05000219/FIN-2010005-03
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Finding | |
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| Title | Failure to Implement Procedures Resulting in Reactor Scram |
| Description | A Green, self-revealing NCV of Technical Specification (TS) 6.8.1.a occurred when Exelon did not adequately implement plant startup procedures which resulted in an automatic reactor scram. lmmediate corrective actions included just in time training with all reactor operators, increased management oversight during the subsequent startup, and procedural changes to list all alarms by name that must be cleared prior to raising reactor pressure above 500 psig. Exelon is performing a full root cause evaluation on the event (lR 1 155520). The inspectors determined that the performance deficiency was similar to the not minor if\'statement contained in example 4b of IMC 0612, Appendix E, Examples of Minor lssues, because the performance issue resulted in a manual reactor scram. The finding was more than minor in accordance with IMC 0612, Appendix B, lssue Screening, because it was associated with the equipment performance attribute of the initiating events cornerstone and atfected the objective to limit the likelihood of those events that upset plant stability and challenge critical safety functions during power operation. In accordance with IMC 0609.04 (Table 4a), Phase 1 - Initial Screen and Characterization of Findings, the finding was determined to be of very low safety significance (Green) because the finding did not contribute to both the likelihood of a reactor trip and the likelihood that mitigation equipment or functions would not be available. This finding has a cross-cutting aspect in the area of human performance, work practices (H.4(b)), where personnef work practices support human performance, specifically, Exelon defines and etfectively communicates expectations regarding procedural compliance and personnel follow procedures. On December 23, operators did not verify that condenser vacuum was adequate prior to raising reactor pressure above 500 psig, contrary to established procedural guidance. |
| Site: | Oyster Creek |
|---|---|
| Report | IR 05000219/2010005 Section 4OA3 |
| Date counted | Dec 31, 2010 (2010Q4) |
| Type: | NCV: Green |
| cornerstone | Initiating Events |
| Identified by: | Self-revealing |
| Inspection Procedure: | IP 71153 |
| Inspectors (proximate) | M Modes J Kulp R Nimitz R Bellamy J Ambrosini C Newport |
| CCA | H.8, Procedure Adherence |
| INPO aspect | WP.4 |
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Finding - Oyster Creek - IR 05000219/2010005 | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Finding List (Oyster Creek) @ 2010Q4
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