ML17261A454

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LER 87-003-00:on 870316,major Portion of Fire Sys Detection & Auto Suppression Found Inoperable.Caused by Operator Failure to Follow Procedural Direction During Fire Sys Disconnect Procedure.Procedure updated.W/870415 Ltr
ML17261A454
Person / Time
Site: Ginna Constellation icon.png
Issue date: 04/15/1987
From: Backus W, Kober R
ROCHESTER GAS & ELECTRIC CORP.
To:
NRC OFFICE OF ADMINISTRATION & RESOURCES MANAGEMENT (ARM)
References
LER-87-003, LER-87-3, NUDOCS 8704220215
Download: ML17261A454 (17)
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Text

REQULATQRY I RMATION DISTR IHUTION BYS" 'R IDS)

,ACCESSION NHR 8704220215 DQC. DAT&: 87/09 /15 NOTAR I 2'.ED: NO DOCKET t

FACIL: 0- 44 Rob ert Emmet Ginna Nuc I eav P 1 ant> Uni 1, Roche s tev 0 05000244 AUTH. NAl }E AU I HOR AFFILIATION HACKUS> W. H. Rochestev Gas '5 Electric Corp.

KQBER> R. W. Rochestev Gas 8c Electric Corp.

RECIP. NAME REC IP I ENT AFFILIATION

SUBJECT:

LER 87-'003-00: on 870415> mayor pov tion of fiv e sos detection auto suppv ession Found inoperab le. Caused be operator

~c Failuv'e to follow pv oceduv al direction duv inire sos disconnect proceduv e. Pv ocedure updated. W/870415 ltr.

DISTRIBUTION CODE: IE22D COPIES RECEIVED: LTR TITLE; 50. 73 f icensee Event Repov't (LER) Incident Rpt> etc.

ENCL J SI NOTES: License Exp date in accov dan" e uith 10CFR2> 2. 109(9/19/72). 05000244 RECIr IENT COPIEB REC I P I EhlT COP lES ID CODE/NAME LTTR ENCL ID CODE/NAME LTTR ENCL PD3-3 LA 1 PD1-3 PD 1 BTAHLE> C 1 1 INTERNAL: ACRB MICHELSQN 1 *CRS I'}OELLER 1 AEOO/DQA 1 AEOD/DSP/RQAB 2 2 AEOD/DSP/TAPB 1 AEODIDSPITPAB 1 NRR/*Df t.'RR /DEST/ADE 1 0 NRP /DEBT/ADB 0 ti!RR/DEBT/CEH NRR/DEBT/ELB t}RR/DEBT/ ICSB 1 ERR/DEBT/MFfi i f' RR /D EST I MTH 1 1 NRR/DEBT/PSB 1 t~RR/DEBT/RSH 1 1 NHRIDEBTIBGB 1 NR R /DLP G/HFH 1 NRR/DLPG/9*B 1 t:RR/DOEA/E*H 1 1 NRR/DREPIEPB NRR/DREP/RAH 1 ERR/DREP/RPH i~!RR/PMAS/ ILRB 1 NRR/PMAS/PTBB 3 1 62 1 RES SPEIB T 1 FILE 0' 1 EXTER NAL: EQScG QROH> l'} 5 5 H ST LOHH Y WARD 1 1 LPDfk 1 t!RC PDR 1 NSlC HARRlS> J 1 1 f"S I C MAYS G 1 1 TOTAL NUMBER OF COPIES REQUIRED: LT I R 43 ENCL 41

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NRC Form 255 U.S. NUCLEAR REOULA'TORY COMMISSION rte2) Afr'ROVED OMS IIO, 2)NOMIOa EXPIRES: SIS I IS5 LICENSEE EVENT REPORT tLER)

SACILITY NAME (I) DOCKET NUMSER (21 R E Ginn Nucle r Plant 0 5 0 0 0,244 1 OF1 0 E

EVENT DATE (SI Dur'm Inoperable Fire System Detection Alarms and Autanatic Suppression, LER NVMSKR (5)

Disconn c Perfo REPORT DATE (7l OTHtR SACILITIKS INVOLVtDDl)

Due To Personnel 5N Ore ENTRE AL OAY YEAR FACILITYNAMES OOCKKT NUMSER(5)

MONTH OAY YEAR YEAR HUMNNII MONTH 0 5 0 0 0 0 31 687 87 003 0 0 041 5 8 7 0 5 0 0 0 THIS RtfORT IS SVSMITTED WRSUANT TO THE RKOVIREMKNTS OS 10 CSR ()r (Crrack one or more ol tne lollorrlnf) Il'll Of ERATINO MODE (5)

N 20.e02(N) 20AOS(cl 50.7241(2)(tr) 72.7101)

SOFIER 20.OOS(a) I)HO SOM(e)III 50,724) l2) Ia) 72.71(c)

LEYEL 1 p p 20AOS la l(1) IN) 50.25(c) (2) 50,724)(2) (at I OTHER (Speclty In Aproect Oerow cart In tert, lYIIC form 20AOS(el(1)(NO 50.724I(21(0 50.724)(21(rIN)(A) JIIEAJ 20.405 Ia) Ill(lr) 50.724)(2l(tl 50.724) (2) (r(N)(~ )

20.eOSIal(11(r) 50.72(a) 12I ONI 50 72(el (2)(el LICENSES CONTACT SOR THIS LER (12)

NAME TELEPHONE NUMSER AREA CODE

'.H. Backus, Technical Assistant to the Operations Manager 31 55 24- 444 6 COMPLETE ONE LINE SOll KACH COMPONENT FAILURE OESCRISKO IN THIS REPORT Iltl MANVFAC EPORTASLE MANUFAC. EPORTASL CAVSE SYSTEM COMPONENT TO NPRDS CAUSE SYSTEM COMPONKNT TURER TURER TO NPROS eNj%j. 2( '<:;.

SUPPLEMENTAL REPORT EXPECTED I(el MONTH OAY YEAR EXfECTED SUSMISSION DATE (15)

YKS (II yer, c<<rrprere EXPECTED SVEMISSION DATEI NO ASSTRACT (Llmlt to IOOO rpecee, I 5, epprorimerely Rrreen rlnple~e typerrrrlnen liner) (I ~ I On March 16, 1987 at 1100 EST, with the unit at 100% reactor power, a major portion of the Fire System Detection and Auto Suppression was found inoperable. This inoperability was due to an "Alarm Off" pushbutton in the Relay Room Fire Panel being inadvertently left depressed during the earlier performance of a Fire System Disconnect procedure.

Operations and the Instrument and Control Technician who initially observed the problem, immediately restored the "Alarm Off 0 pushbutton to normal, thus restoring the Fire System to operable status again.

The event was caused by the failure of the operator to follow procedural direction while performing the Fire System Disconnect procedure.

Corrective Acti'on planned to prevent recurrence will be the upgrading of the disconnect procedure to have a second verification by a Fire Control and Safety person or a Licensed Operator.

870422021 5 87041 5 PDR ADOCK 05000244 8 PDR NRC Form 255 (Se2)

NRC Fo<M 300A U.S. NUCLEAR REGULATORY COMMISSION (9.83 I LICENSEE EVEN EPORT ILER) TEXT CONTINUATION APPROVEO OMB NO, 3150 0104 EXPIRES: 8/31/85 FACILITY NAME (ll OOCXET NUMBER (3( LER NUMBER (El ~ AGE (3I TFI 5EGUENTIAL Py@ REVISION NUM0 0 II NUMBER R.E. Ginna Nuclear Power Plant 0 S 0 0 0 2 4 4 7 0 0 3 000 2OF 1 0 TEXT /// INNO Ope(o /I /OookoIL ooo aAWonel HRC FooII 3850'e/ ((TI PRE-EVENT PLANT CONDITIONS The unit was at 100% reactor power and a Fire System Disconnect had been performed on Fire Zone Z-35 at 0940 EST per procedure SC-3. 16. 2. 4 (Fire Signaling/Component (s)

Disconnection - Reconnection). This disconnect was done so that personnel could perform work in the Fire Zone Z-35 area without inadvertently actuating the Fire Detection System due to dust, grinding, etc. A firewatch had been assigned to the Fire Zone Z-35 area prior to disconnect.

At 1045 EST, an Instrument and Control (I&C) Technician

~

began work on the Fire System Tamper Switch Panel in Satellite Station C (SSC) in the Relay Room.

DESCRIPTION OF EVENT A. EVENT:

On March 16, 1987 at 1100 EST, while the I&C Technician was working on the Tamper Switch in SSC, he observed a "Trouble Alarm" on Satellite Station A (SSA). SSA and SSC are very close together in the Relay Room.

The I&C Technician immediately checked SSA for the source of the "Trouble Alarm" and observed the "Alarm Off" button depressed. Knowing that, with this button depressed, a major portion of the Fire Systems Detection Alarms and Auto Suppression was rendered inoperable, the I&C Technician notified the Control Room.

The Ginna Station Technical, Specifications (TS)

Section 3. 14. 3. 1 requires that system is inoperable, except during emergency condi-if a spray/sprinkler tions which prohibit access, or for testing, within one hour, establish a continuous firewatch with backup fire suppression equipment for those areas in which redundant systems or components necessary for safe-shutdown could be damaged; for other areas, establish a firewatch patrol to inspect the zone with the inoperable system at least once per hour and NRC FORM 300A (9 83l

~ NRC FeIm SSSA U.S. NUCLEAR REOULATORY COMMISSION

~ 19 81I LICENSEE EVENT REPORT ILER) TEXT CONTINUATION APPROVEO OM8 NO, SISOWIOI EXPIRE&i 8111185 FACILITY NAME III OOCKET NUMEER 111 LER NUMSER ISI ~ AOE IS)

SEOVENTIAL REVISION YEAR @ NVM ER  : NVM ER R E TExT III mern eee1e H eeeeeed. eee ~

Ginna Nuclear Power Plant HAc femI 40&A'eI IITI 0 S 0 0 0 2 4 4 8 70 0 3 00 03 OF 1 0 place backup fire suppression equipment in the unprotected area(s). Because from 0940 EST on March 16, 1987, until 1100 EST on- March 16, 1987 (a lapsed time of approximately 1 hour1.157407e-5 days <br />2.777778e-4 hours <br />1.653439e-6 weeks <br />3.805e-7 months <br /> and 20 minutes) with many of the spray/sprinkler systems inoperable without a firewatch and backup fire suppression being established, the requirements of Section 3.14.3.1 of TS was exceeded.

B. INOPERABLE STRUCTURES, COMPONENTS OR SYSTEMS THAT CONTRIBUTED TO THE EVENT:

None.

C. DATES AND APPROXIMATE TIMES FOR MOTOR OCCtG&ENCES:

o March 16, 1987, 0940 EST: Event date and time o March 16, 1987, 1100 EST: Discovery date and time o March 16, 1987, 1100 EST: SSA "Alarm Of f" button restored to normal restoring the Fire System operability.

D. OTHER SYSTEMS OR SECONDARY FUNCTIONS 'AFFECTED:

With the "Alarm Of f" button depressed in SSA, the following functions were affected on a ma)or portion of the Fire System; 0 Audible Control Room Fire System alarms were defeated 0 Automatic Fire Suppression was prevented N 0 Manual-Remote Fire Suppression from the Control

.,Room was prevented 0 Manual-Remote Fire Suppression from the area electric release stations was prevented.

NRC FOIIM SSSA IS 8SI

NRC FrrrrR OSSA V.S, NVCLEA4 4EOVLATORY COMMISSION I9.81 I LICENSEE EVENT REPORT {LER) TEXT CONTINUATION AFI ROVEO OM8 NO. 8150 OIOI EXFIRES: SISIISS FACILI'TY NAME <II OOCKET NVMSER 11l

'I LER NVMOER IS) FACE ISI YEAR SEOVENTIAL .Rrrr REVISION NUMSER  :. 8 NUM ER TEXT G'

N Ituuu NMtu 8 tuFuked, l r Power Plant uuu AjtuuRAINFICFuuu 8SSAEI IITI 0 5 0 0 0 2 4 4 8 7 0 0 3 0 4 " 1 0 The major portions of the Fire System affected are as follows:

NOTE The prefix "S" denotes Fire Suppression Detection System and the prefix "Z" denotes Fire Detection only. The

  • denotes Auto Actuation of a Fire Suppression System.

0 S01

  • Auxiliary Building Basement East Safety Injection (SI) pumps 0 S02
  • 1-G Charcoal Filter in Auxiliary Building 0 S03
  • Auxiliary Building Intermediate Center Bus gl6 0 S04
  • Auxiliary Building Intermediate East-Cable Tray 0 S05
  • Cable Tunnel 0 S06
  • Control Building Air Handling Room 0 S07
  • Turbine Driven Auxiliary Feed Pump 0 S15
  • Intermediate Building Basement North Cable Trays 0 S16
  • Oil Storage Room 0 S17
  • Screen House Basement - Cable Trays 0 S24 Condenser Pit NRC FORM SFSA Ol 8SI

lc J

NRC ferro 344A U.S. NUCLEAR RECULATORY COMMISSION

~ l9.83 I LICENSEE EVENT REPORT (LERI TEXT CONTINUATION APPROVED OM8 NO, 3I50 010l r EXPIRES: 8/31/85 FACILITY NAME III DOCKET NUMEER l1l LER NUMEER (41 ~ AOE l31 VEAII SEOUENSIAL II/5 REVISION NUM E II MUM ER TEXT /I/ more SO>>e II reeueIR/. u>>

P r%MY/

POP/oooo/ HIIC Form Plant llll 0 6 0 0 0 2 4 4 8 7 0 0 3 00 05 oF l 0 o S25

  • Turbine Oil Reservoir 0 S29
  • Control Room/Turbine Building Wall 0 Z01 Auxiliary Building Basement East and Charging Pumps o Z02 Auxiliary Building Basement West and Residual Heat Removal (RHR) Sump area o Z03 Auxiliary Building Intermediate West o Z04 Auxiliary Building Operating Floor Bus 414 and Component Cooling Water (CCW) pumps o Z05 Cable Tunnel o Z06 Containment "A" Auxiliary Filter Charcoal Bank o Z07 Containment "B" Auxiliary Filter Charcoal Bank o ZOS Containment Basement Cable Trays o Z09 Containment "A" Post Accident Charcoal Bank o Z10 Containment "ALE Post Accident Charcoal Bank o Zll Containment "B" Post Accident Charcoal Bank o Z12 Containment "B" Post Accident Charcoal Bank 0 Z13 Containment "All RCP Cable Trays NRC POIIM 344A I9 83I

NRC form SOSA U.S. NUCLEAR REOULATORY COMMISSION l94SI LICENSEE EVENT REPORT (LER) TEXT CONTINUATION APPROVEO OM8 NO. S150-OIOE EXPIRES.'8/SINS FACILITY NAME III OOCKET NUMSER ISI PACE IS)

LER NUMSER ISI YEAR PrX< EEQVENTIAL REVISION NVMOEII NUM E II R E Ginna Nuclear Power Plant TEXT Ilfmoro <<Mee << Ieeoeof, we PPOOe<<NP FIIIC forrrr SSSA'eI I Ill 0 5 0 0 0 2 4 ' 003 00 06 OF l 0 o Z14 Containment <<B<< RCP Cable Trays o Z15 Containment Intermediate Level Cable Trays o '16 Containment Operating Floor Cable Trays o Z19 Control Room Area o Z20' <<A<< Emergency Diesel Generator Vault Z21 <<B<< Emergency Diesel Generator Vault o Z22 Motor Driven Auxiliary Feed Pump area 0 Z23 <<A<< Containment Purge Filter o Z24 <<B<< Containment Purge Filter o Z25 Standby Auxiliary Feed Pump area o Z26 Screen House Service Water Pump area o Z35 Auxiliary Building - Spent Fuel Pit area o Z36 Intermediate Building - Sub-basement o Z37D1 Intermediate Building - Steam Header area o Z37D2 Intermediate Building - Above Steam Header o Z37D3 Intermediate Building - Top Floor area o Z38D1 Intermediate Building Basement - Hot Side o Z38D2 Intermediate Building Main Floor - Hot Side o Z38D3 Intermediate Building - Top Floor Hot Side o The Fire Pumps Auto Start Signal NRC FOIIM SEEA I9 8SI

,SC NRC Form 3SSA U.SNUCLEAR REGULATORY COMMISSION (9.83)

LICENSEE EVENT REPORT (LER) TEXT CONTINUATION APPROV EO OMB NO 3150&(04 EXPIRES 8/31r85 FACILITY NAME (TI OOCKET NUMBER (2( LFR NUMBER (Sl PAGE (3l Y E A II SEOVENTrAL 4EYISIOrr NUM(IS 4 rrvMeeo R.E. Ginna Nuclear Power Plant TEXT ((p more epece (e rerRriNE oee ~ NRC Feem 3((BA'PI ((TI 244 87 0 0 3 000 7 OF 1 0 E. METHOD OF DISCOVERY:

The "Alarm Off" button in SSA was found depressed by an I&C Technician while he was performing maintenance on a tamper switch in SSC.

F. OPERATOR ACTION:

Operations and the I&C Technician immediately restored the Fire System to operable status.

III 'AUSE OF EVENT A. IMMEDIATE CAUSE A major portion of the Fire System Detection Alarms and Automatic Suppression rendered inoperable due to the "Alarm Off" button in SSA being depressed.

B. RCOT CAUSE:

Two root causes contributed to this event. They are as follows:

0 The operator's failure to follow procedural direction while performing the disconnect procedure, (i.e. there was a distinct step in the disconnect procedure that instructed the operator to, release the alarm off button by depressing it again and verifying the trouble light goes out").

0 There is currently n'o selective visual indication in the Control Room that alerts the operator when any of the fire zones supervised at SSA are disconnected, reconnected, or inadvertently left in trouble.

NRC FORM SSSA (8 83 I

NRC Forro'388A U.S, NUCLEAR REGULATORY COMMISSION I9 83)

LICENSEE EVENT REPORT ILER) TEXT CONTINUATION APPROVEO OMS NO. 3 ISO-GIOS EXPIREE: 8/3I/85 FACILITY NAME Ill OOCKET NUMSER I?I LER NUMSER ISI ~ AGE IS)

SEQUENTIAL Pgp RSVISION NVMSSII NVMSSII R E Ginna Nuclear Power Plant:

TExT ///moro opoco 8 PSrrsoor, voo PM/oonro/Hp/c Forrrr ~8/llTI 0 5 0 0 0 2 4 4 8 7 0 0 3 000 8 1 0 ANALYSTS OF EVENT This event is reportable in accordance with 10 CFR 50.73, Licensee Event Report System, item (a) (2) (i) (B), which requires reporting of "any operation or condition prohibited by the Plant's Technical Specifications" in that portions of the Fire Suppression System and the Fire Detection System were inoperable for more than 1 hour1.157407e-5 days <br />2.777778e-4 hours <br />1.653439e-6 weeks <br />3.805e-7 months <br /> without a firewatch and backup fire suppression being established.

An assessment was p<.rformed of the safety consequences and implications of the event with the following results and conclusions:

0 Although the above systems would not have operated as designed, the area fire detectors were still operating and if a fire in any of the areas existed a visual indication at the Fire Control Panel in the Control Room would have been received. Should indication have been received, the Station Fire Brigade would have been activated and they could have operated the suppression system locally at the hydraulic release stations. The Fire Service Pumps could have been started manually from the Control Room.

0 Fire barriers are located throughout the plant to separate major areas from each other and also to separate certain safety related areas from the remainder of the plant. These are designed to stop a fire from propagating frombarriers one area to another. All penetrations in these are sealed with appropriate materials to match the requirements of the barrier. Tt is reasonable to assume that even if a fire went undetected in an area, that the fire would be restricted to that area due to the installed fire barriers.

0 The Ginna Station Fire Hazard Safe Shutdown Analysis assumes achieving and/or maintaining cold shutdown status from a fire in any area of the plant. Modifi-cations have been made and procedures developed to assure this.

NRC FORM SSSA I9 83 I

NRC ForrR SOBA U.S. NUCLEAR REOULA'TORY COMMISSION IWISI LlCENSEE EVENT REPORT ILER) TEXT CONTINUATION APPROVEO OMB NO. S150&10<

EXPIRES; 8/SI/85 FACILITY NAME Ill OOCKET NUMBER ISI L'ER NUMBER IBI PACE IS)

SEOVENTIAL ru'r? REYISKIN NVM ER >Ilr NVMBER TEXT ///rrrrrr ~ rpece /P n /r/rrrrL rr>> I/h/Pr>>/h'hC frrrrR ~8/ IITI o 6 o o o 244 87 0 0 3 0 0 0 9 QF 1 0 There were no safety consequences or implications from this event because, the Fire Detection and Suppression System was only inoperable for approximately 1 hour1.157407e-5 days <br />2.777778e-4 hours <br />1.653439e-6 weeks <br />3.805e-7 months <br /> and 20 minutes and the above defense in depth concepts (i.e. fire barriers, and Fire Hazard Safe Shutdown Systems) were used in the plant design. Added to this Fire Detection System visual detection was still available in the Control Room, with local-manual fire suppression actuation possible.

V. CORRECTIVE ACTION A. ACTION TAKEN TO RETURN THE FIRE SYSTEM TO OPERABLE STATUS:

o Operations and the I & C Technician immediately.

restored the "Alarm Off" button to normal thus restoring the fire system to operable status.

B. ACTION TAKEN OR PLANNED 'I!0 PREVENT RECUEGU'.NCE:

o Make changes to SC-3.16.2.4 (Fire Signaling System/Component(s) Disconnection - Reconnection) procedure to have either a knowledgeable fire control and safety person or a Licensed Operator observe and verify the Fire System Disconnect-Reconnect operation.

o Implement with a high priority status, Engineering Work Request (EWR) 4280 to provide an alarm light to be located on the Control Room Fire when the Fire Display Panel to clearly indicate System has been disconnected/reconnected either by choice or inadvertently.

NRC FORM SeeA I Q.BSI

NRC F<<III 3SSA U.S. NUCLEAR REOULATORY, COMMISSION (9WI LICENSEE EVENT EPORT ILER) TEXT CONTINUATION APPROVEO OMS NO. 3150&104 EXPIRES: S/31/85 FACILITY NAME I'l DOCKET NUMSER 13l LER NUMSER ISI PACE LSI SEOVENTI*L IIE V IS IO N NVMSER NVMSFII R.E. Ginna Nuclear Power Plant TEXT //Fm<<p NMce /I mpvP<</ vpp A//I/<<M/N/ICF<<III 3SSAS/IITI 0500024487 003 0 0 1 0 1 0 VI ADDITIONAL INFORMATION A. FAILED COMPONENTS:

There were no component failures that contributed to this event.

B. PREVIOUS LER's ON SIMILAR EVENTS:

A similar LER event historical search was conducted with the following results:

o LER 84-010 "Inoperable Fire Suppression System".

The LER 84-010 event was caused by operator error, (i.e. failure to restore the "Alarm Off" button on the Fire Detection Panel to normal) when restoring Fire Systems S-15 and Z-22 back to service per SC-3.16.2.4. The Corrective Action for LER 84-010 dealt w(th Reconnection and not Disconnection. It was only partially applicable and incapable of preventing the LER 87-003 event.

NIIC FORM 300A I9 93l

ROCHESTER GAS At."c r~r .>'. (.<.'tc>'.,s""7l )I' dQ EAST AVENUE, ROCHESIER, N.Y. 14649-000't ROGER W, KODt;>c vie ~seQoeur erat CTRIC 05EODVCY',Qtt April 15, 1987 U.S. Nuclear Regulatory Commission Document Control Desk Washington, DC 20555 Sub) ect: LER 87-003, Inoperable Fire System Detection Alarms and Automatic Suppression Due To Personnel Error During System Disconnect Performance.

R.E. Ginna Nuclear Power Plant Docket No. 50-244 In accordance with 10 CFR 50.73, Licensee Event Report System, item (a)(2)(i)(B) which requires a report of, "any event or condition prohibited by the Plant's Technical Specifications,"

the attached Licensee Event Report LER 87-003 is hereby submitted.

This event has in no way affected the public's health and safety.

V truly yours, Roger W. Kober xc'.S. Region I Nuclear Regulatory Commission 631 Park Avenue King of Prussia, PA 19406 Ginna USNRC Resident Inspector

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