Event Notification Report for December 22, 2008

U.S. Nuclear Regulatory Commission
Operations Center

Event Reports For
12/19/2008 - 12/22/2008

** EVENT NUMBERS **


44725 44727 44735 44736 44737 44738

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General Information or Other Event Number: 44725
Rep Org: TEXAS DEPARTMENT OF HEALTH
Licensee: PROFESSIONAL SERVICE INDUSTRIES, INC.
Region: 4
City: DALLAS State: TX
County: DALLAS
License #: L04940
Agreement: Y
Docket:
NRC Notified By: RAY JISHA
HQ OPS Officer: JASON KOZAL
Notification Date: 12/17/2008
Notification Time: 10:51 [ET]
Event Date: 12/17/2008
Event Time: 07:35 [CST]
Last Update Date: 12/17/2008
Emergency Class: NON EMERGENCY
10 CFR Section:
AGREEMENT STATE
Person (Organization):
GREG PICK (R4)
MICHELE BURGESS (FSME)
ILTAB VIA E-MAIL ()
MEXICO VIA E-MAIL ()

This material event contains a "Less than Cat 3" level of radioactive material.

Event Text

STOLEN TROXLER GAUGE

"On Wednesday, December 17, 2008 a Troxler moisture density gauge, Model 3430 (S/N 37875 with 8mCi of Cs-137 S/N 77-5152; and 40mCi of AmBe-241 S/N 78-2656) was stolen from the bed of a company pick-up truck along with some other field equipment. The transport case was chained as required by company procedures, but the entire case with gauge was noted missing when the technician briefly left the truck unattended. The chain had been cut and the theft was immediately reported to the Dallas Police Department. The area will be canvassed and dumpsters checked to see if the device had been inadvertently discarded. A reward will be posted through a notice that will be distributed to local authorities."

TX Case Number I-8591.

THIS MATERIAL EVENT CONTAINS A "LESS THAN CAT 3" LEVEL OF RADIOACTIVE MATERIAL

Sources that are "Less than IAEA Category 3 sources," are either sources that are very unlikely to cause permanent injury to individuals or contain a very small amount of radioactive material that would not cause any permanent injury. Some of these sources, such as moisture density gauges or thickness gauges that are Category 4, the amount of unshielded radioactive material, if not safely managed or securely protected, could possibly - although it is unlikely - temporarily injure someone who handled it or were otherwise in contact with it, or who were close to it for a period of many weeks.

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Hospital Event Number: 44727
Rep Org: CJW MEDICAL CENTER
Licensee: CJW MEDICAL CENTER
Region: 1
City: RICHMOND State: VA
County:
License #: 45-15249-01
Agreement: N
Docket:
NRC Notified By: RUTH MICHAUD
HQ OPS Officer: JASON KOZAL
Notification Date: 12/17/2008
Notification Time: 16:07 [ET]
Event Date: 12/16/2008
Event Time: 15:00 [EST]
Last Update Date: 12/17/2008
Emergency Class: NON EMERGENCY
10 CFR Section:
35.3045(a)(2) - DOSE > SPECIFIED EFF LIMITS
Person (Organization):
RICHARD BARKLEY (R1)
CHRIS EINGERG (FSME)

Event Text

MEDICAL EVENT - MISADMINISTRATION

A patient was prescribed a gammaknife procedure to treat trigeminal neuralgia on the right side of the face and the left was treated in error. The prescribed dose was 40 Gray (Gy) to 50% isodose. The patient was notified of the misadministration. There are no expected adverse effects to the patient.

The licensee is continuing to investigate this incident to determine the cause of the misadministration and the total dose to the patient.

A Medical Event may indicate potential problems in a medical facilities use of radioactive materials. It does not necessarily result in harm to the patient.

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Power Reactor Event Number: 44735
Facility: PILGRIM
Region: 1 State: MA
Unit: [1] [ ] [ ]
RX Type: [1] GE-3
NRC Notified By: BRUCE CHENARD
HQ OPS Officer: JOHN KNOKE
Notification Date: 12/19/2008
Notification Time: 21:52 [ET]
Event Date: 12/19/2008
Event Time: 18:31 [EST]
Last Update Date: 12/19/2008
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(2)(iv)(B) - RPS ACTUATION - CRITICAL
50.72(b)(3)(iv)(A) - VALID SPECIF SYS ACTUATION
Person (Organization):
RICHARD BARKLEY (R1)

Unit SCRAM Code RX CRIT Initial PWR Initial RX Mode Current PWR Current RX Mode
1 A/R Y 100 Power Operation 0 Hot Shutdown

Event Text

AUTOMATIC REACTOR SCRAM DUE TO LOAD REJECT

"On December 19, 2008, at 1831 hours with the reactor at 100% core thermal power (CTP) an automatic reactor scram occurred. It appears the scram occurred as a result of a load reject experienced during a severe winter storm. Three of the four safety relief valves opened in response to the event. Primary Containment Isolation System (PCIS) Group 2 (sample valves) and Group 6 (reactor water cleanup system) and the reactor building isolation system (RBIS-secondary containment) isolated as designed (all have since been restored) on the reactor water level +12 inches setpoint due to normal vessel shrink. Initial review indicates all safety-related systems responded as designed. Off-site power has been maintained; however the two 4kv safety related buses (A5&A6) were conservatively placed on the station emergency diesel generators due to potential grid stability concern. Currently, the reactor mode select switch (RMSS) is in the Shutdown position; the reactor scram has been reset; the reactor is being maintained at approximately 940 psig, with pressure being maintained by the main turbine by-pass valves; and reactor water level is being maintained at normal levels of 29 inches with the main condensate and feedwater system. Station maintenance personnel are assessing the status of the station switchyard. Once this activity is complete the duration of the forced outage and recovery plans will be determined."

All control rods fully inserted on the scram.

The licensee has notified the NRC Resident Inspector.

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Power Reactor Event Number: 44736
Facility: ARKANSAS NUCLEAR
Region: 4 State: AR
Unit: [1] [ ] [ ]
RX Type: [1] B&W-L-LP,[2] CE
NRC Notified By: TIMOTHY STEWART
HQ OPS Officer: MARK ABRAMOVITZ
Notification Date: 12/20/2008
Notification Time: 14:23 [ET]
Event Date: 12/20/2008
Event Time: 12:12 [CST]
Last Update Date: 12/20/2008
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(2)(iv)(B) - RPS ACTUATION - CRITICAL
Person (Organization):
GREG PICK (R4)
WILLIAM RULAND (NRR)
BRIAN McDERMOTT (IRD)

Unit SCRAM Code RX CRIT Initial PWR Initial RX Mode Current PWR Current RX Mode
1 M/R Y 100 Power Operation 0 Hot Standby

Event Text

MANUAL REACTOR TRIP WHEN CONTROL ROD BANK INSERTED WITHOUT OPERATOR ACTION

"Arkansas Nuclear one Unit 1 manually tripped from 100% power due to control rod mechanism group 7 unexpectedly dropping from 90% to 70%. No Primary safeties lifted. Secondary safeties lifted for approximately 1 minute. Emergency feedwater did not actuate and was not needed. Post trip response was normal and the plant is stable in mode 3. Post transient review is in progress."

All control rods fully inserted on the trip. The plant is in its normal shutdown electrical lineup. Steam generator level is being maintained using aux feed and steam is being dumped to the main condenser through the turbine bypass valves. There is no primary to secondary leakage.

The licensee notified the NRC Resident Inspector, the State of Arkansas, and the Arkansas Department of Health.

See similar event number 44716.

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Power Reactor Event Number: 44737
Facility: PILGRIM
Region: 1 State: MA
Unit: [1] [ ] [ ]
RX Type: [1] GE-3
NRC Notified By: R.M. PROBASCO
HQ OPS Officer: MARK ABRAMOVITZ
Notification Date: 12/20/2008
Notification Time: 17:07 [ET]
Event Date: 12/20/2008
Event Time: 10:45 [EST]
Last Update Date: 12/20/2008
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(3)(iv)(A) - VALID SPECIF SYS ACTUATION
Person (Organization):
RICHARD BARKLEY (R1)
WILLIAM RULAND (NRR)

Unit SCRAM Code RX CRIT Initial PWR Initial RX Mode Current PWR Current RX Mode
1 N N 0 Hot Shutdown 0 Hot Shutdown

Event Text

MOMENTARY LOSS OF 345KV OFFSITE POWER

"At approximately 1045 hours on Saturday, December 20, 2008, while in a Hot Shutdown condition, Pilgrim Station experienced a momentary loss of all 345kV off-site power to the Startup Transformer (SUT). As a result, the following safety system actuations occurred: automatic Reactor Protection System (RPS) actuation (all control rods were previously inserted), automatic start of both Emergency Diesel Generators (EDG) and loading of their respective emergency buses, automatic actuation of Primary Containment Isolation Systems (PCIS) Groups I, II, VI and Reactor Building Ventilation, manual initiation of the High Pressure Coolant Injection (HPCI) system for reactor pressure control, and manual initiation of the Reactor Core Isolation Cooling (RCIC) system for reactor level control. All systems functioned as designed and expected.

"Because power from an off-site source remained available from the 23kV Shutdown Transformer, the criteria for declaration of an Unusual Event were not met (Pilgrim EAL 6.3.2.1).

"345kV power was automatically restored to the Startup Transformer via breaker reclose logic. Restoration of normal on-site power to all 4kV buses is complete and efforts to return systems to normal shutdown alignments are in progress.

"Current plans are in place to maneuver the plant to a Cold Shutdown condition as necessary to support recovery actions.

"The NRC Resident was on-site at the time of the event and has been notified.

"There was no threat to the health or safety of the public as a result of this event."

The loss of power was caused by a breaker icing in the onsite switchyard. The switchyard breakers were inspected for icing.

The licensee notified the State of Massachusetts.

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Power Reactor Event Number: 44738
Facility: LASALLE
Region: 3 State: IL
Unit: [1] [2] [ ]
RX Type: [1] GE-5,[2] GE-5
NRC Notified By: MICHAEL FITZPATRICK
HQ OPS Officer: MARK ABRAMOVITZ
Notification Date: 12/21/2008
Notification Time: 11:42 [ET]
Event Date: 12/21/2008
Event Time: 08:22 [CST]
Last Update Date: 12/21/2008
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(3)(xiii) - LOSS COMM/ASMT/RESPONSE
Person (Organization):
RICHARD SKOKOWSKI (R3)

Unit SCRAM Code RX CRIT Initial PWR Initial RX Mode Current PWR Current RX Mode
1 N Y 80 Power Operation 80 Power Operation
2 N Y 98 Power Operation 98 Power Operation

Event Text

WEATHER RELATED LOSS OF EMERGENCY SIRENS

"This telephone notification is provided in accordance with 10 CFR 50.72(b)(3)(xiii) to report complications from an ice storm, including a loss of power, which has disabled seventeen (17) of the fifty EP sirens (34%). The sirens were lost at 07:22 CST and have not been restored.

"This meets the threshold of Reportability based on the loss of a public notification system.

"Restoration efforts are underway and are expected to occur as soon as reasonably possible with the current winter weather conditions.

"At the time of the event, Unit 1 is at 80% power for scheduled surveillances and Unit 2 is at 98% power due to end of cycle conditions, and neither Unit power level is related to this event.

"Unit 1 will return to full power as scheduled and Unit 2 will remain at 98% power and both units are unaffected by the loss of power."

Twelve of the lost sirens were due to a loss of power. Five were lost due to a loss of communications with the data center.

The licensee notified the NRC Resident Inspector.

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