Headquarters Daily Report DECEMBER 08, 1994 *************************************************************************** REPORT NEGATIVE NO INPUT ATTACHED INPUT RECEIVED RECEIVED HEADQUARTERS X REGION I X REGION II X REGION III X REGION IV X *************************************************************************** PRIORITY ATTENTION REQUIRED MORNING REPORT - REGION DECEMBER 8, 1994 MR Number: H-94-0113 NRR DAILY REPORT ITEM SIGNIFICANT EVENTS EVENTS ASSESSMENT BRANCH DIVISION OF OPERATING REACTOR SUPPORT Subject: IMPROPERLY MONITORED REACTOR COOLANT SYSTEM HEAT UP The NRR/AEOD Events Assessment Panel on November 29, 1994 classified the inadvertent heat up of the reactor coolant system at Peach Bottom Unit 2, as a Significant Event for the purpose of the NRC Performance Indicator Program. The basis for the classification is the inadequate attention and lack of adherence to procedures exhibited by the operating crew. NRC management was briefed on this event at Operating Reactors Events Briefing 94-38. On October 16, 1994, with Unit 2 in a refueling outage, the reactor vessel hydrostatic test was completed at 8:15 p.m. The bottom head temperature was 191 F and the reactor shell temperature just below the top flange was 205 F. The "A" loop of shutdown cooling was available but not running. At 8:30 p.m., the "B" recirculation pump was secured because the control room supervisor was concerned that the running pump would add heat to the reactor inventory. The "A" recirculation pump was scheduled to be run as part of post maintenance testing. Operators also began aligning the "B" loop of shutdown cooling for flushing prior to placing it in service. The "A" loop of shutdown cooling was realigned to spent fuel pool cooling. At 9:00 p.m., the reactor head vents were opened to depressurize the vessel and operators began lowering reactor inventory to its normal level below the main steam lines. Between 9:30 p.m. and 10:00 p.m., the "B" loop of shutdown cooling was flushed with reactor coolant. At 10:00 p.m. and again at 10:15 p.m., operators attempted to start the "A" recirculation pump but the breaker tripped both times. Bottom head temperature was 152 F and flange temperature was at 208 F and trending upward at 2 F per hour. The operator responsible for monitoring temperature was also involved with starting the "A" recirculation pump. The operator was focused more on the cooldown of the bottom head than the heat up of the flange area. Shift turnover occurred between 10:45 p.m. and 11:30 p.m. The reactor flange temperature recorded at 11:00 p.m. was 210 F and the bottom head temperature was 128 F. The "B" loop of shutdown cooling was available but the operating crew did not recognize a need to place it in service. At 12:30 a.m., on October 17, 1994, the reactor operator noted a slight pressure increase in the steam dome and realized that the flange temperature was greater than 212 F. He alerted the control room supervisor, who directed the crew to start shutdown cooling loop "B" immediately. By 12:50 a.m., shutdown cooling was in service. Reactor flange temperature was 230 F and the bulk temperature as measured at the RHR heat exchanger was 205 F. The licensee stated that there was no mode change because bulk temperature remained below 212 F. A special inspection by Region I identified 3 areas of weakness: 1. Operator Inattentiveness - The reactor operator (RO) logged temperatures greater than 212 F eleven times without realizing that a mode change from cold to hot shutdown could be taking place. Operators did not recognize that the highest reactor temperature should be considered when there was no forced flow through the core. 2. Inadequate Control of the Evolution - There was no detailed schedule for restoring the plant to normal after the hydrostatic test. The control room supervisor (CRS) jumped from the hydro test procedure to the shutdown cooling procedure without documenting his actions or initiating a temporary change to the procedure. The hydro test had been revised and did not have the operators secure the recirculation pump until the shutdown cooling loop was flushed and aligned. Had the operators stayed in the hydro test procedure, they could have prevented the event. The CRS did not brief the crew of his plan nor did he direct a temperature band to be maintained. At shift turnover, shutdown cooling was available but the oncoming CRS did not get any notice from the CRS he was relieving that reactor temperature was a priority. 3. Inadequate Procedures - The procedure for logging reactor skin temperatures did not address operation without forced flow from at least one of the recirculation pumps and did not address an upper bound for temperature. The hydro test procedure did not address the addition of heat to the system by the recirculation pump, which led the CRS to secure the running pump due to heat concerns. CONTACT: David Skeen, NRR/DOPS/OECB (301) 504-1174 PRIORITY ATTENTION REQUIRED MORNING REPORT - REGION III DECEMBER 8, 1994 Licensee/Facility: Notification: Detroit Edison Co. MR Number: 3-94-0233 Fermi 2 Date: 12/08/94 Newport,Michigan resident inspector pc Dockets: 50-341 BWR/GE-4 Subject: FERMI 2 READINESS FOR RESTART - UPDATE Reportable Event Number: N/A Discussion: THE LICENSEE, ACCOMPANIED BY NRC INSPECTORS, REPERFORMED THE FINAL DRYWELL CLOSEOUT TOUR. HOUSEKEEPING WAS ACCEPTABLE; HOWEVER, SEVERAL ADDITIONAL TECHNICAL ISSUES WERE IDENTIFIED. THE ONE REMAINING OPEN ITEM PERTAINS TO A SUPPORT ASSOCIATED WITH A FUEL POOL DRAIN LINE. THE LICENSEE EXPECTS TO DISPOSITION THE DRAIN LINE SUPPORT ISSUE SOME TIME TODAY. THE LICENSEE PLANS TO ENTER MODE 2 UPON COMPLETION OF THE DRYWELL CLOSEOUT. HOWEVER, RESTART OF THE PLANT WILL NOT OCCUR UNTIL THE LICENSEE'S RESTART CERTIFICATION CHECKLIST SIGNOFFS ARE COMPLETE. CURRENTLY, 78 OF 111 SIGNOFFS ARE COMPLETED ON THE CHECKLIST. AN NRC RESTART PANEL RECOMMENDATION IS NOT ANTICIPATED PRIOR TO COMPLETION OF THIS CHECKLIST. Regional Action: INFORMATION ONLY Contact: E. GREENMAN (708)829-9600