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Who Destroyed Three Mile Island?
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Nickolas Means
April 17, 2018
Programming
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950
Who Destroyed Three Mile Island?
(as presented at RailsConf 2018)
Nickolas Means
April 17, 2018
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Transcript
Who Destroyed Nickolas Means @nmeans
Who Destroyed Nickolas Means @nmeans
@nmeans
@nmeans • #WhoDestroyedTMI @nmeans
@nmeans
@nmeans
@nmeans
@nmeans
@nmeans
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Three Mile Island Nuclear Generating Station Londonderry Township, Pennsylvania @nmeans
Three Mile Island Harrisburg, Pennsylvania @nmeans • #WhoDestroyedTMI @nmeans TMI
Unit 2 906 MWe Babcock and Wilcox PWR
@nmeans Bill Zewe Fred Schiemann Ed Frederick Craig Faust
Condensate Polishers @nmeans
Three Mile Island Unit 2 @nmeans
Three Mile Island Unit 2 @nmeans
Three Mile Island Unit 2 @nmeans
Three Mile Island Unit 2 @nmeans
Three Mile Island Unit 2 @nmeans
Three Mile Island Unit 2 @nmeans ❌
Three Mile Island Unit 2 @nmeans ❌
Three Mile Island Unit 2 @nmeans ❌
@nmeans TMI Unit 2 Control Room
Three Mile Island Unit 2 Three Mile Island Unit 2
@nmeans
Pressurizer @nmeans Connection to Primary Cooling Loop Heating Element Water
Spray 1. Regulates System Pressure 2. Measures Water Level 3. Absorbs Pressure Shocks
Three Mile Island Unit 2 Three Mile Island Unit 2
@nmeans
Three Mile Island Unit 2 Three Mile Island Unit 2
@nmeans
Three Mile Island Unit 2 @nmeans
Three Mile Island Unit 2 @nmeans
@nmeans
Three Mile Island Unit 2 @nmeans
Three Mile Island Unit 2 Three Mile Island Unit 2
@nmeans
@nmeans
Three Mile Island Unit 2 Three Mile Island Unit 2
@nmeans
@nmeans
Three Mile Island Unit 2 Three Mile Island Unit 2
@nmeans
Three Mile Island Unit 2 Three Mile Island Unit 2
@nmeans
Three Mile Island Unit 2 @nmeans
@nmeans
Three Mile Island Unit 2 @nmeans ❌ ❌
@nmeans
Fuel Rod Assembly @nmeans
Gary Miller George Kunder @nmeans
Three Mile Island Unit 2 @nmeans ❌
Three Mile Island Unit 2 @nmeans ❌ ❌ ❌
@nmeans
@nmeans
@nmeans
Final Core State @nmeans
@nmeans
Three Mile Island Today @nmeans
@nmeans
@nmeans
@nmeans Hindsight Bias
@nmeans Outcome Bias
@nmeans
Three Mile Island Unit 2 @nmeans
Three Mile Island Unit 2 @nmeans
Pressurizer @nmeans Connection to Primary Cooling Loop Heating Element Water
Spray 1. Maintains System Pressure 2. Measures Water Level 3. Absorbs Pressure Shocks
@nmeans
Heat at 100% 12 MWth 2,841 MWth Heat at Shutdown
(6.5%) 0.78 MWth 185 MWth @nmeans
Three Mile Island Unit 2 @nmeans
Three Mile Island Unit 2 Three Mile Island Unit 2
@nmeans
@nmeans
Three Mile Island Unit 2 @nmeans • #WhoDestroyedTMI Three Mile
Island Unit 2 @nmeans
@nmeans
@nmeans
@nmeans
@nmeans
@nmeans Human error is never the cause.
@nmeans Ask what is responsible, not who.
@nmeans Understand why it made sense.
@nmeans Seek forward accountability, not backward.
@nmeans Always look for the second story.
Who Destroyed Nickolas Means @nmeans
Who What Destroyed Nickolas Means @nmeans
@nmeans
@nmeans
Who What Destroyed Nickolas Means @nmeans