ML20045E994

Responds to Violations Noted in Insp Repts 50-348/93-08 & 50-364/93-08.Corrective Actions:Breaker for DG 1B Returned to Svc within 1 Minute & on 930513,meetings Held in Each Dept to Discuss Clearance Tag Out Instructions

ML20045E994
Person / Time
Site:	Farley
Issue date:	07/02/1993
From:	Woodard J SOUTHERN NUCLEAR OPERATING CO.
To:	NRC OFFICE OF INFORMATION RESOURCES MANAGEMENT (IRM)
References
NUDOCS 9307060283
Download: ML20045E994 (4)

Text

i Southern Nach Opererg Comany Post Once Bc4 1295 Domingbarn. Abbama 35201 12'35 Tetohone 205 EGB 50')0 m

Southern Nudear Operating Company the soumem elecinc v; stem July 2,1993 Docket Nos.: 50-348 50-364 U.S. Nuclear Regulatory Commission ATTN: Document Control Desk Washington, DC 20555 Joseph M. Farley Nuclear Plant i

Reply to Notice of Violation (NCV)

NRC Inspection Report Nos. 50-348/93-08 and 50-364/93-08 Gentlemen:

This letter refers to the vio!ation as cited in the subject NRC inspection report. The violation therein states:

Technical Specification 6.8.1 requires that applicable written procedures recommended in Appendix A of Regulatory Guide (RG) 1.33, Revision 2,1978 shall be established, implemented and maintained.

Contrary to the above, on May 12, with Unit I at power, an electrician, failed to follow the specified clearance tag out instructions when he erroneously removed from service, the Unit 1 "lB" emergency diesel generator output circuit br aker rather than the specified " approved for clearance" Unit 2 "2B" cmcrgency diesel generator output circuit breaker. Prior to racking out the "IB" diesel generator circuit breaker, the electrician de-energized the DC power supply for the "lB" emergency diesel generator output circuit breaker, rendering it inoperable.

This is a Severity Level IV violation (Supplement 1).

This incident has been determined to be singular in nature and not to have programmatic implications due to the fact that multiple barriers were in place which should have reasonably prevented this event. The following barriers were in place at the time of the incident:

The System Operator who gave the individual the tagging order directed the individual to Unit 2 to tag out the 2B diesel generator output breaker.

The written tagging order given to the individual by the System Operater (in addition to his verbal instructions) was properly written and clearly identified the component to be worked as the Unit 2 2B" diesel generator output breaker.

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Nuclear Regulatrsry Commission Page 2 The label for the diesel generator output circuit breaker that was incorrectly de-energized clearly stated the correct nomenclature for a Unit I diesel generator output circuit breaker.

i At FNP it is standard practice that the color Yellow represents Unit I and the color Green is Unit 2. This applies to both the doors used to access each Unit and to the procedures used during work activities. The tagging order that was given to the individual was printed on i

green paper and had Unit 2 written on it. The individual entered the Unit I switch gear room (where the 1B diesel generator output circuit breaker is located) through a yellow l

door. This disparity between the door color and the procedure should have alerted him to the fact that he was accessing the incorrect Unit's equipment.

The area was well lighted and allowed easy reading of the tagging order and the equipment identification label.

The individual involved had been thoroughly trained on the proper execution of a tagging

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order.

The administrative procedure governing tagging orders required that the individual, " Review i

the Tagging Operations Order ensuring that he has no doubts as to the positioning of each control device and the sequence of placement of the hold tags. If the Tagging Operations Order is unclear in any aspect or if a discrepancy in positioning or placement sequence is noted, the Designated Operator will review the clearance with the Tagging Oflicial."

Despite all of the above barriers, the individual proceeded to the wrong unit and opened the Unit -

1 "IB" diesel generator output breaker. Due to the obvious performance failings of the individual involved in this event, the individual was formally disciplined.

In order to prevent this type of personnel error, FNP has introduced the STAR program. As previously described to the NRC, the STAR program emphasizes a "Stop, Think, Act, and l

Review" approach to performing any task. In this event the Review aspect of the program worked to limit the event to approximately one minute when the control room operator responded to an unexpected alarm on the 1B diesel generator and paged for the electrician. The electrician, upon hearing the page, realized he had actuated the incorrect Unit's equipment and returned it to servicc. FNP will continue to emphasize the importance of the Stop, Think, and Act portions of the program which were not correctly implemented in this event. This includes periodic nev sletters that inform personnel of potential plant events that were prevented through the use of STAR techniques, and other periodic promotional activities.

I In addition, all plant work activities were halted on May 13,1993 (the day after the incident) to stress to employees how the STAR program, if followed by the individual, would have prevented this event.

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j Nuclear Regulatory Commission Page 3 FNP has recognized that the incorporation of the STAR program into our plant culture will take some time. FNP will be working on. ways to keep the STAR program awareness level up until it becomes an established part of our culture and day-to-day business.

The SNC response to this violation is included as Attachment 1.

Confirmation I aflirm that this response is true and complete to the best of my knowledge, information, and belief. The information contained in this letter is not considered to be of a proprietary nature.

J Respectfully submitted,

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SOUTHERN NUCLEAR OPERATING COMPANY r

'(Q rdd J. D.3 oodard W

.. es6tive Vice President j

JDW/FTW/EFB

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Attachment cc:

Mr. S. D. Ebneter Mr. T. A. Reed l

Mr. G. F. Maxwell

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Admission or Denial The above violation occurred as described in the subject report.

i Reason for Violation

- 1 This violation was caused by personne I error. The individuals involved failed to pay adequate attention to the tagging order and to the breaker identification label.

Corrective Action Taken and Results Achieved i

The breaker for 1B diesel generator was returned to service within one minute.

Corrective Steps to Avoid Further Violations The following actions have been taken to prevent recurrence of this event:

j The responsible individuals were formally disciplined. On May 13,1993, meetings were held m each plant department to discuss this incident.

1 Date of Full Compliance June 22,1993 t

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