TRADEMARK DISCLAIMER. Reference herein to my specific commercial product, process, or service by bade name, bademark, manufacturer, or athewise, dws not n w r i l y constitute or imply ifs endorsement, recommendation, or favoring by the United States Government or any agency thereof or io conmctors or subconhaetors
Printed in the United States of America. To obtain copies ofthis dacurnent, contact: Dmument Control Services, P.O. Box 950, Mailstop H6-08, Richland W A 99352, Phone (509) 312-2420; Fax (509) 3764989. c
HANFORD DATE
Approved for Public Release A4400673 (01/97) GEF321
commkrcial Grade Item Upgrade Dedication Form w
CGI No. CGI-SNF-D-47-P4443 ECNNo. NA Title: WORCESTER BALL TW CASK MANUAL FILL VALWS. TW-V
*021, *027
I item No.: NA I Manufacturer:
Rev.No. 0
Page 1 of 11
- 5 k/r - 3cp -3.5
Mfg. ParVModei No.: Supplier's PN:
Part Description:
End Use Description:
Equipment No.: Specification No.: Manufacturer: Past P.O. No.: NA TW-V-*021, '027 W-441 -P4, Rev. 2 Worcester Controls
Manufacturer's ParV Model No.: TED 1 " K5966RTBW4
Equipment Supplier ( i dfferent from manufacturer): Equip. Supplier's Part No.: NA
1. Is the Item available from a catalogue from a qualified NQAl supplier (coordinatewith project CGI interface Engineer or BTR)?
[ ] YES (go to #2 below) [ x ] NO (go to procedure step 5.3.2, proceed to dedicate Item)
company name &type 2. List of Candidate qualified suppliers ' / / j /S/P/ / /
contact name && ,.y++phone
NA
3. Recommended Procurement Shtegy(coordinate with project CGI interface Engineer or BTR): NA
1, Question #I: Is the Item subject to design or specification requirements that are unique to nuclear facilities or activities? [ ] YES (the Item is not commercial grade) [XI NO (continue)
[ ] NO (the item is not commercial grade) 2. Question #2: Is the Item used in applications other than nudear facilities or activities?
[ X] YES (continue) 3. Question #3: is the Item ordered from manufacturerlsupplier on the basis or specifications set fotth in the manufacturers
catalog?
[ ] NO (the Item is not commercial grade) [ X] YES(continue)
[ X ] All three criteria have been satisfied. The Item meets the definition of commercial grade.
12/18/98
Rev.No. 0 d2ommercial Grade Item Upgrade Dedication Form ECNNo. NA CGINo. CGI-SNF-D-47-P4-043 Page2of 11
Title: WORCESTER BALL TW CASK MANUAL FILL VALVES, W - V *021. "027 SR)F 3q35
I X 1 Item is being purchased from a non ESL manufacturer supplier as commercial grade to be used in a Safety Class
[ ]
[ I
Item is being purchased from a non ESL manufacturer supplier as commercial grade to be used in a Safety Significant application. Item was purchased from a non ESL manufacturer supplier as commercial grade to be used in a Safety Class
~
i 1 Item was purchased from a non ESL manufacturer supplier as commercial grade to be used in a Safety Significant
A. PartlComponent Safety Function: 1. Confinement 2. Maintain Critical Function During And After Seismic Event.
B. ParUComponent Functional Mode: Safety Function #I:
[ 1 Active - Mechanical or Electrical change of state is required to occur forthe component to perform its safety function [ X I Passive - Change of state is not required for the component to perform its safety function
[ ] Active - Mechanical or Electrical change of state is required to occur for the component to perform its safety function. [ X 1 Passive - Change of state is not required for the component to perform its safety function
[ ] Active - Mechanical or Electrical change of state is required to occur for the ccinponent to perform its safety function. [ ] Passive - Change of state is not required for the component to perform its safetyfunction
Safety Function #L?:
Safety Function #3:
C. Host Component Safety Function ( i applicable):
D. Failure Mode(s) and the effects on component or system safetyfunction (see Worksheet 1): 1. Structural Failure of valve or seat- 2. Valve failure to open results in loss of capability for manual makeoff of TW to the cask.
12/18/98
Commercial Grade Item Upgrade Dedication Form ECNNo. NA CGI No. CGI-SNF-D-47-P4-043 Title: WORCESTER BALL TW CASK MANUAL FILL VALVES, TW-V
*021. *027
Environmental Qualification Required If yes: Environmental Qualification Requirements YSI I Limiting Environmental Condtions: No [ X I Required Safety Functions:
Environmental Condition B Qualification Period: Natural Phenomena Hazard (NPH) Design Required: If yes: NPH Design Requirements
[ X ] Safety Class (SC) [ 1 General Setvice [ ] Safety Significant (SS) If partlcomponent classification is different from host cwnponentkystem, document basis.
Critical Characteristics Verification Document Vendor Specifications: HNF-SD-SNF-SEL-002, Rev. 4 1. Item Identification Critical Characteristics Manufacturer Model Number Nameplate Data
I I I 3. Performance Critical Characteristics (for reasonable assurance that the Item will perform its intended safety function(s))
Acceptance CriteriaJTolerances Acceptance ID Function Method
(necessary for reasonable assurance that the Item delivered is the Item specified) Worcester Controls 1, IN X
1" K5966 RTBW4 1, IN X
Per Vendor Manual 1, IN X
Pressure Boundary Integrity
Seat Leakage
Body Material Stainless Steel ConfigurationlMounting Factory Installed Locking Mechanism
Process Connection 1 " Buttweld SS, SCH 40
Environmental Seismic Condition A
1,T X
1, IN X
1, IN X
Pressure Test at 165 psig (zero leakage) Note 3 Pressure Test to 1 5 0 psig (e IO' cc He/Sec Bubbletight) Note 1
Note 2
4. Notes and Legend: 1. These valves have TFE Packing and Buna & Vitron Seals. These
materials are not subject to degradation at 40°F and 60% RH or 11 5'F and 22% RH and are suitable for Condition B Application.
2. Maintain critical function during and after Seismic event. W-441- P4, Rev. 2 Appendix L, Page L- (later) provides a seismic testing plan for these safety class, Seismic Condition A valves at a Seismic Spectra TBD.
3. Pressure test at 110% o f design accident condition pressure of 150 psig.
1, T X
1,T X
1. T X
Acceptance Method: 1. Special Test and Inspection
1, INforlnspection 1.T for Test
2. Commercial Grade Survey 3. Source Verification 4. VendorAtem History
Approvals: Designated Engineer: ,
I
Commercial Grade Item Upgrade Dedication Form ECNNo. h% CGI No. CGISNF-D-47-P4-043 Title: WORCESTER BALL TW CASK MANUAL FILL VALVES, TW-V
The gradual deterioration of a material due to chemical or electrochemical reactions, such as oxidation, between the material and its environment Destruction of materials by the abrasive action of moving fluids, usually accelerated by the presence of solid particles canied with the fluid. An electrical circuit that is unintentionally broken so that there is no complete path for current flow.
An abnormal connection by which an electrical current is connected to ground, or to some conducting body, resulting in excessive current flow. Clogging of a filtering medium resulting in the inability to perform its purification function or blockage of flow. Binding of a normally moving item through excessive pressure, temperature, friction, jamming.
Mechanical oscillations produced are beyond the defined permissible limits due to unbalancing, poor support, or rotation at critical speeds. A loss of mechanical and physical properties of a material due to exposure to high temperatures, radiation emsure. Under the action of excessive external forces the material of the part has been deformed or distorted.
From prolonged exposure to high temperature and stress, the Objed will show a slow change in its physical (shape and dimension) and mechanical characteristics. Fracture charactelized by tearing of metal accompanied by appreciable gross plastic
Yes [ ] No [ XI; If Yes, indicate failure
Yes [ 1 No [XI; If Yes, indicate failure
Yes [ ] No [ XI; If Yes, indicate failure
Yes [ ] No [XI; If Yes, indicate failure Mode
Yes [ 1 No [ X]; If Yes, indicate failure Mode
Yes [ X I No [ 1; If Yes, indicate failure Mode Structural Failure or Seizure of Valve Seat Yes I 1 No[XI; If Yes, indicatefailure . . Mo&
Yes [ 1 No [XI; If Yes, indicate failure Mode
.
Yes [ ] No [ XI; If Yes, indicate failure Mode
Yes [ 1 No [XI; If Yes, indicate failure
Yes [ ] No [XI; If Yes, indicate failure Mode
1.
2.
3.
4.
12/18/98
Comniercial Grade Item Upgrade Dedication Form CGI No. CGISNF-D47-P4-043 ECNNo. NA
~ i t ~ e : WORCESTER BALL TW CASK MANUAL FILL VALWS. TW-V *021. *027
SPECIAL TESTlIlr
Rev. No. 0
Pagedof 11
so3F: 343s
[tern Description: TW Manual Cask Fill Valves
System#: 47
Manufacturer (Addresflhone):
Worcester Controls
P.O. Box 538
33 Lock Dr.
Marborough, MA 01752
(508) 481-4800
P.O. #
llyp Tat P& Tat
PECTION VERIFICATION
muip #: TW-V-*O21,*027
Model #: 1 " K5966RTBW4
Supplier (AddressPhone):
TBD
[XI I [ I 1. Manufacturer
[XI [ ] [ ] 2. Model Number
[XI [ 1 [ I 3. NameplateData
[ ] [XI [ ] 4. Body Material
[XI [ ] [ ] 5. ConfigurationlMounting
[XI [ ] [ ] 6. ProcessConnection
[ I [XI [ I 7. Pressure Boundary Integrity
[ I [XI [ I 8. Seat Leakage
* See Attachment G of Desk Instruction for Sampling Size Chaiacteristic: Manufacturer
Sample Size*: All Items
Acceptance Criteria: Worcester Controls
Receipt Inspection Plan / Report #:
References (see Section 7):
Characteristic: Model Number
Sample Size*: All Items
Acceptance Criteria: 1 " K 5966RTBW4
Receipt Inspection Plan / Repoa #:
References (see Section 7): Worcester PB451-22
12/18/98
Commercial Grade Item Upgrade Dedication Form CGI No. CGI-SNJ?-D-47-P4-043
Characteristic for Test: Body Material Acceptance Criteria: Stainless Steel Sample Size*: Normal Sampling Size Actual Test Value: Test Plan and Report #:
characteristic for Test: Pressure Boundary Integrity Acceptance Critaia: Pressure Test at 165 psig (zero leakage) Sample Si*: Normal Sampling Size Actual Test Value: Test Plan and Report #:
Characteristic for Test: Seat Leakage Acceptance Criteria: Pressure Test to 150 psig ( C 1 O4 cc He/Sec Bubbletight) Sample Size*: Normal Sampling Size Actual Test Value:
References (see Section 7):
References (see Section 7):
Test Plan and Report # References (see Section 7):
12/18/98
Commercial Grade Item Upgrade Dedication Form ECN No. NA CGI No. CGI-SNF-D-47-P4-043 ~it le : WORCESTER BALL TW CASK MANUAL FILL VALVES. TW-V
*021, *027
I n s t i c for Test: Seismic Condition A
Rev.No. 0
Page8af 11
sa 3935
Acceptance Criteria: Maintain Critical Function During and After Seismic Event. Sample Size*: Normal Sampling Size Actual Test Value: Test Plan and Repoa #: References (see Section 7): **If SupplierlMawfacturer or Other, Refer to CGI Checklist-2 for Support Jnfomaiion
12/18/98
Commercial Grade Item Upgrade Dedication Form ECN No. NA CGI No. CGI-SNF-D-47-P4-043 Title: WORCESTER BALL TW CASK MANUAL FILL VALVES, TW-V
Page 9 of I 1 I ScOC 3935
ITEM DESCRIPTION Critical Characteristics
Critical Charscluirtlcn Aeceptaoa CxiitaidPderan~ m
Manufacturer Worcester Controls X Model Number I 1" K5966 RTBW4 Ix Namedate Data I Per Vendor Manual Ix Bodv Material
ConfigurationlMounting
Process Connection
Stainless Steel
1 " Buttweld SS, SCH
Pressure Boundary Integrity Seat Leakage
Seismic Condition A
Pressure Test at 165
Pressure Test to 150 psig ( < I O 4 cc He/Sec
Function
12/18/98
Commercial Grade Item Upgrade Dedication Form ECNNo. NA CGI No. CGI-SNF-D47-P4-043 Title: WORCESTER BALL TW CASK MANUAL FJLL VALVES, TW-V
*021. "027
2. DISPOSITION OF UNVERIFIED ORFAILED CRITICAL CHARACTERISTICS
Rev.No. 0
Page IO of 11
3R)G 3435
Critical Characteristic Disposition
.
Testing Agency Approval: Date Testing Agency QA Engineer Date.
12/18/98
Design Authority: Date.
QA Engineer Date
eonh6ercial Grade Item Upgrade Dedication Form ECN No. NA CGI No. CGI-SNF-D-47-P4-043 Tae: WORCESTER BALL TW CASK MANUAL FILL VALVES, TW-V
*021. *027
Initial Procurement Documents
[ ] Drawings:
[ ] Mannals (specify type & number): [ ] DesignCalcnlations
