|
---|
Category:LICENSEE EVENT REPORT (SEE ALSO AO
MONTHYEARML20046C2121993-07-30030 July 1993 LER 93-004-01:on 930301,confirmed That Channel D Axial Shape Index (Asi) Being Calculated in Reverse Since 921031-930301 Due to Drawing Discrepancies Associated W/Control Channel B. Temporary Mod 92-078 & Standing Order 0-25 Revised ML20046A8691993-07-26026 July 1993 LER 93-011-00:on 930624,experienced Reactor Trip Due to Loss of Load.Caused by Lack of Proper Job Planning,Lack of Formal Decision Making Process & Incomplete Communications.Training Will Be Provided to Operations personnel.W/930726 Ltr ML20045H2561993-07-12012 July 1993 LER 93-010-00:on 930611,1 of 14 Halon Cylinders Did Not Meet Min Pressure Acceptance Criteria Listed in Semiannual Switchgear Rooms Surveillance Test.Caused by Failure of Test to Include Necessary Steps.Cylinder recharged.W/930712 Ltr ML20045D7201993-06-22022 June 1993 LER 93-009-00:on 930524,apparent Spurious Signal from Pressurizer Level Instrumentation Caused Backup Charging Pumps to Automatically Start,Due to Deterioration of Wiring. Instrument Loop Calibration Will Be performed.W/930622 Ltr ML20045D3741993-06-21021 June 1993 LER 93-008-00:on 930520,determined That TS SR Not Satisfied for Stack Flow Indicator,Per Amend 137 Issued on 910307. Caused by Lack of Attention to Detail.Calibr & Functional Test Procedures developed.W/930621 Ltr ML20044H5261993-06-0101 June 1993 LER 93-007-00:on 930430,unplanned Emergency Generator Start & Rt Signal Occurred.Caused by Inadequate Attention to Detail,Labeling of Fuse Drawers,Caution Signs & Training. Labeling & Caution Signs upgraded.W/930601 Ltr ML20044G4941993-05-26026 May 1993 LER 93-006-00:on 930118,Halon Fire Suppression Sys for Switchgear Rooms Disabled to Allow Repair/Replacement of Halon Sys Piping.On 930427,individual Responsible for Fire Watch Not Present.Individual Relieved of Responsibilities ML20044B6711993-02-22022 February 1993 LER 93-002-00:on 930122,determined That Current SG LP Signal Block Reset Values Greater than Allowed Ts.Caused by Improper Design.Test Procedures Will Be Revised by 930917 to Specify Desired Value for Block function.W/930222 Ltr ML20024G6821991-04-19019 April 1991 LER 91-007-00:on 910320,480 Volt Circuit Breaker Coordination Outside Design Basis.Caused by Deficiencies in Original Sys Design.Breaker/Fuse Coordination Study to Be Completed & Problems Will Be corrected.W/910419 Ltr ML20029C1591991-03-21021 March 1991 LER 91-004-00:on 910212,offsite Power Low Signal Outside Design Basis.Caused by Inadequate Mod Design at Time of Performance of Original Degraded Voltage Analysis. Engineering Analysis EA-FC-91-017 performed.W/910321 Ltr ML20029C1051991-03-18018 March 1991 LER 91-002-00:on 901209,ventilation Isolation Actuation Signal Generated by High Alarm on Process Radiation Monitor RM-062.Caused by Accumulation of Noncondensible Gases in Sample Piping.Valve Packing Leak repaired.W/910318 Ltr ML20029A2981991-02-0808 February 1991 LER 91-001-00:on 910109,determined That Containment Tendon Surveillances Performed in 1981 & 1985 Did Not Reflect Guidance in Tech Specs.Caused by Inadequate Administrative Controls.Testing Program Plan implemented.W/910208 Ltr ML20029A2971991-02-0606 February 1991 LER 90-022-02:on 900907,approx 460 Fire Barrier Penetration seals,60 Fire Dampers & 6 Fire Doors Declared Nonfunctional Per NRC Info Notice 88-004 Due to Lack of Documentation. Plant Outage Required to Implement Repairs/Replacements ML20028G9171990-09-28028 September 1990 LER 90-021-00:on 900829,inadvertent Reactor Protective Sys Actuation Occurred While Operator Changed Power Source. Caused by Operator Not Following Proper Procedures.Operator counseled.W/900928 Ltr ML20044B0131990-07-12012 July 1990 LER 90-018-00:on 900612,reactor Protective Sys (RPS) Trip Units for Axial Power Distribution Determined to Be Inoperable.Caused by Procedural Deficiencies.Procedure Revised & RPS Surveillance Tests reviewed.W/900712 Ltr ML20043F6301990-06-11011 June 1990 LER 90-016-00:on 900511,accident Scenarios Identified by Which Auxiliary Feedwater Piping from Discharge of Turbine Driven Auxiliary Feedwater Pump FW-10 Can Be Overpressurized.Caused by Design deficiency.W/900611 Ltr ML20043F2441990-06-0707 June 1990 LER 90-015-00:on 900507,PORV Variable Setpoints Used for Low Pressure Overpressure Protection Determined to Be Nonconservative for PORV Opening Time.Caused by Design Deficiency.Tech Spec Amend prepared.W/900607 Ltr ML20043C0991990-05-29029 May 1990 LER 90-014-00:on 900427,investigation Revealed That Component Cooling Water Piping to Reactor Coolant Pump Seal Coolers Could Be Targets of High Energy Line Break.Safety Analysis for Operability completed.W/900529 Ltr ML20042G7211990-05-10010 May 1990 LER 90-011-00:on 900402,inadvertent Actuation of Pressurizer Pressure Low Signal Occurred While Performing Calibr Procedure.Caused by Inappropriate Action by Technician Involved.Validation of Procedures reviewed.W/900510 Ltr ML20042E6871990-04-23023 April 1990 LER 90-007-01:on 900228,determined That Several Supports Would Be Overloaded During Seismic Event on Nonsafety Related & safety-related Main Steam Piping.Caused by Design Deficiency.Piping Supports modified.W/900423 Ltr ML20042E6861990-04-23023 April 1990 LER 90-009-00:on 900316,potential Overpressurization of Auxiliary Feedwater Piping Could Have Occurred During Thermal Expansion of Process Fluid Between Closed Valved. Caused by Design deficiencies.W/900423 Ltr ML20012E7641990-03-26026 March 1990 LER 90-005-00:on 900223,determined That Spent Fuel Pool Area Charcoal Filtration Unit VA-66 Was Outside Design Basis. Caused by Insufficient Airflow Into Unit.Affected Updated SAR Analysis Will Be updated.W/900326 Ltr ML20012D0121990-03-19019 March 1990 LER 90-004-00:on 900217,lift Pressures for 6 of 10 Main Steam Safety Valves Found Outside Acceptance Criteria. Caused by Overly Restrictive Operability Criteria.Valves Recalibr & License Amend Submitted to NRC.W/900319 Ltr ML20012D0101990-03-19019 March 1990 LER 90-003-00:on 900216,determined That Auxiliary Feedwater Piping Outside Normal Stress Limits of ASME Code & Design Basis Specified in Updated Sar.Caused by Design Deficiency.Valve Operators Will Be inspected.W/900319 Ltr ML20012B6361990-03-0909 March 1990 LER 89-017-01:on 890624,internal Valve Component from Check Valve Found Lying on Pump Discharge Vane.Repair or Replacement of Valve Internals Could Not Be Accomplished within Time Requirement of Tech Spec.W/900309 Ltr ML20006E1041990-02-0909 February 1990 LER 90-001-00:on 900108,fire Barrier for Wall Between Auxiliary Bldg Rooms 26 & 34 Breached But Hourly Fire Watch Patrol Not Established.Caused by Lack of Sufficient Training for Shift Supervisors.Standing Order revised.W/900209 Ltr ML20011E2691990-02-0505 February 1990 LER 89-024-00:on 891221,determined That Containment Spray Pumps & Suction Header Piping Not Constructed for Use as Backup to LPSI Sys for Shutdown Cooling.Caused by Inadequate Review of Assumptions.Firewatch established.W/900205 Ltr ML20011E2271990-02-0101 February 1990 LER 89-021-00:on 891010,util Informed by C-E of Potential Nonconservative Setpoint in Reactor Protection Sys Thermal Margin/Low Pressure Trip Unit.Caused by Error in Incorporating Transient Setpoint analyses.W/900201 Ltr ML20005F7151990-01-10010 January 1990 LER 89-023-00:on 891211,hourly Firewatch Patrol Entered Posted High Radiation Area W/O Meeting Entry Requirements for Area.Briefings on High Radiation Entry Requirements Held for Personnel W/Assigned dosimetry.W/900110 Ltr ML19354D6381989-12-20020 December 1989 LER 89-022-00:on 890805,change to Surveillance Procedure ST-CEA-1 Became Effective Which Would Have Made Both Emergency Diesel Generators Simultaneously Inoperable During Portion of Test.Change removed.W/891220 Ltr ML19332E7431989-12-0808 December 1989 LER 88-037-01:on 881214,one of Two Supply Headers Supplying Fire Suppression Headers in Auxiliary Bldg Isolated.Caused by Lack of Procedural Guidance & Inadequate Procedural Controls.Standing Order G-58 Will Be revised.W/891208 Ltr ML19332E2681989-12-0101 December 1989 LER 89-016-02:on 890616,for Unknown Period Since 890614, Auxiliary Feedwater Pump FW-10 Operated Outside Design Basis for Certain Accident Conditions.Caused by Inoperable Speed Control Loop.Action Plan implemented.W/891201 Ltr ML19351A4541989-11-22022 November 1989 LER 89-020-00:on 891012,determined That Two of Four Component Cooling Water HXs Simultaneously Inoperable for More than 24 H.Caused by Inadequate Controls Re Return of Equipment to Svc.Standing Order revised.W/891122 Ltr ML19327B5481989-10-24024 October 1989 LER 89-019-00:on 890924,indication of High Temp for Reactor Coolant Pump RC-3A Upper Motor Thrust Bearing Received in Control Room.Caused by Damaged Cable for Bearing Resistive Temp Device.Damaged Cable replaced.W/891024 Ltr ML19325D2471989-10-13013 October 1989 LER 89-012-01:on 890502,main Feedwater Isolation Valve to Steam Generator a Found Inoperable Due to Improperly Set Torque Switch.Caused by Inadequate Program for Maint of Motor Operated Valves.Torque Switches reset.W/891013 Ltr ML20028C7711983-01-0606 January 1983 LER 82-020/03L-0:on 821207,during Main Steam Safety Valve Test,Four Main Steam Safety Valves Had Lift Setpoints Out of Tolerance.Caused by Normal Drift of Valves Over Operating Cycle.Valves Readjusted ML20028B5451982-10-28028 October 1982 LER 82-019/03L-0:on 821024,MSIVs HCV-1041A & HCV-1042A Stopped Three to Four Degrees Off Seat When Signaled to Close.Caused by Binding Between Valve Packing & Shaft. Packings Sprayed W/Penetrant Oil ML20052J0631982-04-27027 April 1982 LER 82-009/03L-0:on 820411,while Exchanging Component Cooling Water Heat Exchangers,Associated Outlet Valves HCV-490B,HCV-491B & HCV-492B Failed to Open.Cause Not stated.HCV-491B Reassembled & Tested ML20052B2361982-04-0707 April 1982 LER 82-006/03L-0:on 820323,during Surveillance Test ST-ISI- WD-1,F.1,valve HCV-506A Failed to Close Via Control Room Switch.Caused by Solenoid Valve Malfunction.Solenoid Valve Disassembled,Cleaned & Reassembled ML20052D9291982-04-0606 April 1982 LER 82-008/03L-0:on 820330,during Performance of ST-FW-1, F.2(b)(6)per Tech Spec 3.9,steam Driven Auxiliary Feedwater Pump Failed to Start.Caused by Back Pressure Trip Lever in Tripped Position.Lever Reset ML20041G1291982-02-22022 February 1982 LER 82-005/03L-0:on 820210,at 98% Power,Control Element 24 Inserted Into Core.Emergency Procedure EP-13,CEDM Malfunctions,Implemented & Power Stabilized at 88%.Caused by Erroneous Operating Instruction.Instruction Changed ML20041F7481982-02-17017 February 1982 LER 82-003/03L-0:on 820203,containment Isolation Valve Associated W/Gas Vent Header HCV-507A Failed to Close on Demand.Caused by Solenoid Valve Plunger Sticking in Energized Position.Plunger Freed ML20041F6251982-02-0505 February 1982 LER 82-004/03L-0:on 820203,small Quantity of Radioactive Gas/Particulate Released to Auxiliary Bldg During Routine Operation.Caused by Failure of Stack Gas Monitor RM-062 to Alarm at Appropriate Setpoint Due to Faulty Alarm Module ML20041B1051982-01-28028 January 1982 LER 82-002/03L-0:on 820114,at 99% Power,Lockout Relay 86B1, Containment Radiation High Signal,Failed to Actuate on Demand by Plant Radiation Monitoring Sys.Caused by Burnt Coil on Lockout Relay.Coil Replaced & Tested Satisfactorily ML20041B1171982-01-19019 January 1982 LER 82-001/03L-0:on 820111,during Normal Operation,Two Fire Barrier Penetrations Found Nonfunctional.Shift Supervisor Immediately Notified;However,Fire Watch Not Posted.Insp & Supervisor Personnel Instructed on Proper Actions ML20039B4561981-12-11011 December 1981 LER 81-011/03L-0:on 811113,containment Isolation Valves Opened & Ventilation Process Initiated W/Containment Air Monitor RM-050/051 Inoperable.Caused by Personnel Error. Valves Closed ML20010H8581981-08-27027 August 1981 LER 81-008/03L-0:on 810813,86B/CRHS (Containment Radiation High Signal) Lockout Relay Failed to Actuate When RM-062 Was Placed in Alarm,Resulting in Failure of 86B1/CRHS Relay to Actuate.Caused by Dirt in Relay Latching Mechanism ML20041F6291981-08-27027 August 1981 LER 81-008/03L-1:on 810813,containment Radiation High Signal 86B Lockout Relay Failed to Actuate When Radiation Monitor RM-062 Placed in Alarm.Caused by Bound Relay Latching Mechanism Due to Dirt & Grease.Latch Cleaned ML20010C2271981-07-0707 July 1981 LER 81-006/03L-0:on 810624,reactor Protection Sys Nuclear Power Recorder Channel B Trip Setpoints Determined to Be Nonconservative.Caused by Faulty Temp Change Power Calculation Due to Grounded Hot Leg Temp Loop ML20004B1111981-05-0606 May 1981 LER 81-005/03L-0:on 810423,dc Sequencer Timers AC-3A (Component Cooling Water Pump) & AC-102A (Raw Water Pump) Failed to Time Out within Prescribed Limit.Cause Unknown Mechanisms Satisfactorily Inspected 1993-07-30
[Table view] Category:RO)
MONTHYEARML20046C2121993-07-30030 July 1993 LER 93-004-01:on 930301,confirmed That Channel D Axial Shape Index (Asi) Being Calculated in Reverse Since 921031-930301 Due to Drawing Discrepancies Associated W/Control Channel B. Temporary Mod 92-078 & Standing Order 0-25 Revised ML20046A8691993-07-26026 July 1993 LER 93-011-00:on 930624,experienced Reactor Trip Due to Loss of Load.Caused by Lack of Proper Job Planning,Lack of Formal Decision Making Process & Incomplete Communications.Training Will Be Provided to Operations personnel.W/930726 Ltr ML20045H2561993-07-12012 July 1993 LER 93-010-00:on 930611,1 of 14 Halon Cylinders Did Not Meet Min Pressure Acceptance Criteria Listed in Semiannual Switchgear Rooms Surveillance Test.Caused by Failure of Test to Include Necessary Steps.Cylinder recharged.W/930712 Ltr ML20045D7201993-06-22022 June 1993 LER 93-009-00:on 930524,apparent Spurious Signal from Pressurizer Level Instrumentation Caused Backup Charging Pumps to Automatically Start,Due to Deterioration of Wiring. Instrument Loop Calibration Will Be performed.W/930622 Ltr ML20045D3741993-06-21021 June 1993 LER 93-008-00:on 930520,determined That TS SR Not Satisfied for Stack Flow Indicator,Per Amend 137 Issued on 910307. Caused by Lack of Attention to Detail.Calibr & Functional Test Procedures developed.W/930621 Ltr ML20044H5261993-06-0101 June 1993 LER 93-007-00:on 930430,unplanned Emergency Generator Start & Rt Signal Occurred.Caused by Inadequate Attention to Detail,Labeling of Fuse Drawers,Caution Signs & Training. Labeling & Caution Signs upgraded.W/930601 Ltr ML20044G4941993-05-26026 May 1993 LER 93-006-00:on 930118,Halon Fire Suppression Sys for Switchgear Rooms Disabled to Allow Repair/Replacement of Halon Sys Piping.On 930427,individual Responsible for Fire Watch Not Present.Individual Relieved of Responsibilities ML20044B6711993-02-22022 February 1993 LER 93-002-00:on 930122,determined That Current SG LP Signal Block Reset Values Greater than Allowed Ts.Caused by Improper Design.Test Procedures Will Be Revised by 930917 to Specify Desired Value for Block function.W/930222 Ltr ML20024G6821991-04-19019 April 1991 LER 91-007-00:on 910320,480 Volt Circuit Breaker Coordination Outside Design Basis.Caused by Deficiencies in Original Sys Design.Breaker/Fuse Coordination Study to Be Completed & Problems Will Be corrected.W/910419 Ltr ML20029C1591991-03-21021 March 1991 LER 91-004-00:on 910212,offsite Power Low Signal Outside Design Basis.Caused by Inadequate Mod Design at Time of Performance of Original Degraded Voltage Analysis. Engineering Analysis EA-FC-91-017 performed.W/910321 Ltr ML20029C1051991-03-18018 March 1991 LER 91-002-00:on 901209,ventilation Isolation Actuation Signal Generated by High Alarm on Process Radiation Monitor RM-062.Caused by Accumulation of Noncondensible Gases in Sample Piping.Valve Packing Leak repaired.W/910318 Ltr ML20029A2981991-02-0808 February 1991 LER 91-001-00:on 910109,determined That Containment Tendon Surveillances Performed in 1981 & 1985 Did Not Reflect Guidance in Tech Specs.Caused by Inadequate Administrative Controls.Testing Program Plan implemented.W/910208 Ltr ML20029A2971991-02-0606 February 1991 LER 90-022-02:on 900907,approx 460 Fire Barrier Penetration seals,60 Fire Dampers & 6 Fire Doors Declared Nonfunctional Per NRC Info Notice 88-004 Due to Lack of Documentation. Plant Outage Required to Implement Repairs/Replacements ML20028G9171990-09-28028 September 1990 LER 90-021-00:on 900829,inadvertent Reactor Protective Sys Actuation Occurred While Operator Changed Power Source. Caused by Operator Not Following Proper Procedures.Operator counseled.W/900928 Ltr ML20044B0131990-07-12012 July 1990 LER 90-018-00:on 900612,reactor Protective Sys (RPS) Trip Units for Axial Power Distribution Determined to Be Inoperable.Caused by Procedural Deficiencies.Procedure Revised & RPS Surveillance Tests reviewed.W/900712 Ltr ML20043F6301990-06-11011 June 1990 LER 90-016-00:on 900511,accident Scenarios Identified by Which Auxiliary Feedwater Piping from Discharge of Turbine Driven Auxiliary Feedwater Pump FW-10 Can Be Overpressurized.Caused by Design deficiency.W/900611 Ltr ML20043F2441990-06-0707 June 1990 LER 90-015-00:on 900507,PORV Variable Setpoints Used for Low Pressure Overpressure Protection Determined to Be Nonconservative for PORV Opening Time.Caused by Design Deficiency.Tech Spec Amend prepared.W/900607 Ltr ML20043C0991990-05-29029 May 1990 LER 90-014-00:on 900427,investigation Revealed That Component Cooling Water Piping to Reactor Coolant Pump Seal Coolers Could Be Targets of High Energy Line Break.Safety Analysis for Operability completed.W/900529 Ltr ML20042G7211990-05-10010 May 1990 LER 90-011-00:on 900402,inadvertent Actuation of Pressurizer Pressure Low Signal Occurred While Performing Calibr Procedure.Caused by Inappropriate Action by Technician Involved.Validation of Procedures reviewed.W/900510 Ltr ML20042E6871990-04-23023 April 1990 LER 90-007-01:on 900228,determined That Several Supports Would Be Overloaded During Seismic Event on Nonsafety Related & safety-related Main Steam Piping.Caused by Design Deficiency.Piping Supports modified.W/900423 Ltr ML20042E6861990-04-23023 April 1990 LER 90-009-00:on 900316,potential Overpressurization of Auxiliary Feedwater Piping Could Have Occurred During Thermal Expansion of Process Fluid Between Closed Valved. Caused by Design deficiencies.W/900423 Ltr ML20012E7641990-03-26026 March 1990 LER 90-005-00:on 900223,determined That Spent Fuel Pool Area Charcoal Filtration Unit VA-66 Was Outside Design Basis. Caused by Insufficient Airflow Into Unit.Affected Updated SAR Analysis Will Be updated.W/900326 Ltr ML20012D0121990-03-19019 March 1990 LER 90-004-00:on 900217,lift Pressures for 6 of 10 Main Steam Safety Valves Found Outside Acceptance Criteria. Caused by Overly Restrictive Operability Criteria.Valves Recalibr & License Amend Submitted to NRC.W/900319 Ltr ML20012D0101990-03-19019 March 1990 LER 90-003-00:on 900216,determined That Auxiliary Feedwater Piping Outside Normal Stress Limits of ASME Code & Design Basis Specified in Updated Sar.Caused by Design Deficiency.Valve Operators Will Be inspected.W/900319 Ltr ML20012B6361990-03-0909 March 1990 LER 89-017-01:on 890624,internal Valve Component from Check Valve Found Lying on Pump Discharge Vane.Repair or Replacement of Valve Internals Could Not Be Accomplished within Time Requirement of Tech Spec.W/900309 Ltr ML20006E1041990-02-0909 February 1990 LER 90-001-00:on 900108,fire Barrier for Wall Between Auxiliary Bldg Rooms 26 & 34 Breached But Hourly Fire Watch Patrol Not Established.Caused by Lack of Sufficient Training for Shift Supervisors.Standing Order revised.W/900209 Ltr ML20011E2691990-02-0505 February 1990 LER 89-024-00:on 891221,determined That Containment Spray Pumps & Suction Header Piping Not Constructed for Use as Backup to LPSI Sys for Shutdown Cooling.Caused by Inadequate Review of Assumptions.Firewatch established.W/900205 Ltr ML20011E2271990-02-0101 February 1990 LER 89-021-00:on 891010,util Informed by C-E of Potential Nonconservative Setpoint in Reactor Protection Sys Thermal Margin/Low Pressure Trip Unit.Caused by Error in Incorporating Transient Setpoint analyses.W/900201 Ltr ML20005F7151990-01-10010 January 1990 LER 89-023-00:on 891211,hourly Firewatch Patrol Entered Posted High Radiation Area W/O Meeting Entry Requirements for Area.Briefings on High Radiation Entry Requirements Held for Personnel W/Assigned dosimetry.W/900110 Ltr ML19354D6381989-12-20020 December 1989 LER 89-022-00:on 890805,change to Surveillance Procedure ST-CEA-1 Became Effective Which Would Have Made Both Emergency Diesel Generators Simultaneously Inoperable During Portion of Test.Change removed.W/891220 Ltr ML19332E7431989-12-0808 December 1989 LER 88-037-01:on 881214,one of Two Supply Headers Supplying Fire Suppression Headers in Auxiliary Bldg Isolated.Caused by Lack of Procedural Guidance & Inadequate Procedural Controls.Standing Order G-58 Will Be revised.W/891208 Ltr ML19332E2681989-12-0101 December 1989 LER 89-016-02:on 890616,for Unknown Period Since 890614, Auxiliary Feedwater Pump FW-10 Operated Outside Design Basis for Certain Accident Conditions.Caused by Inoperable Speed Control Loop.Action Plan implemented.W/891201 Ltr ML19351A4541989-11-22022 November 1989 LER 89-020-00:on 891012,determined That Two of Four Component Cooling Water HXs Simultaneously Inoperable for More than 24 H.Caused by Inadequate Controls Re Return of Equipment to Svc.Standing Order revised.W/891122 Ltr ML19327B5481989-10-24024 October 1989 LER 89-019-00:on 890924,indication of High Temp for Reactor Coolant Pump RC-3A Upper Motor Thrust Bearing Received in Control Room.Caused by Damaged Cable for Bearing Resistive Temp Device.Damaged Cable replaced.W/891024 Ltr ML19325D2471989-10-13013 October 1989 LER 89-012-01:on 890502,main Feedwater Isolation Valve to Steam Generator a Found Inoperable Due to Improperly Set Torque Switch.Caused by Inadequate Program for Maint of Motor Operated Valves.Torque Switches reset.W/891013 Ltr ML20028C7711983-01-0606 January 1983 LER 82-020/03L-0:on 821207,during Main Steam Safety Valve Test,Four Main Steam Safety Valves Had Lift Setpoints Out of Tolerance.Caused by Normal Drift of Valves Over Operating Cycle.Valves Readjusted ML20028B5451982-10-28028 October 1982 LER 82-019/03L-0:on 821024,MSIVs HCV-1041A & HCV-1042A Stopped Three to Four Degrees Off Seat When Signaled to Close.Caused by Binding Between Valve Packing & Shaft. Packings Sprayed W/Penetrant Oil ML20052J0631982-04-27027 April 1982 LER 82-009/03L-0:on 820411,while Exchanging Component Cooling Water Heat Exchangers,Associated Outlet Valves HCV-490B,HCV-491B & HCV-492B Failed to Open.Cause Not stated.HCV-491B Reassembled & Tested ML20052B2361982-04-0707 April 1982 LER 82-006/03L-0:on 820323,during Surveillance Test ST-ISI- WD-1,F.1,valve HCV-506A Failed to Close Via Control Room Switch.Caused by Solenoid Valve Malfunction.Solenoid Valve Disassembled,Cleaned & Reassembled ML20052D9291982-04-0606 April 1982 LER 82-008/03L-0:on 820330,during Performance of ST-FW-1, F.2(b)(6)per Tech Spec 3.9,steam Driven Auxiliary Feedwater Pump Failed to Start.Caused by Back Pressure Trip Lever in Tripped Position.Lever Reset ML20041G1291982-02-22022 February 1982 LER 82-005/03L-0:on 820210,at 98% Power,Control Element 24 Inserted Into Core.Emergency Procedure EP-13,CEDM Malfunctions,Implemented & Power Stabilized at 88%.Caused by Erroneous Operating Instruction.Instruction Changed ML20041F7481982-02-17017 February 1982 LER 82-003/03L-0:on 820203,containment Isolation Valve Associated W/Gas Vent Header HCV-507A Failed to Close on Demand.Caused by Solenoid Valve Plunger Sticking in Energized Position.Plunger Freed ML20041F6251982-02-0505 February 1982 LER 82-004/03L-0:on 820203,small Quantity of Radioactive Gas/Particulate Released to Auxiliary Bldg During Routine Operation.Caused by Failure of Stack Gas Monitor RM-062 to Alarm at Appropriate Setpoint Due to Faulty Alarm Module ML20041B1051982-01-28028 January 1982 LER 82-002/03L-0:on 820114,at 99% Power,Lockout Relay 86B1, Containment Radiation High Signal,Failed to Actuate on Demand by Plant Radiation Monitoring Sys.Caused by Burnt Coil on Lockout Relay.Coil Replaced & Tested Satisfactorily ML20041B1171982-01-19019 January 1982 LER 82-001/03L-0:on 820111,during Normal Operation,Two Fire Barrier Penetrations Found Nonfunctional.Shift Supervisor Immediately Notified;However,Fire Watch Not Posted.Insp & Supervisor Personnel Instructed on Proper Actions ML20039B4561981-12-11011 December 1981 LER 81-011/03L-0:on 811113,containment Isolation Valves Opened & Ventilation Process Initiated W/Containment Air Monitor RM-050/051 Inoperable.Caused by Personnel Error. Valves Closed ML20010H8581981-08-27027 August 1981 LER 81-008/03L-0:on 810813,86B/CRHS (Containment Radiation High Signal) Lockout Relay Failed to Actuate When RM-062 Was Placed in Alarm,Resulting in Failure of 86B1/CRHS Relay to Actuate.Caused by Dirt in Relay Latching Mechanism ML20041F6291981-08-27027 August 1981 LER 81-008/03L-1:on 810813,containment Radiation High Signal 86B Lockout Relay Failed to Actuate When Radiation Monitor RM-062 Placed in Alarm.Caused by Bound Relay Latching Mechanism Due to Dirt & Grease.Latch Cleaned ML20010C2271981-07-0707 July 1981 LER 81-006/03L-0:on 810624,reactor Protection Sys Nuclear Power Recorder Channel B Trip Setpoints Determined to Be Nonconservative.Caused by Faulty Temp Change Power Calculation Due to Grounded Hot Leg Temp Loop ML20004B1111981-05-0606 May 1981 LER 81-005/03L-0:on 810423,dc Sequencer Timers AC-3A (Component Cooling Water Pump) & AC-102A (Raw Water Pump) Failed to Time Out within Prescribed Limit.Cause Unknown Mechanisms Satisfactorily Inspected 1993-07-30
[Table view] Category:TEXT-SAFETY REPORT
MONTHYEARML20217B5401999-10-0606 October 1999 Safety Evaluation Supporting Amend 193 to License DPR-40 ML20217A9931999-09-30030 September 1999 NRC Regulatory Assessment & Oversight Pilot Program, Performance Indicator Data LIC-99-0096, Monthly Operating Rept for Sept 1999 for Fcs,Unit 1.With1999-09-30030 September 1999 Monthly Operating Rept for Sept 1999 for Fcs,Unit 1.With ML20211J9321999-09-0202 September 1999 Safety Evaluation Concluding That Licensee Proposed Alternatives Provide Acceptable Level of Quality & Safety. Proposed Alternatives Authorized for Remainder of Third ten- Yr ISI Interval for Fort Calhoun Station,Unit 1 LIC-99-0084, Monthly Operating Rept for Aug 1999 for Fort Calhoun Station.With1999-08-31031 August 1999 Monthly Operating Rept for Aug 1999 for Fort Calhoun Station.With ML20216E6431999-08-26026 August 1999 Rev 19 to TDB-VI, COLR for FCS Unit 1 ML20210R1961999-07-31031 July 1999 Monthly Operating Rept for July 1999 for Fcs,Unit 1 ML20210G2181999-07-27027 July 1999 Safety Evaluation Supporting Amend 192 to License DPR-40 ML20210D9951999-07-22022 July 1999 Safety Evaluation Supporting Amend 191 to License DPR-40 ML20216E6361999-07-21021 July 1999 Rev 18 to TDB-VI, COLR for FCS Unit 1 ML20210R2081999-06-30030 June 1999 Revised Monthly Operating Rept for June 1999 for Fcs,Unit 1 LIC-99-0065, Monthly Operating Rept for June 1999 for Fort Calhoun Station,Unit 1.With1999-06-30030 June 1999 Monthly Operating Rept for June 1999 for Fort Calhoun Station,Unit 1.With ML20196H8621999-06-30030 June 1999 NRC Regulatory Assessment & Oversight Pilot Program, Performance Indicator Data, June 1999 Rept ML20210P5461999-06-0808 June 1999 Rev 0,Vols 1-5 of Fort Calhoun Station 1999 Emergency Preparedness Exercise Manual, to Be Conducted on 990810. Pages 2-20 & 2-40 in Vol 2 & Page 4-1 in Vol 4 of Incoming Submittal Not Included ML20195B4581999-05-31031 May 1999 Rev 3 to CE NPSD-683, Development of RCS Pressure & Temp Limits Rept for Removal of P-T Limits & LTOP Requirements from Ts ML20207H7401999-05-31031 May 1999 Performance Indicators Rept for May 1999 LIC-99-0053, Monthly Operating Rept for May 1999 for Fort Calhoun Station,Unit 11999-05-31031 May 1999 Monthly Operating Rept for May 1999 for Fort Calhoun Station,Unit 1 ML20195B4521999-05-17017 May 1999 Technical Data Book TDB-IX, RCS Pressure - Temp Limits Rept (Ptlr) ML20206L4241999-05-10010 May 1999 Safety Evaluation Supporting Corrective Actions to Ensure That Valves Are Capable of Performing Intended Safety Functions & OPPD Adequately Addressed Requested Actions Discussed in GL 95-07 ML20206M2601999-05-0606 May 1999 SER Concluding That Licensee IPEEE Complete Re Info Requested by Suppl 4 to GL 88-20 & IPEEE Results Reasonable Given FCS Design,Operation & History LIC-99-0047, Monthly Operating Rept for Apr 1999 for Fort Calhoun Station Unit 1.With1999-04-30030 April 1999 Monthly Operating Rept for Apr 1999 for Fort Calhoun Station Unit 1.With ML20195E8621999-04-30030 April 1999 Performance Indicators, for Apr 1999 ML20205Q5831999-04-15015 April 1999 Safety Evaluation Supporting Amend 190 to License DPR-40 ML20210J4331999-03-31031 March 1999 Changes,Tests, & Experiments Carried Out Without Prior Commission Approval for Period 981101-990331.With USAR Changes Other than Those Resulting from 10CFR50.59 ML20206G2641999-03-31031 March 1999 Performance Indicators Rept for Mar 1999 LIC-99-0034, Monthly Operating Rept for Mar 1999 for Fcs,Unit 1.With1999-03-31031 March 1999 Monthly Operating Rept for Mar 1999 for Fcs,Unit 1.With ML20205J8181999-02-28028 February 1999 Performance Indicators, for Feb 1999 LIC-99-0025, Monthly Operating Rept for Feb 1999 for Fort Calhoun Station,Unit 1.With1999-02-28028 February 1999 Monthly Operating Rept for Feb 1999 for Fort Calhoun Station,Unit 1.With ML20207F3291999-01-31031 January 1999 FCS Performance Indicators for Jan 1999 ML20203B0991998-12-31031 December 1998 Performance Indicators for Dec 1998 LIC-99-0026, 1998 Omaha Public Power District Annual Rept. with1998-12-31031 December 1998 1998 Omaha Public Power District Annual Rept. with LIC-99-0003, Monthly Operating Rept for Dec 1998 for Fort Calhoun Station.With1998-12-31031 December 1998 Monthly Operating Rept for Dec 1998 for Fort Calhoun Station.With ML20198S3771998-12-31031 December 1998 Safety Evaluation Supporting Amend 189 to License DPR-40 ML20198S4831998-12-31031 December 1998 Safety Evaluation Supporting Amend 188 to License DPR-40 ML20196G2251998-12-18018 December 1998 Rev 2 to EA-FC-90-082, Potential Over-Pressurization of Containment Penetration Piping Following Main Steam Line Break in Containment ML20198M3141998-11-30030 November 1998 Performance Indicators Rept for Nov 1998 LIC-98-0172, Monthly Operating Rept for Nov 1998 for Fort Calhoun Station,Unit 1.With1998-11-30030 November 1998 Monthly Operating Rept for Nov 1998 for Fort Calhoun Station,Unit 1.With LIC-98-0160, Special Rept:On 981113,MSL RM RM-064 Was Declared Inoperable Due to Leakage Past Isolation Valve HCV-922.Troubleshooting Has Indicated That Leakage Has Stopped & Cause of Leak Continues to Be Investigated1998-11-25025 November 1998 Special Rept:On 981113,MSL RM RM-064 Was Declared Inoperable Due to Leakage Past Isolation Valve HCV-922.Troubleshooting Has Indicated That Leakage Has Stopped & Cause of Leak Continues to Be Investigated ML20203B0721998-11-16016 November 1998 Rev 6 to HI-92828, Licensing Rept for Spent Fuel Storage Capacity Expansion ML20196E4981998-10-31031 October 1998 Performance Indicators Rept for Oct 1998 ML20196G2441998-10-31031 October 1998 Changes,Tests & Experiments Carried Out Without Prior Commission Approval. with USAR Changes Other than Those Resulting from 10CFR50.59 LIC-98-0154, Monthly Operating Rept for Oct 1998 for Fort Calhoun Station,Unit 1.With1998-10-31031 October 1998 Monthly Operating Rept for Oct 1998 for Fort Calhoun Station,Unit 1.With ML20154M4881998-10-19019 October 1998 Safety Evaluation Supporting Amend 186 to License DPR-40 ML20154N2411998-10-19019 October 1998 Safety Evaluation Supporting Amend 187 to License DPR-40 LIC-98-0136, Monthly Operating Rept for Sept 1998 for Fort Calhoun Station,Unit 1.With1998-09-30030 September 1998 Monthly Operating Rept for Sept 1998 for Fort Calhoun Station,Unit 1.With ML20155G4261998-09-30030 September 1998 Performance Indicators for Sept 1998 ML20154A1251998-08-31031 August 1998 Performance Indicators, Rept for Aug 1998 LIC-98-0122, Monthly Operating Rept for Aug 1998 for Fort Calhoun Station Unit 1.With1998-08-31031 August 1998 Monthly Operating Rept for Aug 1998 for Fort Calhoun Station Unit 1.With ML20238F7231998-08-17017 August 1998 Owner'S Rept for Isis ML18066A2771998-08-13013 August 1998 Part 21 Rept Re Deficiency in CE Current Screening Methodology for Determining Limiting Fuel Assembly for Detailed PWR thermal-hydraulic Sa.Evaluations Were Performed for Affected Plants to Determine Effect of Deficiency 1999-09-30
[Table view] |
Text
- - - .
i Omaha Public Power District P.O. Box 399 livy.75 Northof Pt.Calhoun Fort Calhoun. NE 68023-0399 402/636-2000 ,
l l
July 12, 1993 l LIC-93-0175 '
1 U. S. Nuclear Regulatory Commission ;
Attn: Document Control Desk !
Mail Station P1-137 Washington, DC 20555
Reference:
Docket No. 50-285 Gentlemen:
Subject:
Licensee Event Report 93-010 for the Fort Calhoun Station Please find attached Licensee Event Report 93-010 dated July 12, 1993. This ,
report is being submitted pursuant to 10 CFR 50.73(a)(2)(i)(B). If you should '
have any questions, please contact.me.
Sincerely,
$V. N.
W. G. Gates Vice President WGG/jrg Attachment c: J. L. Milhoan, NRC Regional Administrator, Region IV S. D. Bloom, NRC Project Manager R. P. Mullikin, NRC Senior Resident Inspector INPO Records Center l
150006 ,
I l
4s sm 9307200021 930712 PDR ADOCK 05000285 f5
,y 2 l-g PDR w (,
L_
l NRC FORM 366 U.S. NUCLEAR REGULATORY COMMISSION APPROtfED BY OMB NO. 3150 olo4 e o2) EXPlRES 5/31/95 ESTIMATED BURDEN PER RESPONSE TO COMPLY WITH THIS I LICENSEE EVENT REPORT (LER) g h*gNURD% $ ATE O IN R g ;
AND RECORDS MANAGEMENT BRANCH (MNB0 7714), U.S. NUCLEAR REGULATORY COMMISSION. WASHINGTON, DC 20555 0001, AND TO (See reverse for required number of digits / characters for each block) ME D UDG WAS G ON, FAOLITY MME (1) DOCKET NUMBER p) PAGE p)
Fort Calhoun Station Unit No. 1 05000285 1 OF 4 Tms m Failure to Address Low Halon Tank Pressure Following Surveillance Test EVENT DATE (5) LER NUMBER (6) REPORT NUMBER (7) OTHER FACIUTIES INVOLVED (8)
MONTH DAY YEAR YEAR MONTH DAY YEAR NUMBER NUMBER 05000 F ACluTY NAME DOCKET NUMBER 06 11 93 93 --
010 --
00 07 12 93 05000 OPERATING THIS REPORT IS SUBMITTED PURSUANT TO THE REOUIREMENTS OF 10 CFR s: (Check one or more) (11)
MODE (9)
I 20.402(b) 20.405(c) 50.73(a)(2)(lv) 73.71(b)
POWER 2 A 5 anu m er ny m7 (ax2xo 73.7m 100 20.405(a)(1)(ii) 50.36(c)(2) 50.73(a)(2)(vii) OTHER LEVEL (10)
X 50.73(a)(2)(viii)(A) (SpecRyin Abstract 20.405(a)(1)(lii) 50.73(a)(2)(i) 20.405(a)(1)(iv) 50.73fa)(2)(ii) 50.73(a)(2)(vill)(B) p[N) 20.405(a)(1)(v) 50.73(a)(2)(iii) 50.73(a)(2)(x)
UCENSEE CONTACT FOR THIS ER (12)
NAME TELEPHONE NUMBER pnclude Area Code)
Kevin R. Boston, Shift Technical Advisor _(402)533-6477 COMPLETE ONE UNE FOR EACH COMPONENT FAIL 1JRE DESCRIBED IN THIS REPORT (13)
CAUSE SYSTEM COMPONENT MANUFACTURER T N RDS CAUSE SYSTEM COMPONENT MANUFACTURER RS M NTH DAY YEAR SUPPLEMENTAL REPORT EXPECTED (14) EXPECTED yt3 SUBMISSION or yeo, complete EXPECTED SUDM SSION DATE) X W DATE (15) fBSTRACT (Umit to 1400 spaces, l.a., approximately 15 single 4 paced typewritten lines) (16)
On June 11, 1993, during performance of Surveillance Test GM-ST-FP-0005, " Semi-Annual Switchgear Rooms Halon Cylinders Weight and Pressure Test", one of the 14 Halon cylinders did not meet the minimum pressure acceptance criteria listed in the procedure.
This unacceptable pressure value was not noticed during performance of the test. After the surveillance test was completed, the Switchgear Rooms Halon system was returned to service. The unacceptable pressure value was identified during the post-performance 14, 1993. This report is being review of the submitted test bytothe pursuant 10System CFR 50.73(a Eng)ineer on June (2)(i)(B) due to the failure to satisfy Technical Specification 2.19(8)betweenJune 11, 1993 and June 14, 1993.
The causes of the event were determined to be the failure of the surveillance test to include the necessary steps to assign responsibility for verification of data for acceptability and failure to self-check / verify. ,
The Halon cylinder was recharged and retested on June 14, 1993. Additional corrective actions will include revising specified procedures to clarify responsibilities.
1 i
NRC FORM 306 p 92)
NRC FORM 366A U.S. NUCLEAR REGULATORY COMMISSION APPROVED BY OMB NO. 91504104 po2) EXPIRES 5/31/95 ESilMATED BURDEN PER RESPONSE TO COMPLY WITH THIS LICENSEE EVENT REPORT (LER) '"sTMggadouE,sg c gggg TEXT CONTINUATION gRE S MA ME B W DM ) N E
'"M=%"Eh""A sTo%.s=' "" "
M FACILffY NAME (1) DOCKET NUMBER R LER NUMDER M PAGE M SEQUENTIAL HEVISION NUMBER NUMBER Fort Calhoun Station Unit No. 1 05000285 93 --
010 -- 00 11nt pt more space is reqwred, use addinonal copies of NHC Form 3eSA) (17)
BACKGROUND Fort Calhran Station (FCS) Technical Specification (TS) 2.19(8) requires the Control Room, Switchgear Rooms and Cable Spreading Room Halon storage tanks to have at least 90%
of full charge pressure and 95% of full charge weight or level. To demonstrate operability, TS 3.15(8) requires verification of each Halon storage tank pressure and weight or level at least once every 6 months. If the Halon system is determined to be inoperable, a continuous fire watch with backup fire suppression equipment is to be established.
EVENT DESCRIPTION On June 11, 1993, with FCS at 100% power (Mode 1), Surveillance Test GM-ST-FP-0005,
" Semi-Annual Switchgear Rooms Halon Cylinders Weight and Pressure Test," was to be performed to verify operability of the Switchgear Rooms Halon system. This procedure directs the initiation of a Fire Protection Impairment Permit (FPIP) for the Switchgear Rooms prior to its performance. The FPlP for the Switchgear Rooms requires a continuous fire watch.
For each Halon cylinder, GM-ST-FP-0005 requires that the Halon cylinder be disconnected, placed on a scale to determine its weight, a surface thermometer applied to measure the cylinder temperature, the cylinder pressure read from an installed gauge, and the cylinder reinstalled. The data collected is recorded on data sheets within the rocedure.
p(QC) person is required to obtain the test data for each tank.A Thecraftsperson procedure requiresremoves and reconnects that all anomalies and deficiencies identified during the test be reported to the immediate supervisor and Shift Supervisor, and noted on the comment sheet for the test.
The minimum acceptable weight for each cylinder is listed on the cylinder's data sheet.
l The cylinder temperature reading is recorded and used to determine the minimum acceptable cylinder pressures by using a temperature vs. pressure correction table within the procedure. This minimum acceptable pressure is recorded on the data sheet immediately below the recorded tank pressm ? value read from the installed gauge. The QC person is required to initial the data entries for cylinder weight, cylinder temperature and pressure, and minimum acceptable cylinder pressure.
The data recorded for Halon Storage Tank 07565EH indicated that the tank exceeded the minimum weight requirement but was below the minimum pressure specified for the measured cylinder temperature. The QC person collected the test data and signed off the data sheet steps. The unacceptable pressure test value was not identified by either the craftsperson or the QC person. Accordingly, no notifications were made, nor were comments noting the deficiency entered into the test.
Nnc rOnu seeA wo2) 8
NRC FORM 366A U.S. NUCLEAR REGULATORY COMMISSION APPROVED BY OMB NO. 315o4104
&Ba EXPIRES 5/31/95
- O CTON E R LICENSEE EVENT REPORT (LER) "
TEXT CONTINUATION NECNs MANAG MENT VC BB U S?NI RE PF E (3 50- FICE OF MANAGEMENT AND BUDGET, WASHINGTON,DC 20503.
FACILITY NAME (1) DOCXET NUMBDI R LER NUMBER M PAGE R g SEQUENTIAL HEVISION NUMBER NUMBER Fort Calhoun Station Unit No. 1 05000285 3OF4 ;
93 --
010 -- 00 '
uxre, .o.u...ooit,on.i.o,..o,NeiCFc.m3.e43cir;
. - i.,
l l
1 Following the testing of the rest of the Halon tanks for the Switchgear Rooms, Control )
Room Operators were directed by the procedure to return the Halon disconnect switch to 1 the normal position, with OC to witness the reactivation. The Shift Supervisor was then notified that testing was complete, and signed the procedure step reflecting this notification. The Halon system was returned to service on June 11, 1993 at 1459, the l FPIP was closed out, and TS 2.19(8) was cleared. The test was signed-off as complete by 1 the craftsperson and forwarded to the Craft Supervisor for review. 1 The Surveillance Test Coversheet indicates that the Craft Supervisor's review is to address whether the test results are acceptable and, if applicable, whether the test results satisfy Technical Specifications. The Craft Supervisor reviewed the test data sheets but did not notice the unacceptable results. The Craft Supervisor subsequently signed the Surveillance Test Coversheet, indicating acceptable test results.
The post-performance review of the test by the System Engineer identified the cylinder pressure deficiency on June 14, 1993 at 1202, and the Shift Supervisor was notified.
Technical Specification 2.19(8) was entered and a Fire Protection Impairment Permit was initiated. A continuous fire watch was established on June 14, 1993 at 1235.
A Maintenance Work Order (MWO) was initiated to recharge and retest the Halon tank.
Following completion of the MWO the FPIP was closed out, TS 2.19(8) cleared and the .
system declared operable on June 14, 1993 at 1858. l This report is being submitted pursuant to 10 CFR 50.73(a)(2)(i)(B) due to the failure to satisfy TS 2.19(8) between June 11, 1993 and June 14, 1993.
SAFETY ASSESSMENT The effect of this event on nuclear safety was negligible. None of the 14 Halon cylinders for the Switchgear Rooms was found to be below minimum acceptable weight.
(Cylinders contain Halon and nitrogen. Meeting minimum acceptable weight ensures sufficient Halon is available.) Only one of the 14 Halon cylinders was below its minimum acceptable pressure. The pressure recorded for storage tank #77565EH was 360 psig, while its minimum acceptable pressure was recorded as 386 psig. Although this pressure did not meet the established acceptance criteria for the recorded tem)erature, a pressure as low as approximately 200 psig is sufficient to fully discharge t1e contents of the cylinder. The event did not affect the operability of the Switchgear Rooms fire detection system. In the event of a fire, the Control Room would have been alerted to the situation by the fire detection system and the fire brigade could have ;
been dispatched to provide additional fire suppression. ;
i i
NRC FORM 3GBA (5-D4 l
.. _ _ - . ~ . . -- , .. . ~ - - . . . = = - - - _ . .
NRC FORM 306A U.S. NUCLEAR RE2ULATORY COMMIS810N APPROVED BY OMB NO. 31504104 4 82i EXPIRES 5/31/95 -
ESTIMATED DURDEN pea FESPONSE TO COMPLY WITH THIS ON U 50 "
UCENSEE EVENT REPORT (LER) g,%LCOLLE BU c 0T INF
" ""A" ^"a2 R J'C#3s"'w=Tr=",APA."=
Fw /o N 7 E Eo" E As E EN.E *,o E D " " ' "
FACRJW NAME p) 00CEET NUMBER R LER NUMBER R PAGE R BEQUENTIAL REVISION p YEAR NUMBER NUMBER Fort Calhoun Station Unit No. 1 05000285 '
4OF4 93 -- 010 -- 00 ;
Text a mo,. . ,.w.a. u .oa,iion.i .oPi ., Nrc ro,. aosA: p73 ,
I CONCLUSIONS l
A Root Cause Analysis (RCA) was performed following the identification of the failure =to address the unacceptable Halon storage tank pressure. The causes of the event were :
determined to be the failure of the surveillance test to include the necessary steps to assign responsibility for verification of data for acceptability and failure to self-check / verify. The procedure was found not to be in accordance with the procedure- ,
writers guide with respect to verification of data acceptability.-
CORRECTIVE ACTIONS r
As previously noted, the Halon cylinder was recharged and retested on June 14, 1993.
The following additional corrective actions have been or will be completed:
1.- Appropriate disciplinary action was taken. ;
- 2. Procedure GM-ST-FP-0005 and two similar procedures, GM-ST-FP-0003 and GM-ST-FP-0004, will be revised to clarify responsibilities by ,
November 8, 1993. The next scheduled performance of these tests is December '
1993.
- 3. A sample of other surveillance tests performed by Crafts will be reviewed by ,
September 15, 1993 to determine whether review of data for acceptability is-adequately addressed prior to test completion. ,
- 4. Management expectations for proper evaluation of test results will be emphasized to personnel responsible for surveillance testing by ,
September 1, 1993. ,
PREVIOUS SIMILAR EVENTS LER 92-021 discusses a previous event in which TS 2.19 requirements were not met with i respect to results of a surveillance test. However, LER 92-021 involved a broken fire !
door latch, rather than Halon cylinder acceptance criteria.
NRC FORM 38BA p4g
. - . . . . -, - -- . .-__ -.- . , , , _ , - , - - _ .