At the Advanced Test Reactor (ATR), the M-43 Diesel Generator suffered a loss of fuel oil pressure and tripped offline (quit running due to loss of fuel). The M-6 Emergency Diesel Generator sensed a loss of voltage and came online, replacing the output of the M-43 generator. Reactor operation was not impacted, as it had already been shut down earlier that day. Numerous factors lead up to this failure, including poor communication, a failure of procedure use and adherence, a misunderstanding of the systems, hidden system response, and lack of questioning attitude.
Read the attached lessons learned for a detailed description of each contributing factor.
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