IR 05000263/2008008
Download: ML083330412
Text
November 28, 2008
Mr. Timothy Site Vice President Monticello Nuclear Generating Plant Northern States Power Company, Minnesota 2807 West County Road 75 Monticello, MN 55362-9637
SUBJECT: MONTICELLO NUCLEAR GENERATING PLANT PROBLEM IDENTIFICATION AND RESOLUTION INSPECTION REPORT 05000263/2008008
Dear Mr. O'Connor:
On November 7, 2008, the U.S. Nuclear Regulatory Commission (NRC) completed a Problem Identification and Resolution (PI&R) inspection at your Monticello Nuclear Generating Plant.
The enclosed report documents the inspection results, which were discussed on November 7, 2008, with you and other members of your staff. The inspection examined activities conducted under your license as they relate to safety and compliance with the Commission's rules and regulations and with the conditions of your license. The inspectors reviewed selected procedures and records, observed activities, and interviewed personnel. The inspection concluded that your staff was effective at identifying problems and incorporating them into the corrective action program. In general, issues were appropriately prioritized, evaluated, and corrected, audits and self-assessments were thorough and probing, and operating experience was appropriately screened and disseminated. Your staff was aware of the importance of having a strong safety-conscious work environment and expressed a willingness to raise safety issues.
However, your staff not always effective in ensuring that issues, once identified, were properly resolved. The inspectors identified an apparent lack of sensitivity to internal corrective action program performance indicators, examples of inadequate documentation of issues, and inadequate oversight of the Differing Professional Opinions program to ensure that Issues were appropriately addressed and tracked. These were recurring problems, as they had been previously identified during the 2006 PI&R inspection. The inspectors also observed that despite having had several opportunities, your staff had not taken appropriate actions to correct an adverse trend in Human Performance, which had begun in late 2006. Based on the results of this inspection, two NRC-identified findings of very low safety significance were identified. The findings involved violations of NRC requirements. However, because of their very low safety significance, and because the issues were entered into your corrective action program, the NRC is treating the issues as Non-Cited Violations (NCVs) in accordance with Section VI.A.1 of the NRC Enforcement Policy. If you contest the subject or severity of a NCV, you should provide a response within 30 days of the date of this inspection report, with the basis for your denial, to the U.S. Nuclear Regulatory Commission, ATTN: Document Control Desk, Washington, DC 20555-0001, with a copy to the Regional Administrator, U.S. Nuclear Regulatory Commission - Region III, 2443 Warrenville Road, Suite 210, Lisle, IL 60532-4352; the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, Washington, DC 20555-0001; and the Resident Inspector Office at the Monticello Station. In accordance with 10 CFR 2.390 of the NRC's "Rules of Practice," a copy of this letter and its enclosure will be made available electronically for public inspection in the NRC Public Document Room or from the Publicly Available Records (PARS) component of NRC's document system (ADAMS), accessible from the NRC Web site at http://www.nrc.gov/reading-rm/adams.html (the Public Electronic Reading Room).
Sincerely,/RA by N. Shah, Acting For / Kenneth Riemer, Chief Branch 2 Division of Reactor Projects Docket No. 50-263 License No. DPR-22
Enclosure:
Inspection Report 05000263/2008008
w/Attachment:
Supplemental Information DISTRIBUTION: See next page Letter to
SUMMARY OF FINDINGS
.........................................................................................................1
REPORT DETAILS
.....................................................................................................................3
OTHER ACTIVITIES
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4OA2 Problem Identification and Resolution
................................................3 4OA6 Management Meetings....................................................................................12
SUPPLEMENTAL INFORMATION
KEY POINTS OF CONTACT
..................................................................................................1
LIST OF ITEMS
OPENED, CLOSED AND DISCUSSED........................................................1
LIST OF DOCUMENTS REVIEWED
.......................................................................................2
LIST OF ACRONYMS
- US [[]]
ED................................................................................................16
Enclosure
- OF [[]]
- FINDIN [[]]
GS IR 05000263/208008; (October 20, 2008 - November 7, 2008), Monticello Nuclear Generating Station; Biennial Baseline Inspection of the Identification and Resolution of Problems. This team inspection was performed by three regional inspectors and the senior resident inspector. Two findings of very low safety significance (Green) were identified during this
inspection. Each of the findings was classified as a
- NCV. The significance of most findings is indicated by their color (Green, White, Yellow, Red) using
- NRC =s program for overseeing the safe operation of commercial nuclear power reactors is described in
NUREG-1649, AReactor Oversight Process,@ Revision 4, dated December 2006.
Identification and Resolution of Problems The licensee was effective at identifying problems and incorporating them into the corrective action program (CAP). In general, issues were appropriately prioritized, evaluated, and
corrected. Licensee audits and self-assessments were generally thorough, probing, and made good use of outside resources to maintain independence. Operating Experience (OE) was appropriately screened and disseminated and was considered as a potential precursor during cause evaluations. Plant staff was aware of the importance of having a strong safety-conscious work environment (SCWE) and expressed a willingness to raise safety issues. No one
interviewed had experienced retaliation for safety issues raised, or knew of anyone who had failed to raise issues. All persons interviewed had an adequate knowledge of the
- ECP ). However, the inspectors identified several concerns that were similar to those noted during prior
CAP performance indicators, in that some of these indicators, which showed potential deficiencies in the program, had not been evaluated. There were also continued concerns with the proper documentation of issues. Specifically, the inspectors found several examples where the documentation of an issue was insufficient to verify whether it had been appropriately evaluated or resolved. There were also continued problems with the handling of issues identified through the licensee's Differing Professional Opinion (DPO) process. The inspectors also observed that the station
had not taken appropriate corrective action to address an adverse trend in Human Performance. There were two Green findings identified during this inspection. One finding was for failing to properly identify and evaluate a Maintenance Rule Functional Failure associated with the High Pressure Coolant Injection (HPCI) system. The second finding was for failing to capture a
Conditions Adverse to Quality (CAQ) in the
- A. [[]]
- XVI , "Corrective Action," for the failure to identify a Condition Adverse to Quality (CAQ). Specifically, the licensee did not identify a maintenance preventable functional failure (MPFF) associated with the
AI-611) during the 2007 refueling
Enclosure outage. The failure was caused by debris that was lodged in the valve seat. Of particular significance, was the fact that the issue was the subject of three licensee-initiated action requests (ARs) between March 2007 to February 2008, regarding the test failure, the failure to evaluate past-operability and the failure to evaluate the maintenance rule aspects, none of which properly evaluated the issue. The licensee identified the
NRC inspector questioned the adequacy of the
previous evaluations, in particular, why the source of the debris had never been evaluated. This finding also has an associated cross-cutting aspect associated in the area of
- IST [[failure. [P.1(C)] The finding is more than minor because it affects the Equipment Performance attribute of the Mitigating Systems Cornerstone objective to ensure the availability, reliability, and capability of systems that respond to initiating events to prevent undesirable consequences. The finding is of very low safety significance, because the]]
CFR Part 50, Appendix B, Criterion V, "Instructions, Procedures, and Drawings," for the failure to identify and correct a Condition Adverse to Quality (CAQ). Specifically, the licensee failed to capture in the CAP a concern with the potential corrosion of magnesium motor rotor fan blades
associated with safety-related motor operated valves (MOVs). The
- MOV s were associated with the reactor recirculation and residual heat removal (specifically the low pressure core injection mode) systems. The concern was identified during an internal licensee review of
CAP process to ensure that the CAQ had been
properly evaluated and corrected. This finding has an associated cross-cutting aspect associated in the area of
CAQ on the affected, safety-related MOVs. [P.1(C)] The finding is more than minor because it directly affected the Human Performance attribute of the Initiating Events Cornerstone objective to limit the likelihood of events
that upset plant stability and challenge critical safety functions while at power. The finding also directly affected the Equipment Performance attribute of the Mitigating System Cornerstone objective of ensuring the availability, reliability and capability of systems that respond to initiating events to prevent undesirable consequences (i.e., core damage). The finding is of very low safety significance, because the issue
only involved the potential degradation, but not the actual loss of a plant component (i.e., there was no actual initiating event nor loss of a mitigating system). (Section 4OA2.2) B. Licensee-Identified Violations No violations of significance were identified.
Enclosure
- REPORT [[]]
- OTHER [[]]
- PI&R ) (71152B) The activities documented in sections .1 through .4 constituted one biennial sample of
- IP 71152. .1 Assessment of the Corrective Action Program (CAP) Effectiveness a. Inspection Scope The inspectors reviewed the licensee's
- NRC [[]]
PI&R inspection in November 2006. The selection of issues ensured an
adequate review of issues across the
- NRC generic communications, department self-assessments, licensee audits, operating experience reports, and
- AR s generated as a result of facility personnel's performance in daily plant activities. In addition, the inspectors reviewed
- AR [[s and a selection of completed investigations from the licensee's various investigation methods, including root, apparent and common cause evaluations. The inspectors performed a more extensive review of station efforts to resolve high temperature concerns with the number 12 reactor feedwater pump and for managing aging/obsolete equipment. This review consisted primarily of a five year search of related issues identified in the]]
- CAP and discussions with appropriate licensee staff to assess the licensee's efforts in address the above equipment concerns. During the reviews, the inspectors evaluated whether the licensee staff's actions were in compliance with the facility's
CFR Part 50, Appendix B requirements. Specifically, the inspectors evaluated if licensee personnel were identifying plant issues at the proper threshold, entering the plant issues into the station's CAP in a timely manner, and assigning the appropriate prioritization for resolution of the issues. The
inspectors also evaluated whether the licensee staff assigned the appropriate investigation method to ensure the proper determination of root, apparent, and contributing causes. The inspectors also evaluated the timeliness and effectiveness of corrective actions for selected issue reports, completed investigations, and
NCVs. b. Assessment (1) Effectiveness of Problem Identification In general, the inspectors considered the licensee's identification of equipment deficiencies to be good. Workers were encouraged to identify issues and were familiar with the various avenues available (NRC, CAP, etc). This was evident by the large
number of ARs generated annually, which were reasonably distributed across the
Enclosure various departments. A shared computerized database was used for creating individual reports and for subsequent management of the processes of issue evaluation and response. This included determining the issue's significance, addressing such matters as regulatory compliance and reporting, and assigning any actions deemed necessary or appropriate.
However, the inspectors identified a continued lack of sensitivity with the licensee's evaluation of some of the internal performance indicators monitoring the
CAP action items that were open greater than 90, 120 or 180 days. Normally the
licensee expects
- CAP [[actions to be completed within 90 days, however, the indicator showed that about 40 percent of the open items had exceeded this goal as of August 2008. The inspectors noted that there was no explanation or evaluation of why this had occurred or whether this result was acceptable. The inspectors also identified other indicators having similar issues. The licensee documented this issue in]]
The licensee was generally effective at identifying and resolving trends. This was apparent by the large number of trend
- AR s generated either through "binning" of issues or through evaluation via the quarterly department roll-up meeting (
DRUM) reports. However, the inspectors noted that the licensee's trending program was somewhat limited in that it did not always identify trends involving issues affecting the same
functional area, but having dissimilar aspects. The inspectors noted that the licensee had reached a similar conclusion in a recent self-assessment and had generated AR 1129683 to address this concern. For example, the inspectors noted that the licensee had been slow to identify an adverse
trend in human performance. Since late 2006, the plant has experienced numerous issues in this area. These issues were primarily of low significance and did not result in
- NRC findings. These issues continued through 2007 and 2008, with the significance of the findings increasing, until a sufficient number of
NRC findings had accrued (around mid-2008) that an adverse trend in human performance had become evident.
The inspectors noted that the licensee's trending program had identified trends having multiple issues in the same human performance aspect (such as procedural adherence), but was less effective at identifying trends having multiple issues crossing over several aspects (such as procedural adherence, work coordination, training, etc). This limitation
resulted in the licensee believing that the human performance issues were limited to specific behaviors or work groups, instead of recognizing that it was a more widespread concern involving fundamental human behaviors. During the
- NRC [[]]
PI&R inspection, the licensee was in the process of completing a self-assessment of human performance. Although the results had not yet been entered into the CAP, they were discussed with the inspectors and during a Management
Review Committee meeting held on October 22, 2008. The licensee identified that the CAP trending program had been ineffective at identifying the human performance trend and that the issues were principally due to a lack of resources and an inappropriate tolerance for risk among workers. The inspectors concluded that while the licensee had achieved a better understanding of the human performance issue, more effort was
needed to understand the reasons behind the underlying causes.
Enclosure Findings No findings of significance were identified. (2) Effectiveness of Prioritization and Evaluation of Issues The inspectors attended several daily CAP screening meetings and observed that issues were being appropriately screened and challenged. The majority of issues were of low level and were either closed to trend or at a level appropriate for a condition evaluation.
Many of these issues were closed to a work request or to another
- AR [[, but the inspectors noted that both the parent and daughter documents had the necessary verbiage to document the interrelationship. Although fewer in number, the inspectors did not have any concerns with those issues assigned an apparent cause evaluation (]]
ACE) or root cause evaluation. There were no items in the operations, engineering, or maintenance
backlogs that were risk significant, individually or collectively. There were no classifications or immediate operability determinations with which the inspectors disagreed. The inspectors noted that while root cause evaluations were generally of good quality, there continued to be problems with the quality of documentation of
PI&R inspection. For example, ACEs were required
to be reviewed and approved by a licensee
- ACE [[screening inspector prior to issuance. The screening inspectors comprised management representatives from each of the major plant departments (operations, maintenance, etc). The inspectors identified several examples where the screening inspectors had identified issues with the evaluation quality, but had nevertheless assigned the evaluation a passing grade. While this was acceptable under the licensee's procedures, there was no requirement to ensure that the screening team observations were addressed. This meant that potential, recurring issues with]]
- ACE quality were not reinforced. The inspectors noted that similar issues had been identified in recent station audits as documented in
The inspectors identified that the licensee had failed to identify a Maintenance Preventable Functional Failure (MPFF) of the
- SC [[]]
- NRC inspector questioned the adequacy of the licensee's review. The licensee subsequently concluded that the
HPCI system availability had
been affected and that the test failure should have been identified as an
- CAQ and to Take Corrective Actions to Prevent Recurrence Introduction: A finding of very low safety significance and associated
XVI, "Corrective Action," was identified by the inspectors for the failure to identify a CAQ. Specifically, the licensee did not properly
Enclosure evaluate the failure of the
HPCI system. Description: On March 31, 2007, the licensee identified that the AI-611 valve had failed its in-service test due to a piece of debris lodged in the valve seat preventing it from closing. The valve was subsequently repaired and successfully retested. The test
failure was documented in
AR identified that the debris on the valve seat was not caused by any past events and that therefore, there were no past operability concerns. On February 23, 2008, the
licensee initiated
- AR 1128442 after identifying that the leak test failure had not been evaluated against the maintenance rule program. The
AR 1148193, after an NRC inspector found that the licensee had failed to identify the source of the valve debris and that, therefore, the conclusions regarding the affect of the test failure were potentially inaccurate. The licensee subsequently identified that the valve debris was brazing material likely
originating from work on instrument air valve
- AI -611 valve. This work occurred from June 10-14, 2005. Since the debris had resulted from a planned maintenance activity, the licensee subsequently concluded that the test failure should be reevaluated as a potential
- AI -611 is a safety-related valve that has a safety function to close. It allowed instrument air (which is a non-safety related system) to supply a safety-related accumulator that, in turn, supplied air to the
AI-611 valve fails to close, then upon a loss of the instrument air system, air would bleed
out of the accumulator resulting in the
HPCI flow would be diverted to the torus instead of the reactor vessel. Because this is an unevaluated condition, it is possible that there would be insufficient flow to the reactor vessel to meet the design basis. The CV-2065 valve is required to remain operable during a station blackout (where instrument air would be lost) and a
small break loss of coolant accident coincident with a loss of instrument air. Both of these are design basis accidents. The licensee subsequently reclassified the in-service test failure as a
HPCI system. The licensee also identified that other in-service test failures occurring during the 2007 refueling outage also needed to be
reevaluated. These actions were being tracked under
- AR 1148193. Analysis The failure to properly evaluate the in-service test failure was considered a performance deficiency. Specifically, by not considering the source of the debris in the
HPCI system and implementing any corrective actions to prevent recurrence.
Enclosure The finding is more than minor because it directly affected the Equipment Performance attribute of the Mitigating Systems Cornerstone objective of ensuring the availability, reliability and capability of systems that respond to initiating events to prevent undesirable consequences (i.e., core damage). Specifically, the failure to identify the
- HPCI system and implementing any corrective actions to prevent recurrence. The inspectors conducted a Phase I characterization and screening of the finding in accordance with
- IMC 0609, Appendix A, "Determining the Significance of Reactor Inspection Findings for At-Power Situations." Because there had been no loss of the instrument air system during the period that the
- HPCI system remained operable, therefore, the finding screened out as having very low safety significance (Green). The performance deficiency has a cross-cutting aspect in the area of
- PI&R , Corrective Action Program, because the licensee did not evaluate the source of the debris in the
CFR Part 50, Appendix B, Criterion XVI, "Corrective Action," requires, in part, that measures shall be established to assure that conditions adverse to quality, such as failures, malfunctions, deficiencies, deviations, defective material and
equipment, and non-conformances are promptly identified and corrected. Licensee procedure
PA-ARP-01, "CAP Action Request Process," revision 20, defines a CAQ (step 4.23), in part, as "Failures, malfunctions, deficiencies, deviations, defective material and equipment and non-conformances that have the potential to affect operability or functionality of safety-related systems, structures or components." This
same step required that
- CAP. Contrary to the above, on March 31, 2007, the licensee failed to identify that the in-service test failure of the
HPCI system from performing its design function, this met the licensee's definition of a
- CAP. Because this violation was of very low safety significance and it was entered into the licensee's corrective action program as
NCV 05000263/2008008-01 - Failure to Identify a Condition Adverse to Quality and Implement Corrective Actions to Prevent Recurrence).
(3) Effectiveness of Corrective Actions The inspectors concluded that over the two year period encompassed by the inspection, the licensee implemented effective corrective actions. Corrective actions were generally well implemented, effective in addressing the parent issues, and timely. The inspectors
identified no significant examples where problems recurred. Findings No findings of significance were identified.
Enclosure .2 Assessment of the Use of Operating Experience (OE) a. Inspection Scope The inspectors reviewed the licensee's implementation of the facility's
OE composite
performance indicators. The inspectors' review was to determine whether the licensee was effectively integrating OE experience into the performance of daily activities, whether evaluations of issues were proper and conducted by qualified personnel, whether the licensee's program was sufficient to prevent future occurrences of previous industry events, and whether the licensee effectively used the information in developing
departmental assessments and facility audits. The inspectors also assessed if corrective actions, as a result of
- OE was discussed as part of the daily station planning meetings, at shift turnover meetings, and at maintenance pre-briefings. Also, the inspectors determined that
OE was
appropriately reviewed during causal evaluations. During interviews, several licensee personnel commented favorably on the use of
- OE was a precursor to the vessel overfilling event and the underground cabling issues that were reviewed during an
NRC Special Inspection
conducted in September 2008 (Inspection Report 05000263/2008009). The inspectors also identified two examples where
- OE evaluations were poorly documented, in part due to a lack of sufficient oversight regarding the quality of
IN) 2006-26, "Failure of Magnesium Rotors in Motor-Operated Valve Actuators," and 2006-29,
"Potential Common Cause Failure of Motor-Operated Valves as a Result of Stem Nut Wear." The inspectors further noted that the licensee had identified a potential
CFR Part 50, Appendix B, Criterion V, "Instructions, Procedures, and Drawings," was
identified by the inspectors, for the failure to identify and correct a
OE, the licensee identified a concern with the potential corrosion of magnesium motor rotor fan blades and shorting rings associated with some
Enclosure safety-related motor operated valves (MOVs). The licensee did not enter this concern into the
- NRC [[]]
IN described recent failures of MOV actuators due to oxidation and corrosion of the magnesium motor rotor fan blades and shorting ring resulting from exposure to high
humidity and temperatures. The licensee's evaluation concluded that a similar concern existed at Monticello and identified five safety-related
- MOV s that were "at risk" due to the operating environment (i.e., temperature and humidity) and duty cycle. These
- MOV. This review had been performed by a licensee engineer who was no longer working at the station. The engineer had not documented this review or entered it into the
- CAP. Instead, the engineer had initiated a General Action Request (GAR) to track industry resolution of the concern and initiated work requests to examine the
- MOV s during a subsequent outage. Issues potentially affecting safety-related components were required to be identified in the
CAP. A GAR is typically used to track low level items that don't meet the threshold of
the
- CAP items, they are not screened or otherwise evaluated for operability, reportability or otherwise required to have corrective actions. The lack of a
- CAQ [[and that, therefore, there was no independent review of the engineer's conclusions or recommended corrective actions. This also meant that the work requests could be cancelled without justification as there was no indicator that they were necessary to address a]]
CAQ had been properly identified and corrected. The finding is more than minor because it directly affected the Human Performance attribute of the Initiating Events Cornerstone objective to limit the likelihood of events that upset plant stability and challenge critical safety functions while at power. The finding also directly affected the Equipment Performance attribute of the Mitigating System cornerstone objective of ensuring the availability, reliability and capability of systems that respond to initiating events to prevent undesirable consequences
(i.e., core damage). Specifically, by not identifying this issue as a
CAP, the
Enclosure licensee was unable to ensure that the affect on the above safety-related
- MOV s were properly evaluated and that the appropriate corrective actions were implemented. The inspectors conducted a Phase I characterization and screening of the finding in accordance with
IMC 0609, Appendix A, "Determining the Significance of Reactor Inspection Findings for At-Power Situations." Because the issue only involved the potential degradation, but not the actual loss of plant components, there was no actual
initiating event or loss of a mitigating system function; therefore, this finding screened out as having very low safety significance (Green). The performance deficiency has a cross-cutting aspect in the area of
- 10 CFR [[Part 50, Appendix B, Criterion V, "Instructions, Procedures, and Drawings," requires, in part, that activities affecting quality shall be prescribed by documented instructions, procedures, or drawings, of a type appropriate to the circumstances and shall be accomplished in accordance with these instructions, procedures, or drawings. Licensee procedure]]
FP-PA-ARP-01, defines a CAQ (step 4.10), in part, as "failures, malfunctions, deficiencies, deviations, defective material and equipment, and non-conformances that have the potential to affect nuclear safety,
operability or functionality of safety-related systems." Station procedure
- CAP. Contrary to the above, on December 11, 2006, the licensee failed to identify a potential concern associated with some safety-related
CAP. Specifically, the licensee identified that some MOVs may have experienced corrosion of the
magnesium motor rotor fan blades and shorting ring based on their operating history. Because these
- CAP. Because this violation was of very low safety significance and it was entered into the licensee's corrective action program as
- NCV 05000263/2008008-02 - Failure to Identify a Condition Adverse to Quality). .3 Assessment of Self-Assessments and Audits a. Inspection Scope The inspectors assessed the licensee staff's ability to identify and enter issues into the
- CAP program, prioritize and evaluate issues, and implement effective corrective actions, through efforts from departmental assessments and audits. b. Assessment The inspectors considered the quality of the nuclear oversight (
NOS) audits to be thorough and critical. The self-assessments were acceptable but, as expected, they
were not at the same level of quality as the audits. The inspectors observed that
NOS audits and self-assessments.
Enclosure The inspectors attended a meeting of the Performance Assessment Review Board on November 5, and reviewed board meeting minutes from January to June 2007 and from April to October 2008. The Board provided oversight for the
- CAP including the self-assessment program. The inspectors identified no issues with the Board's performance during the inspection. Findings No findings of significance were identified. .4 Assessment of Safety-Conscious Work Environment (
- SCWE ) a. Inspection Scope The inspectors assessed the licensee's safety-conscious work environment through the reviews of the facility's
- ECP [[coordinators, interviews with personnel from various departments, and reviews of issue reports. The inspectors also reviewed the results of licensee safety culture surveys. b. Assessment The inspectors determined that the plant staff were aware of the importance of having a strong]]
- SCWE and expressed a willingness to raise safety issues. No one interviewed had experienced retaliation for safety issues raised, or knew of anyone who had failed to raise issues. All persons interviewed had an adequate knowledge of the
CAP and
- ECP. Based on these limited interviews, the inspectors concluded that there was no evidence of an unacceptable
ARs 01062966 and 01063040. Specifically, in 2006, the inspectors
had identified that there was no designated site individual to assist program users and that typically those wanting to use the programs had to assume the burden in ensuring that the issues were properly resolved. In addition, there was no clear interface between the
DPO items. The inspectors were concerned that
the overall lack of rigor over the
- DPO process may result in some workers feeling reluctant to raise concerns and/or some issues not being properly evaluated or documented. During a self-assessment of the
- 2008 NRC [[]]
DPO that, while it was in the CAP, had not been identified by the licensee during a
review of the
NRC inspection. The licensee documented both of these issues in ARs 1147604 and 1158451, respectively.
Enclosure Findings No findings of significance were identified.
- 4OA [[6 Management Meetings .1 Exit Meeting Summary On November 7, 2008, the inspectors presented the inspection results to Mr. O'Connor and other members of the licensee staff. The licensee acknowledged the issues presented. The inspectors confirmed that none of the potential report input discussed was considered proprietary.]]
- SUPPLE [[]]
- MENTAL [[]]
- INFORM [[]]
- SUPPLE [[]]
- MENTAL [[]]
- INFORM [[]]
- ATION [[]]
- KEY [[]]
- POINTS [[]]
- OF [[]]
CAP Coordinator
- W. Flaga, Maintenance Manager J. Grubb, Engineering Director D. Horgan, Performance Assessment Supervisor K. Jepson, Business Support Manager T. O'Connor, Site Vice-President
- S. [[Radebaugh, Acting Plant Manager L. Taufen, Self-Assessment Coordinator E. Weinkam, Nuclear Licensing and Emergency Preparedness Director Nuclear Regulatory Commission K. Riemer, Chief, Branch 2, Division of Reactor Projects Other J. Ruff, Institute of Nuclear Power Operations]]
- LIST [[]]
- OF [[]]
- ITEMS [[]]
- CLOSED [[]]
- AND [[]]
- NCV Failure to Adequately Identify a Condition Adverse to Quality and Identify Corrective Actions to Prevent Recurrence (4
- NCV Failure to Adequately Identify a Condition Adverse to Quality and Identify Corrective Actions to Prevent Recurrence (4
OA2.2)
Attachment
- LIST [[]]
- OF [[]]
- DOCUME [[]]
- NTS [[]]
- REVIEW [[]]
- ED The following is a list of documents reviewed during the inspection. Inclusion on this list does not imply that the
- NRC inspectors reviewed the documents in their entirety, but rather, that selected sections of portions of the documents were evaluated as part of the overall inspection effort. Inclusion of a document on this list does not imply
- NRC acceptance of the document or any part of it, unless this is stated in the body of the inspection report.
- PLANT [[]]
PA-SA-04 Benchmarking Process 3
- ACTION [[]]
- DOCUME [[]]
- NTS [[]]
- REVIEW [[]]
- ED Number Description or Title Date or Revision 819463 Extensive Repairs to Casing of #12 Reactor Feed Pump (P-2B) Will be Required March 15, 2005 834615
- 12 RFP Inbd Bearing Temp Reading 30 Deg F Less than Expected April 18, 2005 845253 Lube Oil Temp for #12
RFP Inadvertently Reduced to Lowest Level in 6 Years May 13, 2005 1000146 The NMC Fleet Has Not Demonstrated Sufficient and Consistent Oversight to Sustain Training Excellence October 4, 2005
Attachment
- CORREC [[]]
- TIVE [[]]
- ACTION [[]]
- DOCUME [[]]
- NTS [[]]
- REVIEW [[]]
- 1001676 QC Process Interpretations May Not Meet Regulatory Intent 1053159 Training Value Lost by Running Fire Drills w/o a Controller October 1, 2006 1053789
- CAPR Not Institutionalized in Site Procedures October 4, 2006 1053881 Incorrect Acceptance Criteria Specified in
- ITS [[]]
- SR 3.5.1.3.b October 4, 2006 1054166 Adverse Trend in Material Issues October 5, 2006 1054428 Tracking and Trending Low Level/Near Miss Events October 7, 2006 1054920 Unexpected Results from
- DRUM [[Report Potential Adverse Trend in Work Control/Mgmt October 16, 2006 1056116 Fire Brigade Announced Drills May Not Comply with Appendix R October 17, 2006 1056182 Motor Terminal Voltages Could Drop Below 90% Rated October 17, 2006 1056297 Ladder Found Obstructing Access to Fire Extinguisher October 18, 2006 1056430]]
- LOR Cycle Exam Failures October 27, 2006 1058219 Unqualified Instructors Performed Simulator Instruction October 27, 2006 1059020
- ACE [[Quality Improvement Progress Insufficient November 1, 2006 1059454 Bases for Inspection of Fire Dampers Unclear November 2, 2006 1059620 Construction Practices for Radiation Monitors Questioned November 3, 2006 1059908 Adverse Trend in Modification Implementation November 6, 2006 1059908 Adverse Trend in]]
- MOD Implementation November 6, 2006 1060535 Ops Training Comprehensive Identified Issure November 8, 2006 1061159
- TCV [[-8027 Not Maintaining V-MZ-1 Temp Above Trip Setpoint November 11, 2006 1062083 Procedures Issued Without Appropriate Approvals per Process November 16, 2006 1062274 Worker Injures Finger While Threading Pipe at Pipe Machine November 16, 2006 1062435 >25% Failure Rate on]]
EOPs November 17, 2006 1062541 Adverse Trend in Control of Contractor November 30, 2006 1062986 Lack of Rigor in Differing professional Opinion Process November 20, 2006
Attachment
- CORREC [[]]
- TIVE [[]]
- ACTION [[]]
- DOCUME [[]]
- NTS [[]]
- REVIEW [[]]
- CAP Number Not Cross Referenced in Work Request November 28, 2006 1064261 Documentation Shortcomings with
- NRC [[]]
- NRC [[]]
- WR [[s [Work Requests] November 30, 2006 1064612 Sensitivity to]]
- CAP Indicators November 30, 2006 1065327 Contaminated Drain Hose Improperly Contained December 4, 2006 1066632 Adverse Trend in Emergent Work December 9, 2006 1068359 Pipe Hanger Found Disengaged on
- 11 CS [[]]
- TST [[]]
- RTRN [[]]
- TO [[]]
- TORUS Pipe December 19, 2006 1069549 Breaker Trips During Service Water Modification Testing December 30, 2006 1069920 Loss of
- FL [[]]
- ICT [[January 8, 2007 1070596 H-2, Crane Chair Badly Degraged, Has Exposed Lead January 8, 2007 1070767 Sheared Pin On F-100A, 11 Traveling Screen January 9, 2007 1071128 Root Cause Evaluation of January 10, 2007 Group 1 Isolation and Automatic Scram January 10, 2007 1071669 Worker Received Intake of radioactive material and]]
- PCE January 13, 2007 1072679 Weld Rod Control Not in Accordance With the Procedure January 19, 2007 1073031 Abnormal Behavior of
- 1073813 ILT 2007 Audit Exam Results Were Below Expectations January 25, 2007 1074016 Out of Spec Low
SBLC Tank Temp Challenges Operators January 26, 2007 1074246 Welder Did Not Have the Proper Qualification for Welding January 26, 2007 1075283 Combustible Loading Change Request Form is Confusing February 2, 2007 1075452 Continuing Adverse Trend in Procedure Use and Compliance February 3, 2007
Attachment
- CORREC [[]]
- TIVE [[]]
- ACTION [[]]
- DOCUME [[]]
- NTS [[]]
- REVIEW [[]]
- CAP Evals February 3, 2007 1076385 Broken Shear Pin on F-100C #13 Traveling Screen February 9, 2007 1076419
- 1076706 QAF -Recurring Programmatic Issues with Site Welding Program February 12, 2007 1076852 Stack
- WRGM A Maximum High Flow Rate Not As Expected February 21, 2007 1077567 Inadequate Procedure Exists for Temp Heating Boiler Install February 16, 2007 1078193 Procedure Step Performed Incorrectly February 20, 2007 1078384 Errors in Revised
- SRV [[]]
- NRC Question Concerning Temp Heating Boiler Install Time February 21, 2007 1078872 Maint. Rule (a)(3) Periodic Evaluations Late Per
- ESW Pump February 22, 2007 1078997 Exam Scores or Pass Rates for Licensed Operators in Training Lower Than Expected February 19, 2007 1080056 Remaining in
- QAF [[]]
- MO [[-4085A Opened During Shutdown March 14, 2007 1082168 Cords Staged Outside Combustible Loading Permit Zone March 14, 2007 1082734 Lost Essential Bus 16 During Isolation Activities March 18, 2007 1083862 13 Air Compressor Shutdown during Procedure 1335 March 24, 2007 1084697 Worker Entered Drywell on Wrong Work Order March 29, 2007 1084821 55 Gal. Oil Drum Near]]
- TB West March 29, 2007 1084873 Rad Worker Practices March 29, 2007 1085239 Broken Fuel Oil Pump Coupling on 12
MO-2374 Not Installed per Design April 7, 2007
Attachment
- CORREC [[]]
- TIVE [[]]
- ACTION [[]]
- DOCUME [[]]
- NTS [[]]
- REVIEW [[]]
- ECCS Test April 21, 2007 1088981 Adv Trd: Monitoring Fails to Pre-Identify Pipe Wall Failures April 22, 2007 1089760 Scotch Tape Used to Mend Gasket on
- HPCI Ovr Spd Assembly April 27, 2007 1092436 Inadequate Corrective Action Program Implementation May 15, 2007 1092929 Chemistry Procedures in Conflict Re: Chlorine Analysis May 16, 2007 1093098 Perform Evaluation of
- NRC Violation May 17, 2007 1093378 Negative Trend in Simulator Interruptions May 20, 2007 1093863 Adverse Trend on Control of Items Important to
- ACE s Failing Grading May 23, 2007 1093939 Maintenance Rework Program Not Maintained for Approx. 1 Year May 24, 2007 1094396 Trend in Events Attributed to management Oversight May 29, 2007 1094761 Loss of Motor Cooling Flow to Div 1
- RHRSW Pumps June 1, 2007 1095058 Adverse Trend in Vehicle Barrier Performance June 4, 2007 1095107 Wrong Due Date Given to
- ITS [[-Extended Freq. Surveillance June 4, 2007 1095330 Drain Lines on Contaminated Tanker Trailer Rusted Through June 5, 2007 1095951 Negative Trend in Ops Performance using Jumpers and Boots June 8, 2007 1096071 Several Rad Material Control Events in Last 2 years --Trend June 8, 2007 1096082 Common Fire Brigade Turnout Gear Could Result in Unsafe]]
- PCR 1075517 Changes Conflict with Fire Prot. Requirements June 27, 2007 1099678 Inadequate Tamper-Safing for Spent
NRC Cross-Cutting KPI Turns Red for June 2007 June 29, 2007 1100713 Continuing Trend in Critical Relay Failures July 8, 2007
Attachment
- CORREC [[]]
- TIVE [[]]
- ACTION [[]]
- DOCUME [[]]
- NTS [[]]
- REVIEW [[]]
- ED Number Description or Title Date or Revision 1101396 F100D, #14 Traveling Screen Sheared a Pin July 11, 2007 1101494 Non-compliant manual Actions in 4kV Rooms July 12, 2007 1102121 Adverse Trend Noted in Engineering Verification and Validation July 16, 2007
- 1102728 EP Work Process Code Trend is Negative July 20, 2007 1102947 Adverse Trnd in Security Staffing July 23, 2007 1103824 11 & 12
- 1105662 LER [[2007-003 Required Revision August 7, 2007 1106470 Adverse Trend in Events Caused by Inadequate Knowledge August 11, 2007 1106519 Adverse Trend in Equipment Performance August 12, 2007 1107470 Adverse Trend in Numbers of Ops Burdens August 17, 2007 1107640 Adverse Trend/Ineffective Actions]]
- INOP August 20, 2007 1108192 Drain Valve Closed Unexpectedly Due to I&C Calibration August 22, 2007 1108516 Adverse Trend for Entry into Tech Spec 3.0.3 August 23, 2007 1109108 #12
- RPS [[]]
RHR Intertie Line [Condition Evaluation] September 7, 2007 1111293 Grounds for Work on 1N6 Not Hung per Procedure September 13, 2007 1111840 Broken Shear Pin on F-100B, #12 Traveling Screen September 18, 2007 1113483 Screen Wash / Fire Pump Panel C-115 Degraded Cable September 28, 2007 1114068 Maintenance Rule HTV System Disposition to a(1) Status October 5, 2007 1114724 Change in Indicated Reactor Power Following Replacement of Data Acquisition Module
[Root Cause Evaluation] November 12, 2007 1115003 Craftsmen Did Not Follow Procedure Use and Adherence October 16, 2007 1116351 Ability to Extinguish Charcoal Fire in
WRGMs October 31, 2007 1117340 Station Review of NRC Violation 2007-04-01
Attachment
- CORREC [[]]
- TIVE [[]]
- ACTION [[]]
- DOCUME [[]]
- NTS [[]]
- REVIEW [[]]
- CV -1059 Positioner Bypass Valve Gasket Missing November 12, 2007 1117976 Door-27, Upper Latch on West Door is Broken November 13, 2007
- 1118596 MO -1750 as Left Settings Do Not Meet Desired Values November 20, 2007 1119106 Station review of
- ISFISI Pad November 27, 2007 1119165 Broken Shear Pin on F-100C, #13 Traveling Screen November 27, 2007 1119242 Heating Coils Leak on V-
- RPV System Dispostion to a(1) Status October 31, 2007 1119932 Component Labeling Program Not Being Maintained-Repeat Issue December 3, 2007 1120435 Crew Self-Assessment
- DEP Classification Failure December 7, 2007 1120865 V-AC-5 Failure Due to Blown Line Fuse December 11, 2007 1122500 Facts for
- CAP [[1121728 Are in Question January 1, 2008 1122907 Refueling Bridge Struck and Bent Actuator Pole January 7, 2008 1123141 Adverse Trend in Improperly Closing out Level B Assignments January 8, 2008 1123141 Adverse trend in Improperly Closing Out Level B Assignments 1123673 11 Cond Demin Holding Pump Motor has Bearing Defects January 14, 2008 1124113 Incorrect Procedure Steps Leads to Significant Near Miss January 17, 2008 1124434 Excessive Seal Leakage in]]
- SW Pumps January 21, 2008 1124439 Fleet Procedures May Contain Contrary Guidnace January 21, 2008 1124469 Cannot Determine Appropriate Action to Satisfy
- EDG [[]]
- FW Reg Valve Locked-up while Reducing Reactor Power February 2, 2008 1126064 V-AH-4B Tripped While isolating V-AH-4A February 4, 2008 1126745 Differing Professional Opinion on
- HELB [[]]
CAP 1125675 February 8,. 2008
Attachment
- CORREC [[]]
- TIVE [[]]
- ACTION [[]]
- DOCUME [[]]
- NTS [[]]
- REVIEW [[]]
- RCIC Test Return Valve Did Not Operate as Expected February 14, 2008 1127232 Another Component Incorrectly Categorized as Critical 1 February 14, 2008 1127242 Adverse Trend: Inadequate Maintenance of Quality Records
- RCIC Surveillance February 15, 2008 1127954 Extension Cord Found to be Going Through Metal Doors February 19, 2008 1128185 Adverse Trend of #12
- AI [[-611 Failure on Performance Indicator not Considered February 23, 2008 1128547 Unannounced Fire Drills Can be a Safety Issue for Personnel February 24, 2008 1129669 Area for Improvement 1129678 Area for Improvement 1129683 Area for Improvement 1129952 Potential Adverse Trend:]]
- MNGP [[]]
- RFO Maint March 17, 2008 1131482 155,000 Gallons of Excess Water Diverted to Radwaste March 18, 2008
- CAP Closed without Completing Identified Action March 19, 2008 1131914 Safety Concern Associated with
HELB Maintenance March 20, 2008 1132227 Deviations From Overtime Work Restrictions Were Approved for Situations that Did Not Align
with the Requirements of
- DO [[-8000A-33 Found in Open Position April 3, 2008 1133354 14 Traveling Screen Shear Pin Broken April 4, 2008 1133755 Complex Isolation Interactions De-energize Panel P-52 April 8, 2008 1134058 Downward Trend in Human Performance Index April 10, 2008 1134601 Tech Spec Bases 3.3.3.2 is Misleading April 15, 2008 1134645]]
USAR Appendix J.5 Fire Hazards Analysis is Inaccurate April 16, 2008
Attachment
- CORREC [[]]
- TIVE [[]]
- ACTION [[]]
- DOCUME [[]]
- NTS [[]]
- REVIEW [[]]
- 1134671 A. 8 Procedure Quality Does Not Meet Expectations April 16, 2008 1134676 A.8-05.06 to Maximize
- CA -03-052, Diesel Oil Storage Tank-Level Temperature Error April 17, 2008 1135282 Discrepancies Between
- EP Drill Report Timeliness April 22, 2008 1136793 Leakage Into Torus Requires Periodic Pumpdown May 5, 2008 1136879 Oil Flush on 11 Service Water Motor Ineffective May 6, 2008 1136919 Loss of Motor Cooling to Div
- II [[]]
- RHRSW [[Pumps May 6, 2008 1136955 Adverse Trend in Service Water Rad Monitor Flow Alarms May 7, 2008 1136955 Adverse Trend In Service Water Rad Monitor Flow Alarms May 7, 2008 1136991 Workers Contaminated with 1500 cpm Particle on Bottom of Shoe May 7, 2008 1137059 B5b]]
- NRC May 7, 2008 1137191 Trend in Security Injuries and Near Misses May 8, 2008 1137245 Document Quality Issues June 12, 2008 1137297 D10 Exhibits Erratic Voltage Output During Surveillance May 9, 2008 1137382 Shear Pin on #12 Traveling Screen Replaced May 10, 2008 1137953 Unauthorized Personnel had Access to Exam Materials May 16, 2008 1138006 Fire Brigade Responsibilities can be a Danger to Employees May 16, 2008 1138236 Received
- RBCCW Surge Tank Low Level Alarm May 20, 2008 1138609 Scaffolding Obstructs Access to Fire Hose Reel May 23, 2008 1138824 Battery Chargers Maintenance Rule Status Declining May 27, 2008 1139423 Negative Trend in Number of Maintenance
HU CAPs May 30, 2008 1139427 Potential Adverse Trend in Significant and Noteworthy Events May 30, 2008 1139428 Negative Trend in Equipment Performance and Failure Events May 30, 2008 1139430 Negative Trend in Engineering Personnel Related Events May 30, 2008 1139715 Operability Determination Assessment Issues June 3, 2008
Attachment
- CORREC [[]]
- TIVE [[]]
- ACTION [[]]
- DOCUME [[]]
- NTS [[]]
- REVIEW [[]]
- REC [[008 While Trying to Adjust Reactor Power June 4, 2008 1140073 P-105 Diesel Small Fuel Leak June 5, 2008 1140154 Adverse Trend in Rigor of Operational Risk Assessment June 6, 2008 1140237 Differential Pressure Switch Discovered Out of As-Found Spec June 6, 2008 1140362 Danger Tags for]]
- EC [[-746 Remain Hanging for 1 1/2 Years June 9, 2008 1140582 17 250v Battery, Cell 19 Specific Gravity Out of Spec June 11, 2008 1140675 Combustible Material Not Properly Stored in reactor Building June 11, 2008 1140836 Unintentional Transfer of Y-71 to Alternate Source June 12, 2008 1141206]]
- EP Procedure Revised without Notifying Users June 17, 2008 1141296 Adverse Trend in Training Committee Performance June 18, 2008 1141433 On-going Coolant Sample Testing Issues June 19, 2008 1141638 No
- EAC [[-18 and V-CH-28 June 20, 2008 1141662 Items Outside Door-201 Possible Fire Brigade Obstruction June 21, 2008 1142254 Adverse Trend in Human Performance Related Events June 27, 2008 1143567 Inadequate Conclusion Stated in Calculation 05-104 June 30, 2008 1143647 Operability Questions During Maintenance on A]]
- ACE Grading Critiques are Not Evaluated for Trends July 14, 2008 1144214 Trend-RCE Grades Low in 2 Areas July 15, 2008 1144794 Safety- Possible Trip Hazard on Torus Walkway July 21, 2008 1144926 Ops
- HU Data Shows Adverse Trend in Work Activity Engagement July 22, 2008 1145135 Shear Pin Found Broken on #12 Traveling Screen (F-100B) July 24, 2008 1145203 Performance Trend of #12
REC Pump Seal July 24, 2008 1146758 Deficiencies in Troubleshooting Process Identified By Site August 6, 2008 1147201 Unexpected Classification During Simulator Evaluation August 11, 2008 1147604 DPO Process Lacks Rigor August 15, 2008 1147861 Refuel Bridge Contacted Pole During Procedure 9010 August 19, 2008
Attachment
- CORREC [[]]
- TIVE [[]]
- ACTION [[]]
- DOCUME [[]]
- NTS [[]]
- REVIEW [[]]
- EDG Document Power Factor Testing Limitation August 27, 2008 1148801 Adverse Trend in Megger Results on V-EF-18B August 27, 2008 1149927 Iron Fillings Present on Oil Fill Plug on
- EXPERI [[]]
- NRC [[]]
- INPO [[]]
- 1056242 EFT Backdraft Damper Apparently Not Ever Installed October 17, 2006 10889203 Air Leak Found on
CV-1729 April 23, 2007
Attachment
- OPERAT [[]]
- ING [[]]
- EXPERI [[]]
- 1104436 EDG Lister Battery Temp Above 90 deg F July 31, 2007 1088223 Percon-Operator 200 ncpm on Shoe From Clean Area in
- XTIE Valve Position Op Implic Not Doc October 16, 2007 1117957 Unattended Gun Sent Through X-Ray Machine November 13, 2007 1121432 Over Estimated the Dose Estimate for
- PORC Open Items Not Tracked to Closure March 7, 2008 1135418 Small, Short-Term Increase in Reactor Water Iodines Noted April 23, 2008 1135949 11 &
- AND [[]]
- FSA -06-21 (SAR 01022090) Monticello Operations Training Self Evaluation October 23, 2006 thru October 27,
- AR [[]]
NOS 2008-01-004 Radiation Protection February 25, 2008 to March 3, 2008 NOS Assessment Report for Monticello 4th Quarter 2006
Attachment
- AND [[]]
SELF-ASSESSMENTS Number Description or Title Date or Revision NOS 2007-03-001 Fleet Security Assessment September 24, 2007 to
September 28,
- DURING [[]]
- 1158451 DPO Process Lacks Documentation Rigor and Retrievability November 6, 2008 1156990 Recommendations of
- CAP November 6, 2008 1158435 No Guidance for Required Maintenance Rule a(3) Report Approval November 6, 2008 1148193
- IST Failure Not Evaluated for Aggregate System Impact August 21, 2008 1157395 Error Likely Situation Exists for Potential Maintenance Rule
- MISCEL [[]]
- LANEOU [[S Number Description or Title Date or Revision Performance Assessment Review Board Minutes January 3, 2007 to June 20, 2007 Performance Assessment Review Board Minutes April 8, 2008 to October 10, 2008 Alteration 05A-034 P2-B Casing and Diaphragm Alteration March 31,]]
OR 2008-01-032 Corrective Action Program 1st Quarter 2008
Attachment
- MISCEL [[]]
- 2008 OR 2008-03-029 Quarterly Results Review 3rd Quarter 2008 Work Orders Number Description or Title Date or Revision 0311868 P-2B Overhaul and Rotating Assembly Replacement December 17, 2003 00140416 #12
- RFP Inbd Bearing T/C Not Properly Installed February 16, 2007 00330862 P-2B Repair Excessive Oil Leaks on Pump and Motor April 26, 2008 Department Roll-Up Meeting Reports Number Description or Title Date or Revision Engineering 2nd Quarter 2008
- MNGP [[Security 2nd Quarter 2008 Monticello (site wrap-up) 1st Quarter 2008 Monticello (site wrap-up) 4th Quarter 2007 Radiation Protection/Chemistry 4th Quarter 2007 Radiation Protection/Chemistry 1st Quarter 2008 Radiation Protection/Chemistry 2nd Quarter 2008 Security 4th Quarter 2007 Site Roll-Up Performance Results 2nd Quarter 2007 Site Roll-Up Performance Results 3rd Quarter 2007 Site Roll-Up Performance Results 4th Quarter 2007 Site Roll-Up Performance Results 1st Quarter]]
GAR 01143547 Training Department Roll-Up Meeting Report 2nd Quarter 2008 GAR 01144520 Operations Department Roll-Up Meeting Report 2nd Quarter 2008
Attachment
- LIST [[]]
- OF [[]]
- ACRONY [[]]
- MS [[]]
- USED [[]]
- MN [[]]
- SC [[]]