05000498/FIN-2017002-01
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Finding | |
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| Title | Failure to Establish Procedures to Remove Reactor Vessel Head Vent Rig Results In Loss of Reactor Coolant System Inventory |
| Description | Green . The inspectors documented a self -revealed, non -cited violation of Technical Specification 6.8.1.a, Regulatory Guide 1.33, Revision 2, February 1978, Appendix A, Section 9.d.(4). Specifically, inadequate written work instructions to remove the reactor vessel head vent rig and install a breathable foreign material exclusion cover resulted in installing a blind flange and a loss of reactor coolant system water while at lowered inventory. The licensee developed proper instructions and the blind flange was promptly removed to restore the vent path for the reactor vessel head. Reactor coolant system inventory was restored. This issue was entered into the licensees corrective action program as Condition Report 2017- 13155. The failure of the licensee to provide appropriate written work instructions to install a breathable foreign material exclusion cover following the removal of the reactor vessel head vent rig was a performance deficiency. The performance deficiency is more than minor because it was associated with the configuration control attribute of the Initiating Events Cornerstone and adversely affected the cornerstone objective to limit the likelihood of events that upset plant stability and challenge critical safety functions during shutdown as well as power operations. Specifically, the licensee installed a blind flange, instead of a breathable foreign material exclusion cover on the reactor vessel head vent piping, which resulted in an inadvertent loss of reactor coolant during lowered inventory operations. Using Inspection Manual Chapter 0609, Appendix G, Shutdown Operations Significance Determination Process, dated May 9, 2014, Attachment 1, Exhibit 2, Initiating Events Screening Questions, the finding was determined to be of very low safety significance (Green) because the finding would not have resulted in a loss of decay heat removal if undetected for 24 hours2.777778e-4 days <br />0.00667 hours <br />3.968254e-5 weeks <br />9.132e-6 months <br />, AND was determined to be self -limiting because level would have only lowered to the point at which it would have vented to the pressurizer and not lowered to the point of challenging decay heat removal function. The inspectors determined that the finding had a cross -cutting aspect in the area of human performance associated with work management. The licensee failed to implement an adequate process to execute work activities such that nuclear safety is the overriding priority. Specifically, contractors were supplied generic work instructions to remove the reactor coolant system head vent rig which resulted in a loss of reactor coolant system inventory [H.5]. |
| Site: | South Texas  |
|---|---|
| Report | IR 05000498/2017002 Section 1R20 |
| Date counted | Jun 30, 2017 (2017Q2) |
| Type: | NCV: Green |
| cornerstone | Initiating Events |
| Identified by: | Self-revealing |
| Inspection Procedure: | IP 71111.2 |
| Inspectors (proximate) | A Sanchez N Hernandez I Anchando J Braisted W Cullum N Okonkwo C Smith |
| Violation of: | Technical Specification |
| CCA | H.5, Work Management |
| INPO aspect | WP.1 |
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Finding - South Texas - IR 05000498/2017002 | |||||||||||||||||||||||||||||||||||||||||||||||
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Finding List (South Texas) @ 2017Q2
Self-Identified List (South Texas)
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