Event Notification Report for March 6, 2001
U.S. Nuclear Regulatory Commission
Operations Center
Event Reports For
03/05/2001 - 03/06/2001
** EVENT NUMBERS **
37806 37807 37808 37809 37810
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|Power Reactor |Event Number: 37806 |
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| FACILITY: HATCH REGION: 2 |NOTIFICATION DATE: 03/05/2001|
| UNIT: [] [2] [] STATE: GA |NOTIFICATION TIME: 12:25[EST]|
| RXTYPE: [1] GE-4,[2] GE-4 |EVENT DATE: 03/05/2001|
+------------------------------------------------+EVENT TIME: 10:13[EST]|
| NRC NOTIFIED BY: BRUCE BUTLER |LAST UPDATE DATE: 03/05/2001|
| HQ OPS OFFICER: JOHN MacKINNON +-----------------------------+
+------------------------------------------------+PERSON ORGANIZATION |
|EMERGENCY CLASS: N/A |STEPHEN CAHILL R2 |
|10 CFR SECTION: | |
|*INB 50.72(b)(3)(v)(B) POT RHR INOP | |
| | |
| | |
| | |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|UNIT |SCRAM CODE|RX CRIT|INIT PWR| INIT RX MODE |CURR PWR| CURR RX MODE |
+-----+----------+-------+--------+-----------------+--------+-----------------+
| | |
|2 N Y 100 Power Operation |100 Power Operation |
| | |
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EVENT TEXT
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| REACTOR CORE ISOLATION COOLING (RCIC) TRIPPED UNEXPECTEDLY DURING TESTING. |
| |
| Received RCIC "B" logic isolation signal causing RCIC in-board isolation |
| valve, 2E51-F007, to close resulting in RCIC trip signal. I&C personnel |
| were performing 57SV-CAL-003-25 ATTS transmitter calibration for RCIC "B" |
| steam line differential pressure transmitter 2E51-N057B when the isolation |
| occurred and this instrument caused the isolation. Investigation is in |
| progress to determine the cause. Received isolation signal at 1013 ET, I&C |
| backed out of the procedure returning 2E51-N057B transmitter to service and |
| RCIC isolation was reset and RCIC returned to standby at 1105 ET. |
| |
| All other Emergency Core Cooling systems were fully operable during the time |
| period RCIC was declared inoperable. |
| |
| The NRC Resident Inspector was notified of this event by the licensee. |
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|Hospital |Event Number: 37807 |
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| REP ORG: SAINT LUKES HOSPITAL |NOTIFICATION DATE: 03/05/2001|
|LICENSEE: SAINT LUKES HOSPITAL |NOTIFICATION TIME: 15:13[EST]|
| CITY: KANSAS CITY REGION: 3 |EVENT DATE: 02/23/2001|
| COUNTY: STATE: MO |EVENT TIME: 11:15[CST]|
|LICENSE#: 24-00889-01 AGREEMENT: N |LAST UPDATE DATE: 03/05/2001|
| DOCKET: |+----------------------------+
| |PERSON ORGANIZATION |
| |JOHN MADERA R3 |
| |BRIAN SMITH NMSS |
+------------------------------------------------+ |
| NRC NOTIFIED BY: SCOTT SORENSEN | |
| HQ OPS OFFICER: JOHN MacKINNON | |
+------------------------------------------------+ |
|EMERGENCY CLASS: N/A | |
|10 CFR SECTION: | |
|LADM 35.33(a) MED MISADMINISTRATION | |
| | |
| | |
| | |
| | |
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EVENT TEXT
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| POSSIBLE MEDICAL MISADMINISTRATION |
| |
| A remote afterloader device failed to function as it was intended during a |
| random FDA trial. The remote afterloader was in automatic, and it was |
| supposed to insert an intervascular, brachytherapy, 93-mCi, P-32, wire |
| source into a patient. The remote afterloader device did not operate |
| properly, and it inserted and withdrew the wire source 4 times. No dwell |
| time was recorded by the afterloader since the wire source inserted less |
| than 5 seconds each time before the wire source was automatically withdrawn. |
| The patient was supposed to have received a total dose of 20 grays. The |
| patient received a dose much less than intended. The FDA was notified of |
| this event by the licensee. |
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|General Information or Other |Event Number: 37808 |
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| REP ORG: TEXAS DEPARTMENT OF HEALTH |NOTIFICATION DATE: 03/05/2001|
|LICENSEE: NON-DESTRUCTIVE INSPECTION, CORP. |NOTIFICATION TIME: 17:45[EST]|
| CITY: CLUTE REGION: 4 |EVENT DATE: 02/27/2001|
| COUNTY: BRAZORIA STATE: TX |EVENT TIME: 00:00[CST]|
|LICENSE#: L02712 AGREEMENT: Y |LAST UPDATE DATE: 03/05/2001|
| DOCKET: |+----------------------------+
| |PERSON ORGANIZATION |
| |WILLIAM JOHNSON R4 |
| |JOSEPH HOLONICH NMSS |
+------------------------------------------------+ |
| NRC NOTIFIED BY: HELEN WATKINS | |
| HQ OPS OFFICER: JOHN MacKINNON | |
+------------------------------------------------+ |
|EMERGENCY CLASS: N/A | |
|10 CFR SECTION: | |
|NAGR AGREEMENT STATE | |
| | |
| | |
| | |
| | |
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EVENT TEXT
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| FOUR RADIOGRAPHERS EXCEEDED ANNUAL EXPOSURE LIMIT. |
| |
| |
| After receiving a Radiation Dosimeter Report on 01/22/01 for wear date of |
| 11/20/00 through 12/19/00, it was discovered the licensee had 4 individual |
| personnel dosimeters exceeding the annual limits of 5 rem/yr. Participants |
| ID and reported doses are listed below: |
| |
| 1. Participant 00089 ID # 466313013, 5553 mrem. |
| 2. Participant 00190 ID # 452717589, 5661 mrem. |
| 3. Participant 00174 ID # 453959946, 4673 mrem plus as assessment of 417 |
| mrem for a lost dosimeter equal a sum of 5091 mrem. |
| 4. Participant 00255 ID # 222582111, 3995 mrem, plus previous employment |
| assessment of 1065 mrem equal a sum of 5060 mrem. |
| |
| After receiving and reviewing the dosimetry reports phone notification was |
| made confirming the resulting exposures exceeding annual limits in |
| accordance with 25 TAC requirements. At this time the licensee is awaiting |
| the final dosimetry reports for 2000 year to date. Upon receipt of the |
| final dosimetry reports the licensee will set up an investigation date and |
| time. |
| |
| Texas Department of Health is investigating to obtain additional |
| information. |
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|Power Reactor |Event Number: 37809 |
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| FACILITY: NINE MILE POINT REGION: 1 |NOTIFICATION DATE: 03/05/2001|
| UNIT: [1] [] [] STATE: NY |NOTIFICATION TIME: 17:56[EST]|
| RXTYPE: [1] GE-2,[2] GE-5 |EVENT DATE: 03/05/2001|
+------------------------------------------------+EVENT TIME: 16:00[EST]|
| NRC NOTIFIED BY: K BELDEN |LAST UPDATE DATE: 03/05/2001|
| HQ OPS OFFICER: JOHN MacKINNON +-----------------------------+
+------------------------------------------------+PERSON ORGANIZATION |
|EMERGENCY CLASS: N/A |RICHARD CONTE R1 |
|10 CFR SECTION: | |
|*IND 50.72(b)(3)(v)(D) ACCIDENT MITIGATION | |
| | |
| | |
| | |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|UNIT |SCRAM CODE|RX CRIT|INIT PWR| INIT RX MODE |CURR PWR| CURR RX MODE |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|1 N Y 100 Power Operation |100 Power Operation |
| | |
| | |
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EVENT TEXT
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| CONTROL ROOM EMERGENCY VENTILATION DECLARED INOPERABLE. |
| |
| Control Room Emergency Ventilation was declared inoperable at 1600 hours. |
| This was a result of the Lab carbon sample analysis not meeting Technical |
| Specification 3.4.5.c of greater than 90% radioactive methyl iodine |
| removal capability when tested. This required entering into a 7 day |
| shutdown Limiting Condition for Operation. Carbon sample analysis is |
| required per Technical Specification to be performed once per cycle (2 |
| years). Licensee is in the process of replacing the carbon. |
| |
| The NRC Resident Inspector was notified of this event. |
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|Power Reactor |Event Number: 37810 |
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| FACILITY: SEABROOK REGION: 1 |NOTIFICATION DATE: 03/06/2001|
| UNIT: [1] [] [] STATE: NH |NOTIFICATION TIME: 00:24[EST]|
| RXTYPE: [1] W-4-LP |EVENT DATE: 03/05/2001|
+------------------------------------------------+EVENT TIME: 23:24[EST]|
| NRC NOTIFIED BY: JIM CROWLEY |LAST UPDATE DATE: 03/06/2001|
| HQ OPS OFFICER: LEIGH TROCINE +-----------------------------+
+------------------------------------------------+PERSON ORGANIZATION |
|EMERGENCY CLASS: UNU |RICHARD CONTE R1 |
|10 CFR SECTION: |BILL BATEMAN NRR |
|*AEC 50.72(a) (1) (i) EMERGENCY DECLARED |CHARLES MILLER IRO |
|*RPS 50.72(b)(2)(iv)(B) RPS ACTUATION - CRITICA|CHARLIE BAGWELL FEMA |
| | |
| | |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|UNIT |SCRAM CODE|RX CRIT|INIT PWR| INIT RX MODE |CURR PWR| CURR RX MODE |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|1 A/R Y 100 Power Operation |0 Hot Standby |
| | |
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EVENT TEXT
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| DISCRETIONARY UNUSUAL EVENT DECLARED DUE TO A MOMENTARY LOSS OF OFFSITE |
| POWER DURING AN ONGOING SEVERE WINTER STORM AND SUBSEQUENT AUTOMATIC REACTOR |
| TRIP DUE TO GRID INSTABILITY |
| |
| During an ongoing severe winter storm, the 345-kV breakers tripped open and |
| re-closed resulting in a momentary loss of offsite power. An automatic |
| reactor trip also occurred at 2324 on 03/05/01 due to electrical grid |
| instability. (The exact cause of the reactor trip is currently under |
| investigation because there was no first out indication.) All rods fully |
| inserted. The reactor coolant pumps tripped as expected, and one has been |
| placed back in service. Both emergency diesel generators automatically |
| started but did not load. Availability of the condenser was also lost due |
| to the loss of power, and operators closed the main steam isolation valves. |
| There were no radiation releases, and there were no reactor coolant system |
| or steam generator tube leaks. All systems functioned as required with one |
| exception. The steam-driven emergency feedwater pump failed to |
| automatically actuate. |
| |
| At this time, the unit is in Mode 3. Normal charging and letdown, |
| pressurizer heaters and sprays, and one reactor coolant pump are being |
| utilized for primary system level, pressure, and transport control. Water |
| is being supplied to the steam generators via an electric-driven emergency |
| feedwater pump, and the atmospheric dumps are being utilized as the heat |
| sink. Containment parameters are normal. The grid is currently available |
| for offsite power, and the emergency diesel generators are still running. |
| |
| Based on a discretionary shift management call, the licensee declared an |
| Unusual Event at 2336 on 03/05/01. The licensee stated that a |
| "Discretionary Event" under item 18A refers to an event in progress (or has |
| occurred) that indicates a potential degradation of the level of safety of |
| the station. The licensee plans to notify the NRC when the Unusual Event |
| has terminated or if conditions degrade. |
| |
| A severe winter storm is currently ongoing. At the time of the event, the |
| unit was experiencing winds at a rate of approximately 50 miles per hour. |
| The licensee reported that these strong winds were ongoing and that only a |
| few inches of snow had fallen (although up to 2 feet is expected). |
| |
| The licensee notified the state at 2347 on 03/05/01 and plans to notify the |
| NRC resident inspector as well as applicable local officials. The licensee |
| also plans to issue a press release. |
| |
| ***** UPDATE AT 0222 ON 03/06/01 FROM JIM HILL TO LEIGH TROCINE ***** |
| |
| This update provides both clarifications/corrections to the original event |
| notification and additional information regarding licensee plans. |
| |
| CLARIFICATIONS/CORRECTIONS: Prior to the event, two of three offsite power |
| lines had been lost in close succession. The remaining offsite line was |
| subsequently lost, and its breaker re-closed within a short duration. This |
| resulted in the momentary loss of offsite power and subsequent plant |
| transient. This initial electrical imbalance was sufficient to result in |
| the automatic starting and loading of both emergency diesel generators. |
| |
| CURRENT STATUS: The unit remains in the Unusual Event, and winds are |
| currently sustained at a rate of approximately 40 miles per hour. All three |
| offsite power lines have been restored. Both emergency diesel generators |
| remain in operation and continue to provide power to both vital (emergency) |
| buses. The non-vital buses have been re-energized from offsite power. An |
| additional auxiliary pump (the startup feedwater pump) has also been started |
| to provide additional water to the steam generators. This pump is a |
| non-safety related housekeeping pump. |
| |
| PLANS: Within the next half hour, the licensee plans to commence a |
| discretionary plant cooldown and plans to place the unit in Mode 5 (Cold |
| Shutdown). At some point in time, the licensee also plans to secure the |
| electric-driven emergency feedwater pump and rely on the startup feedwater |
| pump to supply water to the steam generators. |
| |
| The licensee notified the NRC resident inspector and an onsite member of an |
| NRC residual heat removal inspection team. The NRC operations officer |
| notified the R1DO (Conte), NRR EO (Bateman), and IRO (Miller). |
| |
| ***** UPDATE AT 0438 ON 03/06/01 FROM JIM HILL TO LEIGH TROCINE ***** |
| |
| The licensee has commenced a plant cooldown and anticipates that it will |
| take approximately 6 hours for the unit to reach Cold Shutdown. Other than |
| commencement of the cooldown, there has been no change in plant conditions |
| or equipment status. |
| |
| The licensee stated that the criteria for exiting the Unusual Event have |
| been met. However, the licensee currently plans to remain in the Unusual |
| Event for a while longer because the high line insulators onsite are still |
| arcing and are suspect and because the in-house vital buses are still being |
| powered by the emergency diesel generators. |
| |
| The licensee notified an onsite member of an NRC residual heat removal |
| inspection team, who in turn notified the NRC resident inspector. The NRC |
| operations officer notified the R1DO (Conte), NRR EO (Bateman), and IRO |
| (Miller). |
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