Event Notification Report for February 2, 2012

U.S. Nuclear Regulatory Commission
Operations Center

Event Reports For
02/01/2012 - 02/02/2012

** EVENT NUMBERS **


46380 47613 47623 47629 47630

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!!!!! THIS EVENT HAS BEEN RETRACTED. THIS EVENT HAS BEEN RETRACTED !!!!!
General Information Event Number: 46380
Rep Org: UTAH DIVISION OF RADIATION CONTROL
Licensee: QUALITY INSPECTION AND TESTING INC.
Region: 4
City: DUTCH JOHN State: UT
County: DAGGET
License #: LA-11238-LO1
Agreement: Y
Docket:
NRC Notified By: GWYN GALLOWAY
HQ OPS Officer: VINCE KLCO
Notification Date: 11/01/2010
Notification Time: 13:17 [ET]
Event Date: 10/30/2010
Event Time: 07:00 [MDT]
Last Update Date: 02/01/2012
Emergency Class: NON EMERGENCY
10 CFR Section:
AGREEMENT STATE
Person (Organization):
BLAIR SPITZBERG (R4DO)
RAYMOND LORSON (NMSS)
MICHELE BURGESS (FSME)
DENNIS ALLSTON (ILTA)

This material event contains a "Category 2" level of radioactive material.

Event Text

AGREEMENT STATE REPORT - STOLEN RADIOGRAPHY CAMERA INVOLVED IN A TRANSPORTATION ACCIDENT

A previously terminated Quality Inspection and Testing employee gained unauthorized access to keys of a company vehicle loaded with a radiography camera. The individual appeared intent to drive the vehicle to the Rock Springs Airport located in Wyoming when the truck experienced an accident on Highway 191 about 4 miles south of Dutch John, Utah. When the Utah highway patrol drove up to the accident scene, the patrol found the radiography camera outside of the truck. The SPEC Model 150 radiography camera S/N 1195 containing 40 Curies of Ir-192 was undamaged and placed into the custody of a representative of Quality Inspection and Testing Inc. The individual driving the truck was transported to a medical facility. A survey of the site indicated no spread of contamination or radiation levels above background. A survey of the radiography camera revealed no leakage.

The radiography company was a Louisiana licensee with reciprocity in the State of Utah.

Utah Incident Number: 100006

* * * UPDATE FROM GWYN GALLOWAY TO JOE O'HARA AT 1940 EST ON 1/26/12 * * *

"During the investigation, DRC [Division of Radiation Control] personnel obtained conflicting statements from QIT [Quality Inspection and Testing Inc] management personnel regarding the employee's termination prior to the incident. Additionally, the driver worked two shifts after QIT management stated he had been terminated. The driver claimed he was not terminated until a number of days after his release from the hospital. Other QIT personnel were not aware the driver had been 'terminated' prior to the incident; therefore, the driver was allowed unescorted access to vehicles and devices containing sources from the day QIT management indicated the driver was terminated until the day the accident occurred (approximately 2 to 3 days). Although initially reported as 'stolen' to DRC personnel, to date, the driver has not been charged with the theft of the vehicle or the source and the DRC does not believe that the employee had been terminated."

The state believes that this event does not meet the abnormal occurrence criteria as determined by the Utah Division of Radiation Control.

Utah Incident Number: 100006

Notified R4DO(Drake), NMSS(McCartin), FSME EO(Hsueh), and ILTAB(Hahn)

* * RETRACTION FROM GWYN GALLOWAY TO JOHN KNOKE AT 1741 EST ON 02/01/12 * *

This information was provided by the State of Utah via email.

"During the investigation of this event, it was determined that the device was not actually stolen. Additionally, according to NRC Region IV and the U.S. DOT, the event did not meet the criteria for a reportable transportation event. Therefore, we are requesting the Event No. 46380 be retracted and will contact NMED personnel to retract NMED event 100544."

Notified the R4DO (Clark), FSME EO (Suber), NMSS EO (Pstrak), ILTAB (Matt Hahn)

THIS MATERIAL EVENT CONTAINS A "CATEGORY 2" LEVEL OF RADIOACTIVE MATERIAL

Category 2 sources, if not safely managed or securely protected, could cause permanent injury to a person who handled them, or were otherwise in contact with them, for a short time (minutes to hours). It could possibly be fatal to be close to this amount of unshielded radioactive material for a period of hours to days. These sources are typically used in practices such as industrial gamma radiography, high dose rate brachytherapy and medium dose rate brachytherapy. For additional information go to http://www-pub.iaea.org/MTCD/publications/PDF/Pub1227_web.pdf

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Agreement State Event Number: 47613
Rep Org: PA BUREAU OF RADIATION PROTECTION
Licensee: UNKNOWN
Region: 1
City: NORRISTOWN State: PA
County:
License #: UNKNOWN
Agreement: Y
Docket:
NRC Notified By: DAVID ALLARD
HQ OPS Officer: BILL HUFFMAN
Notification Date: 01/20/2012
Notification Time: 20:00 [ET]
Event Date: 01/19/2012
Event Time: [EST]
Last Update Date: 01/20/2012
Emergency Class: NON EMERGENCY
10 CFR Section:
AGREEMENT STATE
Person (Organization):
RONALD BELLAMY (R1DO)
BRUCE WATSON (FSME)

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

Event Text

AGREEMENT STATE REPORT - RADIUM-226 SOURCES DISCOVERED AT WASTE TRANSFER STATION

The following event was received via facsimile from the Pennsylvania Department of Environmental Protection [DEP], Bureau of Radiation Protection:

"Event Description: On Thursday, January 19, 2012, DEP's southeast regional office received a call from the Waste Management, Inc. Norristown solid waste transfer station stating that a roll-off container of waste had set off their radiation alarm. The facility's consulting health physicist investigated, along with representatives of the Department's Bureau of Radiation Protection. The radioactive material recovered from the roll-off was four (4) small cylinders identified as approximately one (1) curie [total] of radium-226 contained in what appeared to be a lead-lined box. The lead-lined box (with shiny exterior) was inside an old metal locking box that contained various other source holders, instruments and applicators, some containing the name 'Standard Chemical.' It is believed these Ra-226 sources are vintage circa 1920 medical radiation therapy capsules. Preliminary wipes revealed no significant removable contamination, thus, no leaking sources. The consultant HP was given a DOT Special Permit for transport, and [took] possession of the Ra-226 for safe and secure storage. Contact dose rates outside the closed shiny metal lead-lined box were as high as 2.0 R/hr. In an open configuration, dose rates were about 100 R/h in near contact with the sources.

"The unlocked roll-off container was located for several weeks in a parking lot of an adult-only living community in West Chester, PA while a contractor performed work on townhomes in the development. Department personnel have been in touch with the contractor and will be interviewing workers, as well as nearby homeowners to determine if any people were significantly exposed to these sources. Local outreach is also planned to ensure similar sources are not in the public sector.

"CAUSE OF THE EVENT: Suspected intentional abandonment of old medical radium sources in an open construction waste dumpster.

"ACTIONS: The Department is in contact with DOE and a LLRW vendor for transfer or disposal of Ra-226 sources. Further investigations will be performed, as well as any needed dose reconstruction."

Pennsylvania Report: PA120004

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. For additional information go to http://www-pub.iaea.org/MTCD/publications/PDF/Pub1227_web.pdf

This source is not amongst those sources or devices identified by the IAEA Code of Conduct for the Safety & Security of Radioactive Sources to be of concern from a radiological standpoint. Therefore is it being categorized as a less than Category 3 source.

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!!!!! THIS EVENT HAS BEEN RETRACTED. THIS EVENT HAS BEEN RETRACTED !!!!!
Non-Agreement State Event Number: 47623
Rep Org: BAYHEALTH MEDICAL CENTER
Licensee: BAYHEALTH MEDICAL CENTER
Region: 1
City: MILFORD State: DE
County:
License #: 07-148-50-01
Agreement: N
Docket:
NRC Notified By: CATHY MUNDORF
HQ OPS Officer: JOE O'HARA
Notification Date: 01/26/2012
Notification Time: 15:22 [ET]
Event Date: 01/25/2012
Event Time: 09:30 [EST]
Last Update Date: 01/27/2012
Emergency Class: NON EMERGENCY
10 CFR Section:
35.3045(a)(1) - DOSE <> PRESCRIBED DOSAGE
Person (Organization):
GLENN DENTEL (R1DO)
KEVIN HSUEH (FSME)

Event Text

MISADMINISTRATION OF THALLIUM DURING CARDIO STRESS TEST

A patient received 100% more than the prescribed dose of thallium. The patient was to receive 3.5 milliCuries of thallium followed by 30 milliCuries of Cardiolite, a Tc-99M radiopharmaceutical. Instead, the patient received 3.5 milliCuries of thallium then received an additional 3.6 milliCuries of Thallium. The technician stated that he got confused where the patient was in the treatment process.

The patient and physician have been informed. The licensee is awaiting dosimetry results to determine the organ dosage but does not believe there will be any recurring medical effects from this event.

* * * RETRACTION AT 1227 EST ON 1/27/12 FROM MUNDORF TO HUFFMAN * * *

The licensee is retracting this event report after a review and evaluation of the doses administered. The licensee has determined that this event is not reportable based on the unintended dose being less than 5 Rem effective dose equivalent and therefore not reportable under 10 CFR 35.3045.

The licensee has discussed this conclusion with NRC Region 1 (Lanzisera).

R1DO (Dental) and FSME (McIntosh) have been notified.

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Power Reactor Event Number: 47629
Facility: PRAIRIE ISLAND
Region: 3 State: MN
Unit: [1] [2] [ ]
RX Type: [1] W-2-LP,[2] W-2-LP
NRC Notified By: GENE DAMMANN
HQ OPS Officer: JOHN KNOKE
Notification Date: 02/01/2012
Notification Time: 12:49 [ET]
Event Date: 11/30/2011
Event Time: 07:58 [CST]
Last Update Date: 02/01/2012
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(2)(xi) - OFFSITE NOTIFICATION
Person (Organization):
JAMNES CAMERON (R3DO)

Unit SCRAM Code RX CRIT Initial PWR Initial RX Mode Current PWR Current RX Mode
1 N Y 100 Power Operation 100 Power Operation
2 N Y 100 Power Operation 100 Power Operation

Event Text

OFFSITE NOTIFICATION DUE TO UNMONITORED RELEASE OF TRITIUM (HEATING STEAM CONDENSATE)

"Heating Steam condensate containing 9,430 picocuries per liter [pCi/L] of tritium overflowed from the Main Warehouse between November 22, 2011 and November 29, 2011. The US EPA drinking water limit for tritium is 20,000 pCi/L.

"The Warehouse Condensate Return system failed to operate which resulted in the overflow of the Heating Steam condensate. There was a potential for the condensate to enter the environment where it could reach groundwater. The released volume for this event was conservatively calculated to be up to 3,900 gallons. The 122 Condensate Return Pump was replaced and the system was restored to service.

"This voluntary report is in accordance with the Nuclear Energy Institute's Industry Ground Water Protection Initiative."

The licensee has notified the NRC Resident Inspector and will inform state and local agencies of this event.

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Part 21 Event Number: 47630
Rep Org: GE HITACHI NUCLEAR ENERGY
Licensee: GE HITACHI NUCLEAR ENERGY
Region: 1
City: WILMINGTON State: NC
County:
License #:
Agreement: Y
Docket:
NRC Notified By: DALE PORTER
HQ OPS Officer: JOHN KNOKE
Notification Date: 02/01/2012
Notification Time: 15:33 [ET]
Event Date: 02/01/2012
Event Time: [EST]
Last Update Date: 02/01/2012
Emergency Class: NON EMERGENCY
10 CFR Section:
21.21 - UNSPECIFIED PARAGRAPH
Person (Organization):
WILLIAM COOK (R1DO)
JONATHAN BARTLEY (R2DO)
JAMNES CAMERON (R3DO)
JEFF CLARK (R4DO)
PART21 GROUP ()

Event Text

PART 21 REPORT - FAILURE OF CRD COLLET RETAINER TUBE/OUTER TUBE WELD

The following information was received via facsimile:

"During a recent refurbishment of a Control Rod Drive (CRD) performed by GE Hitachi Nuclear Energy (GEH) for a domestic customer a 360 degree failure of the collet retainer tube fillet weld was identified. This weld is part of the CRD 919D258G003 Cylinder, Tube and Flange (CTF) assembly. The collet retainer tube fillet weld was performed in 1983 and subsequently assembled into a Group 003 part number 919D258G003 CTF. This G003 CTF assembly was assembled into a CRD in 1995 and placed into service in 1996. GEH continues to investigate the cause(s) of the failed fillet weld. Once the cause of the fillet weld failure is determined, GEH will review the extent of condition of this failure as well as the consequences to determine if a reportable condition exists.

"There were no adverse effects on the CRD's operation observed due to this failure.

"This 60-day interim notification, in accordance with 10CFR Part 21.21(a)(2), will be sent to all BWR/2-6 plants that utilize CRDs equipped with either 919D258G002 or 919D258G003 CTF assemblies."

The affected plants are: Nine Mile Point 1-2, Fermi 2, Columbia, Grand Gulf, River Bend, Fitzpatrick, Pilgrim, Vermont Yankee, Clinton, Dresden 2-3, LaSalle 1-2, Limerick 1-2, Oyster Creek, Peach Bottom 2-3, Quad Cities 1-2, Perry 1, Duane Arnold, Cooper, Susquehanna 1-2, Brunswick 1-2, Hope Creek, Hatch 1 - 2, Browns Ferry 1-3, Monticello, and Millstone.

Page Last Reviewed/Updated Thursday, March 25, 2021