifically, for all reactor coolant pump heat exchanger to pump cover bolted connection gasket replacements between the refueling outage of 1986 (Refueling Outage 1) and the refueling outage of 2009 (Refueling Outage 16), the licensee prescribed the wrong gasket material, gasket size, and fastener preload because they had failed to incorporate a design change implemented during Refueling Outage 1 into their instructions, procedures, or drawings. Station Modification Package SMP-1427, an engineering change implemented during Refueling Outage 1 in response to industry operating experience, called for a thicker gasket, different gasket material, and an increased bolt preload in order to increase gasket compression and reduce the probability of leakage. As a consequence of failing to incorporate Station Modification Package SMP-1427 changes into procedures, all heat exchanger gasket replacements since Refueling Outage 1, four gasket replacements in total, have utilized thinner gaskets with less than the vendor recommended compression. The licensee documented this condition in Condition Report CR-WF3-2009-5501. The licensees failure to prescribe appropriate gasket replacement requirements is more than minor because it is associated with the equipment performance attribute of the Initiating Events Cornerstone and affects the cornerstone objective to limit the likelihood of those events that upset plant stability. The finding has very low safety significance because, although the finding contributes to the likelihood of a reactor trip, mitigation equipment is still available. This finding had a crosscutting aspect in the area of problem identification and resolution associated with operating experience in that the licensee did not institutionalize operating experience through changes to the station procedures P.2(b) (Section 4OA2) |
Site: | Waterford |
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Report | IR 05000382/2009005 Section 4OA2 |
Date counted | Dec 31, 2009 (2009Q4) |
Type: | NCV: Green |
cornerstone | Initiating Events |
Identified by: | Self-revealing |
Inspection Procedure: | IP 71152 |
Inspectors (proximate) | L Ricketson P Elkmann J Clark R Azua D Overland M Bloodgood S Anderson T Buchanan N Greene |
CCA | P.5, Operating Experience |
INPO aspect | CL.1 |
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Finding - Waterford - IR 05000382/2009005 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Finding List (Waterford) @ 2009Q4
Self-Identified List (Waterford)
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