Human Performance Improvement - If It Does Not Feel Right, Stop and Discuss It with Your Work Group
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Type:  Lessons Learned

Publisher:  U. S. Department of Energy, Waste Isolation Pilot Plant-DOE

Published As:  Public

Date: 

Topics:  Operations, Waste Management, Work Management/Planning, Material Handling/Storage

A maintenance work package had been written to make adjustments on a Swipe Delivery System Transfer Table while the table was controlled in the manual mode. As adjustments were being made, the transfer table unexpectedly activated and began to close. Mechanical Craftsmen working on the adjustments called an immediate stop to the evolution. No one came in contact with the transfer table. Personnel involved in the planning, development, and work execution later stated they were unfamiliar with the manual operating mode of the system.

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