05000255/FIN-2012002-03
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Finding | |
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| Title | |
| Description | A self-revealed finding of very low safety significance and associated NCV of Technical Specification (TS) 5.4.1, Procedures, was identified for the failure to adequately implement the fuse control procedure during the reinstallation of a safety-related fuse after maintenance. Specifically, insufficient contact was established between a fuse holder clip and fuse ferrule for safety-related fuse FUZ/Y1014-2, resulting in the opening of the A Feedwater Pump Recirculation valve, CV-0711 at full power. This induced a feed transient which required operators to manually trip the reactor. The licensee took compensatory actions to ensure the valve was isolated prior to the return to full power operation. The licensee also entered the issue in their CAP as CR-PLP-2012-02182 to further evaluate the conditions of the procedural guidance implementation, procedural disconnects, application of loose fuse operating experience, and the extent of condition for other safety-related fuses. The finding was determined to be greater than minor in accordance with IMC 0612 Appendix B, Issue Screening, because it is associated with the Initiating Events cornerstone attribute of Equipment Performance and adversely impacted the objective to limit the likelihood of those events that upset plant stability and challenge critical safety functions during power operations. Specifically, the cause of the feedwater transient which led to a plant trip on December 14, 2011 was intermittent electrical contact between FUZ/Y1014-2 and its holder clip. The finding screened as Green in the Initiating Events cornerstone by answering no to the Transient Initiator question of contributing to both the likelihood of a reactor trip and the likelihood that mitigating equipment or functions would not be available. The finding had a cross-cutting aspect in the area of problem identification and resolution related to the cross-cutting component of operating experience, in that the licensee implements and institutionalizes operating experience through changes to station processes, procedures, equipment, and training program. In this finding, the issue of loose fuses, potential causes of these loose fuses, and the potential plant effects this could cause have been identified in externally generated operated experience as well as Palisades own operating experience from a loose fuse on a safety-related component in 2011. Therefore, the inspectors determined this issue was reflective of current performance, and the inspectors determined that lessons learned from these identified loose fuse issues were not extensively reviewed for applicability throughout systems in the plant and were not fully institutionalized to prevent these issues from recurring. |
| Site: | Palisades  |
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| Report | IR 05000255/2012002 Section 1R12 |
| Date counted | Mar 31, 2012 (2012Q1) |
| Type: | NCV: Green |
| cornerstone | Initiating Events |
| Identified by: | Self-revealing |
| Inspection Procedure: | IP 71111.12 |
| Inspectors (proximate) | C Zoia A Dahbur D Szwarc M Bielby J Ellegood K Walton D Betancourt T Taylor A Scarbeary |
| CCA | P.5, Operating Experience |
| INPO aspect | CL.1 |
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Finding - Palisades - IR 05000255/2012002 | ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
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Finding List (Palisades) @ 2012Q1
Self-Identified List (Palisades)
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