Failure of High Pressure Steam Piping on Furnace Outlet

2011AW14 Shell Global Solutions For Information Purposes Only July 2011

Target audience for this alert

 All Production Operations Personnel
 Site Heat Transfer Focal Points
 ESP Focal Points
 Process Engineering, Process Control and Process Safety
Personnel

Figure 1 – Damaged Tubes in Furnace

What happened
In November 2010, a Shell Olefin Unit was shut down due to a 1500 psi (103 bar) steam line failure on the outlet
of the superheat coil near the top of one of the ethylene furnaces.
An hour and fifteen minutes before the steam line failure, the ethane feed had been lost completely, leaving the
total gas feed to the furnaces at roughly 60% of the pre-upset condition. The feed rate to two of the six furnaces
cracking gas feeds fell below the critical low flow alarm. The lower feed rat es upset operation of the
downstream distillation column and process gas compressor as well.
1
Operators began to switch the furnaces to „Hot Steam Standby „ , but they held off doing so because they
thought that the ethane feed could be quickly re-established. They were further delayed by process upsets
downstream of the furnaces and responded to furnace conditions 30-50 minutes later by reducing the number of
burners in operation. Unknown to the operators, radiant tubes had ruptured in one furnace and the ethane and
cracked gas had ignited.
An outside operator noticed flames coming from the furnace outlet piping when she went to the top deck of the
furnace. Two operators res ponded to help the first operator extinguish the fire with steam hos es . Just after they
arrived, the fire escalated. Flames were also seen coming from the observation ports on the top of the furnace.
As the operators were leaving the area, an elbow failed in the 1500 psi (103 bar) superheated steam piping
coming from the furnace convection section. The concussion from the release knocked two of the three
operators down ont o the deck grating. There were no injuries.
The furnace feed was isolated and the unit brought down after the steam line failure. The furnace proc ess out let
motor operator valve (MOV) did not close completely. Hydrocarbon continued to feed the fire in the furnace for
three hours until the emergency response team closed the valve manually.
During the initial upset and emergency shutdown of the furnaces, tubes in all six of the furnaces cracking gas
feeds were damaged. Fires occurred in two more furnaces when tube leaks developed as a result of cooling
during the shutdown. Repairs to the six furnac es cost $6 million USD and took 26 days to complete, impacting
ethylene supply to customers.

1
Hot Steam Standby, (also called High Steam Standby in some units) is an operating mode used on Olefin Unit Furnaces. Firing of the
furnace is reduced by cutting half of the burners and reducing the fuel pressure as required to maintain control of coil outlet temperatures
and to prevent over heating or cooling of the tubes. The hydrocarbon feed is stopped and the steam flow is increased through the tubes.
For Information Purposes Only Awareness Alert 2011AW14 –Failure of High Pressure Steam Piping on Furnace Outlet Page 1 of 5
Why it happened
Loss of feed – The gas feeds to the Olefin Unit typically came from a number of sourc es: dry gas from three
cat crackers, propane from a propane splitter, recycle ethane from the olefin unit, and ethane from a
fractionation plant. On the day of the incident, upsets in two of the three cat cracker supplies led to a high
demand for ethane feed from the fractionation plant. Normal swings in the pressure of the ethane supply were
amplified as its percentage of the total unit feed increased.
Just over an hour before the steam line failed, the pressure control valve for the ethane feed closed completely.
A bolt had been installed backwards, causing the positioner feedback to be incorrect. A deviation between the
positioner feedback and controller output caused the positioner to force the valve to its fail safe position. (See
Attachment 1 for further details). This ethane valve failure was not obvious to the operators.

Overheating of tubes – As the ethane feed rate to the unit was dropping, the unit operators and their shift
supervisor were troubleshooting the problem. The swings and low feed rates were causing numerous ups ets to
the operation of the olefin furnaces, the downstream distillation column, and the four stage centrifugal Process
Gas Compressor on the column overheads. (See Attachment 2 for a schematic of the Olefin Unit.)
The feed system hydraulics caused the feed rates to two of the six furnaces cracking gas to drop below the low
flow alarm. In anticipation of going to „Hot Steam Standby‟ on these furnaces, the console operator switched
the fuel control system from the normal temperature cascade mode to direct pressure control, to more quickly
reduce the fuel flow. This move stabilized the furnace temperature for the current feed rate, but the furnace
feed rate continued to drop. Before he asked the outside operators to reduce the number of burners online in
the two furnaces, he heard his supervis or say „hold up‟.
The console operat or then turned his attention to the process gas compressor and distillation column. Knowing
that the low flow was creating a „surge‟ condition on the compressor, he op ened the compressor recycle valves
to maintain the flow through the compressor. Because the column pressure was approaching a critical alarm
limit, he put the column‟s pressure controller in manual and began venting the column to the flare to prevent
lifting of atmospheric relief valves. These manual interventions were believed to be needed based on past
experiences with and training about the response of the automatic controls for the compressor and column.
While the console operator focused on the column and compressor, multiple critical and standard high
temperature alarms on the two furnaces with low feed rates sounded, but went unnoticed in the flood of alarms
(368 in an hour, with 96 being critical). When the console operat or shift ed his attention from the potential
atmospheric relief and compressor issues back to the furnaces, he directed the outside operator to shutdown
half of the burners in the two furnac es, going to the hottest furnace first. On the way to address the second
furnace, the outside operator was delayed by a series of events relat ed to the loss of et hane feed. The operat or
was unaware of the loss of feed or how hot the furnaces were and the need to shut off the fuel to the burners.
Continued firing with low feed caus ed the tube metal temperatures to rise to a point at which a creep failure of
o o o
the tubes occurred. The peak coil outlet temperatures recorded on the DCS were 2115 F (1157 C), 315 F
o
(157 C) above the critical alarm point.
Data reviewed by the investigation team indicated that just before the outside operat or reached the second
furnace, at least one tube had rupt ured. The outside operator noticed flames exiting the top of the radiant
section of the furnac e about 5-10 minutes after the tube fire started.
The olefin furnace instrumented protection (IPF) did not include trips for low feed flow, high process outlet
temperature or high 1500 psi Steam Superheat er outlet temperature. Instead, low flow or high temperature
alarms were expected to tri gger a manual response to put the furnac e on Hot Steam Standby. In this incident
the operator respons e was delayed due to a combination of believing that the feed supply problem would be
resolved and focusing on ot her critical activities related to the compressor and column. Placing the fuel control
to the furnac e in direct pressure control (instead of outlet temperature cascaded to pressure control) accelerated
the overheating of the tubes, as the feed to the furnace dropped.

Steam line failure – As the feed rate dropped, fuel flow to the furnaces had been reduced while the air flow into
the firebox stayed relatively high. There was sufficient oxygen in the furnac e to create a flammable mixture with
the released hydroc arbon. The mixture ignited in the hot furnace. Data reviewed in the investigation identified
the time of the tube failure by the drop in furnace oxygen levels and the increase in firebox pressure. The
furnace had a high firebox pressure trip, but the pressure spike did not reach the trip point before the steam line

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failed. The pressure spike was smaller than expected because the firing rate was reduced just aft er the tube
rupture, when the outside operator blocked in half of the furnace burners to go to Hot
Steam Standby.
Backflow from the common furnace outlet piping and downstream equipment fed the fire
in the furnace radiant section. The fire increased the flue gas temperatures to near
o o
2400 F (1316 C). Operators were unaware of the tube failure or fire until the outside
operator saw the flames from the furnace.
The 1500 psi (103 bar) steam (being superheated in the convection section ) reached
o o
temperatures close to 1500 F (816 C) which was above the yield point of the 1 ¼
Chrome ½ Moly furnace outlet steam piping. A six inch diameter short radius elbow on
Figure 2 – Failed elbow
in the shop
the superheated steam piping from the furnace failed at the elevated temperature.

Operators in the area The console operator had requested that boiler feed water be drained from the steam
drum for the furnace to reduce the level and avoid slugging the process gas compressor turbine with liquid. The
valves used to drain the liquid were loc ated at the top of the furnace, directly above the roof of the firebox and
within a few feet of the 1500 psi Steam Superheater outlet piping. The operator, who went to the top of the
furnace to access the valves, noticed flames exiting the furnace. Believing it was a small flange leak at the
Trans fer Line Exchanger on top of the furnace, two operators responded to help the operator by getting steam
hoses to extinguish the fire. When additional flames were observed from the observation doors, the operators
left the immediate area, but were still on the upper deck of the furnaces near the steam line when it failed.

Furnace Isolation – The fire from the broken furnace tubes continued to burn for three hours after the furnace
was tripped, fed by backflow from the process outlet. Coke build up in the valves kept the furnace process
outlet isolation MOV from closing completely when it was activat ed in the field. After establishing a safe method
to access the furnace, the emergency response team lined up the steam purge to the isolation valve seat, and
closed the valve using the manual hand-wheel.
After being tripped, two other furnaces experienced tube failures and fires that were fed from the process outlet
lines. The tubes cooled rapidly, and the difference in thermal expansion properties of the coke within the tubes
and the metal of the tubes led to failure of the tubes. The MOV‟s on these furnaces had not been closed in the
emergency shutdown.

Lessons learned

General Learnings
ESP
 Operators may wait on guidance from their supervisor and delay decisions to shutdown equipment or
the unit as a part of Stabilize, Slowdown, Shutdown (SSS ). Through int erviews, the investigation
uncovered that most operators in this area did not believe that they really had authority to SSS.
 Alarm overload during an upset can impact the res ponse to critical alarms, even after changes to the
Variable Table from an ESP Initial Set Up are implemented.
 Some of our process units rely on operator response to alarms for actions that newer units have
automat ed in IPF systems.

Situational A wareness
 To respond to some critical alarms, outside operators may access equipment that is in an unstable
operating mode, without understanding the risk of the situation. (For example, going on top of a furnac e
to address high steam drum levels after a tube leak and fire has started. The outside operator was not
aware of the elevated furnace temperat ures or other unusual operating conditions.)

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Cont rol Systems –
 When the deviation between the input from the DCS to the valve and the valve positioner feedback is
out of a pres et range, some valve positioners may fail a valve to its safe position. Operators may not
know that this could happen or recognize that it has happened.
 Cont rollers which require manual intervention during unit upsets can impact the response time for other
barriers and add to the complexity of an abnormal situation.

Olefin Unit Specific Learnings

IPF
 The current guidance in the Lower Olefins and Aromatics Book of Knowledge recommends automatic
trips to minimum firing (called a partial trip or Hot Steam Standby) on low feed flow, high coil outlet
temperature, and high super-heater outlet temperature.
 Cutting fuel at nearly the same time as the tube failure occurs can dampen the pressure spike, reducing
the effectiveness of the high firebox pressure trip.

Furnace Isolation MOV‟s

 Furnace Isolation MOV‟s on olefin furnaces are the primary barrier to prevent hydrocarbon from back
flowing into a furnace and causing additional damage to equipment and risk to personnel should a tube
failure occur. The barrier can only be considered valid if steps to maint ain the reliability of the MOV‟s
are taken.
 Putting all furnaces on Hot Steam Standby is an alternate barrier to minimize the potential for a fire in
the furnace in a tube failure case if the MOV does not function properly. This causes steam to back flow
through the trans fer line instead of flammabl e cracked gas but oft en would lead to a total unit shutdown.
 The emergency shutdown of olefin furnaces should include isolation of the furnaces from both the feed
system and downstream equipment to minimize the fuel available and reduce the probability of a fire or
explosion occurring in a furnace after a tube leak.

Further information
The information and data sources listed below are provided to assist you if more information is desired or
needed regarding the subject of this alert:

 Attachment1 – Ethane Feed Valve Failure details

Attachment 1 to
Failure of HP Steam P

 Attachment 2 – Olefin Unit Schematic Diagram

Attachment 2 to
Failure of HP Steam P

 Learning Materials
Link to Safety Meeting PowerPoint

Learning LFI Summary

Opportunities - DSM-A DSM-AW-201114.doc

For Information Purposes Only Awareness Alert 2011AW14 –Failure of High Pressure Steam Piping on Furnace Outlet Page 4 of 5
  Lower Olefins and Aromatics Book of Knowledge, Section 1.1.3 Furnace Safeguarding
 P&T Heat Transfer Portal contains guidance information about furnaces, and links to various B est
Practices, PWR‟s, Model Bowtie‟s, LFI‟s, DEP‟s, etc.
 Ethylene Producers Conference Papers – contact your P& T Lower Olefins Support for access to this
material which is available through www.ethyleneweb.com
 “Gas-Fired Steam Cracking Furnace Safeguarding Considerations” GS.08.54413
 “Safeguarding, cracking furnaces” – Restricted Document #GS TLO-LOC-203
 P&T Heat Transfer Group
 P&T Lower Olefins Group
 Manufacturing LFI Coordinator

Goal Zero: Zero injuries, Zero fatalities

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Copyright 2011 All Rights Reserved, Shell Oil Company
Copyright 2011 All Rights Reserved, Shell Internationale Research Maatschappij B.V

For Information Purposes Only Awareness Alert 2011AW14 –Failure of High Pressure Steam Piping on Furnace Outlet Page 5 of 5