United States Nuclear Regulatory Commission - Protecting People and the Environment

Event Notification Report for March 2, 2012

U.S. Nuclear Regulatory Commission
Operations Center

Event Reports For
03/01/2012 - 03/02/2012

** EVENT NUMBERS **


47697 47698 47699 47700 47701 47702 47703 47704 47710 47712 47713

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!!!!! THIS EVENT HAS BEEN RETRACTED. THIS EVENT HAS BEEN RETRACTED !!!!!
Power Reactor Event Number: 47697
Facility: BRUNSWICK
Region: 2 State: NC
Unit: [1] [ ] [ ]
RX Type: [1] GE-4,[2] GE-4
NRC Notified By: STEWART BYRD
HQ OPS Officer: CHARLES TEAL
Notification Date: 02/24/2012
Notification Time: 07:42 [ET]
Event Date: 02/24/2012
Event Time: 00:37 [EST]
Last Update Date: 03/01/2012
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(3)(iv)(A) - VALID SPECIF SYS ACTUATION
Person (Organization):
MIKE ERNSTES (R2DO)

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

Event Text

VALID REACTOR PROTECTION SYSTEM ACTUATION DURING NEUTRON INSTRUMENT TESTING

"On 2/24/2012 at 0037 EST, Unit 1 was in Mode 4 when an unplanned Reactor Protection System (RPS) actuation occurred. The trip occurred while operators were returning the Mode Switch to the 'Shutdown' position during restoration from Neutron Instrumentation testing. Jumpers had not been installed to bypass this actuation signal at the time the Mode Switch was operated, resulting in a valid signal of the RPS.

"The RPS actuation is reportable in accordance with 10 CFR 50.72(b)(3)(iv)(A).

"The safety significance of this event was minimal. Plant equipment performed as expected. All control rods were inserted prior to the RPS actuation and remain inserted.

"The RPS actuation was reset and the plant remains in Mode 4."

The licensee has notified the NRC Resident Inspector.

* * * RETRACTION FROM MARK TURKAL TO JOHN KNOKE AT 1316 EST ON 3/1/12 * * *

"Based on a detailed review of NUREG-1022, Revision 2, 'Event Reporting Guidelines 10 CFR 50.72 and 50.73,' this event has been determined not to be reportable under 10 CFR 50.72(b)(3)(iv)(A). The RPS actuation was inadvertent and was caused by a human error (i.e., failure to install appropriate jumpers) that occurred during a surveillance test. This RPS actuation was not in response to actual plant conditions satisfying the requirements for initiation of the RPS. There was no plant condition present that either warranted a scram or would prompt manual operator action in anticipation of scram condition. Therefore, this RPS actuation is considered invalid and is not reportable per 10 CFR 50.72(b)(3)(iv)(A).

"Investigation of this condition is documented in the corrective action program in Condition Report (CR) 519432.

"The NRC Resident Inspector was notified of this retraction." Notified the R2DO (Mark Franke).

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Agreement State Event Number: 47698
Rep Org: TEXAS DEPARTMENT OF HEALTH
Licensee: UNIVERSITY OF TEXAS SOUTHWESTERN MEDICAL CENTER
Region: 4
City: DALLAS State: TX
County:
License #: L00384
Agreement: Y
Docket:
NRC Notified By: ROBERT FREE
HQ OPS Officer: VINCE KLCO
Notification Date: 02/24/2012
Notification Time: 16:54 [ET]
Event Date: 02/16/2012
Event Time: [CST]
Last Update Date: 02/24/2012
Emergency Class: NON EMERGENCY
10 CFR Section:
AGREEMENT STATE
Person (Organization):
RICK DEESE (R4DO)
KEVIN O'SULLIVAN (FSME)

Event Text

AGREEMENT STATE REPORT - MISADMINISTRATION OF A RADIOPHARMACEUTICAL

The following information was received from the State of Texas via email:

"On 2/22/12 the licensee notified the Agency [Texas Department of State Health Services] of a medical event that occurred on 2/16/12. The licensee reported that the wrong radiopharmaceutical had been administered to a patient. Tc-99m MAA was administered rather than the prescribed Tc-99m Pertechnitate. During the administration of the wrong drug, an estimated 1/3-1/2 of the dose infiltrated the skin causing an estimated 400 rad exposure subcutaneously. The referring physician and patient have been notified. No signs or symptoms have been observed in the patient as a result of the incident. The estimated exposure is being reevaluated by the licensee."

Texas Incident: I-8937

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

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Power Reactor Event Number: 47699
Facility: CALVERT CLIFFS
Region: 1 State: MD
Unit: [1] [2] [ ]
RX Type: [1] CE,[2] CE
NRC Notified By: KENT MILLS
HQ OPS Officer: VINCE KLCO
Notification Date: 02/26/2012
Notification Time: 20:15 [ET]
Event Date: 02/26/2012
Event Time: 15:46 [EST]
Last Update Date: 03/01/2012
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(3)(xiii) - LOSS COMM/ASMT/RESPONSE
Person (Organization):
MEL GRAY (R1DO)

Unit SCRAM Code RX CRIT Initial PWR Initial RX Mode Current PWR Current RX Mode
1 N N 0 Refueling 0 Refueling
2 N Y 100 Power Operation 100 Power Operation

Event Text

LOSS OF PLANT ASSESSMENT CAPABILITIES DUE TO AN OUT OF SERVICE PLANT PROCESS COMPUTER

"Calvert Cliffs will be performing planned maintenance to the U-1 Plant Process Computer to install isolation transformers. This maintenance window was expected to start at 2100 [EST] today, 2/26/2012, but the U-1 Plant Process Computer failed at 1546 this afternoon and it was decided to commence the planned maintenance window at that time versus spending resources to attempt recovery of the computer for just a short time period. The planned maintenance window is expected to be 54 hours long and end February 28, around 2300. This will impact the Unit 1 data dissemination to the Safety Parameter Display System (SPDS), TSC Computer. PI [Plant Trending Software] and ERDS will also be out of service for both Unit-1 and Unit-2. Should an emergency be declared during this period, the Control Room will continue to have the capability to retrieve plant data inputs to assess plant conditions and perform core damage assessment. Control Room Emergency Response Organization personnel will use backup methods already captured in emergency response procedures to disseminate plant parameter data to the effected Emergency Response Facilities and NRC during the plant data network outage. MIDAS (Meteorological Data) will continue to be operational at the site.

"Applicable Reporting Requirement: 10 CFR 50.72 (b) (3) (xiii); 8 Hour report."

The licensee notified the NRC Resident Inspector.

* * * UPDATE AT 1209 EST ON 03/01/12 FROM JAY GAINES TO S. SANDIN * * *

"At 1000 [EST] this morning planned maintenance was completed to the Unit 1 plant process computer. All plant assessment capabilities have been restored."

The licensee informed the NRC Resident Inspector. Notified R1DO (Ferdas).

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Agreement State Event Number: 47700
Rep Org: NC DIV OF RADIATION PROTECTION
Licensee: CAROLINA CUSTOM FINISHING, LLC.
Region: 1
City:  State: NC
County:
License #: 076-1820-0G
Agreement: Y
Docket:
NRC Notified By: WILLIAM JOHNSON
HQ OPS Officer: BILL HUFFMAN
Notification Date: 02/27/2012
Notification Time: 11:17 [ET]
Event Date: 02/27/2012
Event Time: 10:30 [EST]
Last Update Date: 02/27/2012
Emergency Class: NON EMERGENCY
10 CFR Section:
AGREEMENT STATE
Person (Organization):
MARC FERDAS (R1DO)
ANGELA MCINTOSH (FSME)
MATTHEW HAHN (ILTA)

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

Event Text

AGREEMENT STATE REPORT - LOST PO-210 SOURCE

The following was received from the state of North Carolina Division of Radiation Control by facsimile:

"On February 16, 2012, the Section [North Carolina Division of Radiation Control] received a letter from the RSO for Carolina Custom Finishing LLC, License Number: 076-1820-0G, [stating] that on February 13, 2012, [the licensee] could not find a Po-210 source, 10 mCi, Model P-2021, S/N A2HL674. [This source is contained in] a static eliminator used for painting customer parts. [The RSO] performed an inspection and area survey of the facility on February 22, 2012 and could not locate the above source."

NC Incident Number: 12-25

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. 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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Agreement State Event Number: 47701
Rep Org: KENTUCKY DEPT OF RADIATION CONTROL
Licensee: EAST KENTUCKY POWER COOPERATIVE
Region: 1
City: WINCHESTER State: KY
County:
License #: 201-161-51
Agreement: Y
Docket:
NRC Notified By: CURT PENDERGRASS
HQ OPS Officer: CHARLES TEAL
Notification Date: 02/27/2012
Notification Time: 15:38 [ET]
Event Date: 02/24/2012
Event Time: 11:26 [CST]
Last Update Date: 02/27/2012
Emergency Class: NON EMERGENCY
10 CFR Section:
AGREEMENT STATE
Person (Organization):
MARC FERDAS (R1DO)
KEVIN O'SULLIVAN (FSME)

Event Text

AGREEMENT STATE REPORT - STUCK SHUTTER ON PROCESS GAUGE

The following was received from the State of Kentucky via facsimile:

" KY RHB [Kentucky Radiation Health Branch] was notified by telephone and email on 2/24/12 at 2:32 p.m. EST by the Radiation Safety Officer at East Kentucky Power Cooperative of a shutter on a Kay-Ray Model 7700D (S/N 17902) containing 10 mCi of Cs-137 being stuck in the closed position. The event occurred on 2/24/12 at 12:26 p.m. EST. The RSO is stationed in Winchester, KY and the incident occurred at the licensee's facility in Maysville, KY. The State has received an initial telephone notification and an initial written report from the licensee and will continue to keep NRC informed of the status of our investigation."

KY Event Report ID No: KY 120001

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Agreement State Event Number: 47702
Rep Org: TENNESSEE DIV OF RAD HEALTH
Licensee: EASTMAN CHEMICAL COMPANY
Region: 1
City: KINGSPORT State: TN
County:
License #: R-82007-H15
Agreement: Y
Docket:
NRC Notified By: DEBRA SHULTS
HQ OPS Officer: CHARLES TEAL
Notification Date: 02/28/2012
Notification Time: 13:09 [ET]
Event Date: 10/19/2010
Event Time: 16:30 [EST]
Last Update Date: 02/28/2012
Emergency Class: NON EMERGENCY
10 CFR Section:
AGREEMENT STATE
Person (Organization):
MARC FERDAS (R1DO)
ANGELA MCINTOSH (FSME)

Event Text

AGREEMENT STATE REPORT - SOURCE CARRIER ON OHMART GAUGE FAILED TO RETRACT

The following was received from the State of Tennessee via facsimile:

"On 10/19/10, it was discovered that the source carrier on Ohmart gauge, Model SHLM-C, could not retract from the well pipe back into the source holder. An Ohmart technician attempted to repair the gauge without success. A visual inspection confirmed that the process materials had leaked into the well pipe around the source carrier preventing retraction of the source. A remediation team was called to retrieve the source carrier. The gauge contained Cesium-137, two sealed sources of 63 milliCuries each."

Event Report ID No.: TN-10-143

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Agreement State Event Number: 47703
Rep Org: TENNESSEE DIV OF RAD HEALTH
Licensee: SAINT THOMAS HOSPITAL
Region: 1
City: NASHVILLE State: TN
County:
License #: R-19190-H14
Agreement: Y
Docket:
NRC Notified By: DEBRA SHULTS
HQ OPS Officer: CHARLES TEAL
Notification Date: 02/28/2012
Notification Time: 13:09 [ET]
Event Date: 08/10/2009
Event Time: [EST]
Last Update Date: 02/28/2012
Emergency Class: NON EMERGENCY
10 CFR Section:
AGREEMENT STATE
Person (Organization):
MARC FERDAS (R1DO)
ANGELA MCINTOSH (FSME)

Event Text

AGREEMENT STATE REPORT - EFFLUENT CONCENTRATIONS EXCEEDED REGULATORY LIMITS

The following was received from the State of Tennessee via facsimile:

"A pharmacy technician noted that the exhaust fan connected to the I-131 glove box was not working. Maintenance was contacted and found a broken fan belt which was repaired the same day. Up to 35% of the air exhaust of the I-131 vapor was not available for dilution. On 8/28/09, it was noted the effluent concentration of I-131 was over the limit of state regulations. It was immediately reported to the Radiation Safety Officer. An investigation revealed a bolus of I-131 was released through the ventilation system. Minor release in the room but the continuous air concentration in the pharmacist's breathing zone remained under regulatory limits. Surveys of the room revealed three locations of fixed contamination which were covered with cardboard and allowed to decay to background. All staff bioassays were below detectable limits."

Event Report ID No.: TN-09-110

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Agreement State Event Number: 47704
Rep Org: TENNESSEE DIV OF RAD HEALTH
Licensee: EASTMAN CHEMICAL COMPANY
Region: 1
City: KINGSPORT State: TN
County:
License #: R-82007-H10
Agreement: Y
Docket:
NRC Notified By: DERA SHULTS
HQ OPS Officer: CHARLES TEAL
Notification Date: 02/28/2012
Notification Time: 13:09 [ET]
Event Date: 01/19/2010
Event Time: [EST]
Last Update Date: 02/28/2012
Emergency Class: NON EMERGENCY
10 CFR Section:
AGREEMENT STATE
Person (Organization):
MARC FERDAS (R1DO)
ANGELA MCINTOSH (FSME)

Event Text

AGREEMENT STATE REPORT - PROCESS GAUGE SHUTTER STUCK IN OPEN POSITION

The following was received from the State of Tennessee via facsimile:

"On January 19, 2010, during performance of routine shutter check, it was discovered that the shutter on an Ohmart Model SH-F2 source was stuck in the open position. In an attempt to open the shutter by hand, the shutter handle separated from the top of the housing. Two bolts attaching the handle were sheared off. The gauge was manufactured in 12/04 and is located on a column which is part of a polymer manufacturing process. The gauge contains 150 milliCuries of Cesium-137. Ohmart technicians were called to repair the shutter. No individuals were exposed to the excessive levels of radiation."

Event Report ID No.: TN-10-006

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Power Reactor Event Number: 47710
Facility: PERRY
Region: 3 State: OH
Unit: [1] [ ] [ ]
RX Type: [1] GE-6
NRC Notified By: ROBERT KIDDER
HQ OPS Officer: PETE SNYDER
Notification Date: 03/01/2012
Notification Time: 05:51 [ET]
Event Date: 03/01/2012
Event Time: [EST]
Last Update Date: 03/01/2012
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(2)(iv)(B) - RPS ACTUATION - CRITICAL
Person (Organization):
ANN MARIE STONE (R3DO)

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

Event Text

MANUAL REACTOR PROTECTION SYSTEM ACTUATION DUE TO AUTOMATIC TURBINE RUNBACK

"On March 1,2012, at approximately 0224 [EST], a manual Reactor Protection System (RPS) actuation was initiated due to 3 turbine bypass valves going open as a result of an automatic turbine runback signal. At the time of the event, the plant was in Mode 1 at 100% power. All control rods are inserted into the core and the plant is currently stable in Mode 3 (Hot Shutdown) with reactor pressure at approximately 930 psig.

"No Emergency Core Cooling Systems were required or utilized to respond to the event and there were no other reportable actuations. Reactor coolant level is being maintained in its normal band by the feedwater system and decay heat is being removed by the condenser. The plant is in a normal electrical line-up with all three Emergency Diesel Generators operable and available if needed. The cause of the automatic turbine runback has not been determined and is being investigated.

"During the transient, Reactor Water Cleanup System (RWCU) tripped. No automatic isolation signal was received.

"At the time of the event, restoration of a Stator Water Cooling pressure gauge was being performed [following maintenance].

"The NRC Resident Inspector has been notified."

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Fuel Cycle Facility Event Number: 47712
Facility: B&W NUCLEAR OPERATING GROUP, INC.
RX Type: URANIUM FUEL FABRICATION
Comments: HEU FABRICATION & SCRAP
Region: 2
City: LYNCHBURG State: VA
County: CAMPBELL
License #: SNM-42
Agreement: N
Docket: 070-27
NRC Notified By: KENNY KIRBY
HQ OPS Officer: STEVE SANDIN
Notification Date: 03/01/2012
Notification Time: 12:12 [ET]
Event Date: 03/01/2012
Event Time: 09:15 [EST]
Last Update Date: 03/01/2012
Emergency Class: NON EMERGENCY
10 CFR Section:
20.1906(d)(2) - EXTERNAL RAD LEVELS > LIMITS
Person (Organization):
MARK FRANKE (R2DO)
JAMES RUBENSTONE (NMSS)
FUEL GROUP via email ()

Event Text

EXTERNAL RADIATION LEVELS EXCEEDED PART 20 LIMITS DURING SHIPMENT

"Evaluation of LTC [Lynchburg Technology Center] AmBe Shipment issues for 030112 receipt.

"The conditions for reporting under the requirements of 10 CFR 20 1906(d) have been met. QWI 14.1.10 Classification & Notification Criteria for Unusual Incidents Radiation Protection section - for shipments, bases reporting requirements on receipt of a shipment with radiation or contamination levels in excess of 10 CFR 20.1906(d). This requirement was exceeded and an NRC report is required. The truck cab sleeping area (normally occupied space) dose rate of 3.4 mrem/hr is greater than the allowable limit of 2.0 mrem/hr. The private carrier personnel state that they do not have dosimetry.

"Immediate Actions taken have been: digital photographs have been taken, confirmatory surveys (with other instruments) were taken, additional spot surveys were taken, the shipper has been notified, and an evaluation of the regulations has been made."

The licensee informed the NRC Resident Inspector.

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Power Reactor Event Number: 47713
Facility: COMANCHE PEAK
Region: 4 State: TX
Unit: [1] [2] [ ]
RX Type: [1] W-4-LP,[2] W-4-LP
NRC Notified By: RAUL MARTINEZ
HQ OPS Officer: JOHN KNOKE
Notification Date: 03/01/2012
Notification Time: 18:41 [ET]
Event Date: 03/01/2012
Event Time: 17:05 [CST]
Last Update Date: 03/01/2012
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(3)(ii)(B) - UNANALYZED CONDITION
Person (Organization):
RYAN LANTZ (R4DO)

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

BATTERY ROOM VENTILATION SYSTEM DEGRADED

"While Units 1 and 2 were in Mode 1, operating at 100% power, an issue was identified with the doors for the safety related battery rooms and their normal position. Several doors to the battery rooms were found to be held open via electromagnetic door devices. These doors are an integral part of their battery room exhaust system. As designed, there is no uninterruptible power to the door mechanisms, all the doors are expected to close in the event of a Loss of Offsite Power.

"The closure of the doors to the battery rooms, being an integral part of the exhaust system, would disrupt ventilation in the battery rooms and could allow hydrogen to increase to unacceptable levels during Loss of Offsite Power events.

"Compensatory measures have been taken to secure the doors open to maintain the hydrogen purging function before required limits are reached. The battery room ventilation system remains functional supporting operability of the batteries.

"Luminant Power determined this issue to be reportable as an unanalyzed condition per 10 CFR 50.72(b)(3)(ii)(B)."

The licensee will notify the NRC Resident Inspector.

Page Last Reviewed/Updated Thursday, March 29, 2012
Thursday, March 29, 2012