An Evaluation of Recent Events Involving Hazardous Energy at INL Facilities
Idaho National Laboratory (INL) Facilities and Site Services (F&SS) has experienced 14 reportable events relating to work performed under lockout / tagout (LOTO) during the period of March 4, 2019 through August 18, 2020. The 14 events are described in Appendix A and were numerous enough and similar enough in nature to be indicative of an adverse trend that warranted further evaluation. A qualified cause analyst was assigned to lead a team in the review of these non-compliances, to determine commonalities, and to provide recommendations to the sponsoring organization. The team focused on both individual and institutional behaviors as well as the LOTO process and procedure. The non-compliances were reported in the Department of Energy (DOE) Occurrence Reporting and Processing System (ORPS) and/or the INL issues tracking system.