NRC 2/9/2012: San Onofre operator errors caused 11/1/2011 ammonia leak emergency alert

A Nuclear Regulatory Commission (NRC) February 9, 2012 Inspection Report says operator error caused the San Onofre Nuclear Generator Station (SONGS) ammonia leak that resulted in the November 1, 2011 Emergency Alert at the nuclear power plant. This is just another in a long series of management and employee performance problems at the San Onofre nuclear plant.

For an insider’s perspective, here are comments from whistleblower, James Chambers.  James is a NRC Licensed Nuclear Reactor Operator and worked at SONGS Units 2 & 3. He worked for Southern California Edison for over 25 years.

Yes, this is very significant. The reason is because this could be categorized as an “operator fundamentals” issue where something happens and the Operator does not know what to do, or he doesn’t call for help, or is distracted with other things.

When an alarm comes in, it is the responsibility of the operator to understand and, possibly, visually verify the cause. You never know if there is an “integrity” problem because not all operators do what they say they did. You have to realize that, as with many employees, because of years of abuse, there may be operators that just don’t care any more. The easiest way to deflect a problem is to apologize profusely, fall on your sword, and move on. This has been going on for years and years.

What is so significant is that they had to evacuate the Turbine Plant and surrounding areas and declare an emergency event, an Alert. This left some plant equipment in areas that could not be monitored or responded to in the event of Control Room alarms.

As far as the NRC is concerned, please bear in mind that the technical knowledge of the NRC is not really the best, or the same as plant operators. Many NRC inspectors have been laughed at by SONGS personnel because they have not been the brightest in the bunch. The NRC is not and can never be a saving barrier to a serious event–they just don’t have the knowledge nor the training. The public needs to understand this, because they just show up AFTER something goes wrong.

The “Full Flow” is a watchstation where the condensate water is purified in large spherical tanks, and the resin in these tanks is regenerated using acid, caustic, and ammonia. The waste water is ph “neutralized” and pumped into the ocean. This is a watch where people have routinely fallen asleep or are distracted by the internet. An operator was terminated in the 2009 timeframe for falling asleep at his watchstations which included the Full Flow.

So, there you have it, it was operator error. The greater problem, though, is that there appears to be a relationship between the NRC and SONGS which is preventing the NRC from intervening and shutting SONGS down. As you see in the write-ups, everything is going to be played down to nothing. They are always going to say it is OK, because, as many employees have opined, there are back room dealings that allow SONGS to continue to run in the face of overwhelming evidence that says otherwise.

Many employees, including myself, said it for years, when are they going to shut us down and clean up the joint? No one wants to work for a failed management team at the worst INPO rated plant because there is only shame and no pride. The opinion about the overriding relationship with the regulator, by many employees, was always that there was some other motivation that prevented them from intervening… You must decide what is really going on and why SONGS continues to operate.

If you look at the track record, what other justifiable reason allows an INPO 4 rated, INPO 3 (rated) two times in a row, degraded cornerstones, longest cross cutting issues in Human Performance in U.S. history, probably the worst industrial safety in U.S. history, a Chilling Effect letter issued because people were afraid to tell the truth, the largest number of Nuclear Safety Concerns (Employee Concerns), etc., what allows SONGS to continue to run?

— James Chambers

Excerpt from NRC Inspection Report about the ammonia leak – 4OA3 Event Follow-up (71153):

Green. A self-revealing finding was identified for the failure to take adequate corrective actions for degraded equipment associated with the Unit 3 full flow condensate polishing demineralizer system. Specifically, on October 27, 2011, operations personnel failed to take adequate corrective actions for an unexpected rise in ammonia day tank level and annunciation of an ammonia day tank high level, which eventually resulted in an ammonia leak from the ammonia day tank on November 1, 2011, that caused areas of the turbine building to become inaccessible requiring an emergency declaration at the ALERT level.

The issue was entered into the licensee’s corrective action program as Nuclear Notification NN 201713841. The performance deficiency is more than minor because the performance deficiency was a precursor to a significant event (Emergency Declaration), and is therefore a finding. Using the Manual Chapter 0609, “Significance Determination Process,” Phase 1 Worksheets, the finding is determined to have very low safety significance because the finding did not result in a loss of safety function for greater than the technical specification allowed outage time, and did not screen as potentially risk significant due to a seismic, flooding, or severe weather initiating event.

The finding has a cross-cutting aspect in the area of human performance associated with resources because the licensee failed to provide adequate procedural guidance to operations personnel for responding to full flow condensate polishing demineralizer system degrading conditions [H.2(c)](Section 4OA3.2).

The ammonia leak portion of the report, 4OA3 Event Follow-up (71153), starts on page 27 of the 02/09/2012 San Onofre Nuclear Generating Station – NRC Integrated Inspection Report 05000361/2011005 and 05000362/2011005

About Donna Gilmore

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4 Responses to NRC 2/9/2012: San Onofre operator errors caused 11/1/2011 ammonia leak emergency alert

  1. 1captd says:

    Who questions the commenters motivation and or sanity?

    At some point, one must ask themselves when is gross denial,
    … Best left for mental profession­­als?

    Case in Point, Japan is now suffering with a Trillion Dollar Eco-Disast­­er,
    … Yet some commenting here consider that it, in effect, is “no big deal”:

    Polluted Ocean, N☢ Problem, it will get better after a while….
    Polluted Fields, N☢ Problem, they can remove the upper layer
    Polluted Air, N☢ Problem, they can wear paper masks for a while
    Polluted Food, N☢ Problem, they can mix the good food to dilute the bad
    Polluted Homes, N☢ Problem, they can power wash them clean
    Polluted Schools. N☢ Problem, they can clean them off
    Polluted Cities, N☢ Problem, they can return soon…
    Polluted Lives, N☢ Problem, they can move on…
    Polluted Country N☢ Problem, the rich can relocate

    With answers like these from our Nuclear Profession­­als,
    …Perhaps you would consider a followup article, asking this question,

    … “What exactly would it take for you to stop supporting­­,
    … Land based Nuclear Reactors and go SOLAR,
    … Like Germany is now doing?”

    • Patti says:

      I think you are referring to the commenting that goes on over at the Huffington Post.
      The nuclear industry has a stable of paid posters and nuclear enthusiasts to promote their toxic message. With all their “expertise”, they should be in Japan offering to help with the impossible task of tying to put the Gennie back in the bottle. Shame on them.

  2. 1captd says:

    How to increase Solar usage nation wide in the shortest amount of time:
    What is holding America Back?

    The Utilities want to maximize the profits for the shareholders and so they donate to Candidates to get them to support traditional Energy Production, which does not include anything but a token amount of Solar… We are being “forced” to accept their Energy “mix”, instead of using our own and being fairly paid for the Energy we produce and push INTO the grid!!

    When The Energy Utilities pay each of us for the energy we put into the grid, at the same rate that the Utility charges for that same energy someone else uses at that exact time, then you will see Solar being installed Nation wide!

    Because Solar is generated during the daytime, it is the most valuable since the Utilities charge the most for daytime usage (where they have SMART metering)! Everyone pays an additional amount to support the infrastructure (The Grid) so that when the Energy Utilities begin to pay the same as what they charge (no pun intended), then it will make adding Solar panels a no brainer, since the payback period will be much shorter. Another benefit for all of us is that during a power outage, all the small solar panel producers can help to keep power flowing which will be a huge benefit during such times as hurricane, tornadoes and flooding!

  3. 1captd says:

    1. We all are speaking our views, mine are simple:
    Japan had a Trillion Dollar Eco-Disaster because their experts did not think Nature could destroy their Reactor Complex. Nature did destroy it and now the greater Nuclear supporters are trying to say that it will never happen again! This to me is the biggest bunch of Nuclear Baloney (NB) I have ever heard, so I continue to call them on it!

    2. As far as training goes, many here assume that others have little or no training that will allow them to access the situation in Japan, that too is a mistake since “underestimating” is yet a core “fault” that is responsible in part for this Trillion Dollar Eco-Disaster! (I.E. One should never underestimate Nature, especially where millions of lives are concerned).

    3. Most of us are basing our comments on what we have learned about Japans Trillion Dollar Eco-Disaster and do not have “insider information”. Therefore when stories come out that TEPCO is spinning the truth, one must take that into consideration when interpolating the facts! See

    4. I believe in calling this a Trillion Dollar Eco-Disaster instead of an “Industrial accident” because I believe that my description is much more factual, and challenge anyone to come up with a better description, using the criteria I listed about about a page or two ago..

    5. The Japanese people are suffering from widespread Radioactiv­e pollution and trying to downplay that, is insulting to them and all those that have been following this debacle since 3/11. The Tsunami was bad enough but the radioactiv­e pollution is making the recovery many levels of magnitude harder and also is spreading radio active pollution Globally since the Japanese are both burning contaminat­ed material and also dumping or allowing radioactiv­e water to enter the Pacific Ocean!

    6. I have been amazed at how the Nuclear Industry in Japan has been able to control the media and keep this Trillion Dollar Eco-Disast­er “quiet”… By blogging about every aspect of this Disaster, I hope that I am setting a higher standard for both the Japanese and those of us in the USA and World-Wide­! We are the eyes of the World and that is a great responsibi­lity! The Japanese are afraid now because they cannot trust their Gov’t. to tell the truth; not because folks blog about what might be happening and that is unacceptab­le for them and for US!

    7. After seeing our own Gov’t. in action and how resistant our own NRC is to make any changes after learning about Japans Trillion Dollar Eco-Disaster, I now realize that MY Gov’t. is not any more proactive than the Japanese Government when it comes to Nuclear safety especially where large Naturally occurring events like Quakes, Floods, Tsunami’s and Fires are concerned… In short we in the USA have been very lucky to only have had less severe Nuclear Accidents in the past, but that is no indication that another Trillion Dollar Eco-Disaster cannot happen here any place anytime 24/7/365!

    8. Finally, this question is always in my mind:
    The human tragedy aside, where will America get the money to pay for a Trillion Dollar Eco-Disast­er here or in a developing country if another reactor has Meltdown and how much Global pollution will it cause! That is a major concern to me and should be to any person living on the Planet!

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