United States Nuclear Regulatory Commission - Protecting People and the Environment

Event Notification Report for August 20, 2012

U.S. Nuclear Regulatory Commission
Operations Center

Event Reports For
08/17/2012 - 08/20/2012

** EVENT NUMBERS **


48108 48160 48176 48177 48197 48199 48200 48202 48204

To top of page
!!!!! THIS EVENT HAS BEEN RETRACTED. THIS EVENT HAS BEEN RETRACTED !!!!!
Power Reactor Event Number: 48108
Facility: QUAD CITIES
Region: 3 State: IL
Unit: [1] [ ] [ ]
RX Type: [1] GE-3,[2] GE-3
NRC Notified By: JOE BELLISH
HQ OPS Officer: CHARLES TEAL
Notification Date: 07/15/2012
Notification Time: 16:05 [ET]
Event Date: 07/15/2012
Event Time: 10:30 [CDT]
Last Update Date: 08/17/2012
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(3)(v)(D) - ACCIDENT MITIGATION
Person (Organization):
ERIC DUNCAN (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

Event Text

UNIT 1 HIGH PRESSURE COOLANT INJECTION (HPCI) INOPERABLE DUE TO VALVE LEAK

"On July 15, 2012, at 1030 hours, a defect (pinhole through-wall leak) was identified on the 1-2301-29 valve (HPCI Steam Line to Main Condenser Isolation Valve). The defect was identified during a routine system walkdown. The 1-2301-29 valve (1" valve downstream of the HPCI drain pot) is normally open during HPCI standby operation and closes upon system initiation. Due to the location of the defect, the 1-2301-29 valve would not have completely isolated the steam line as designed. As a result, HPCI was declared inoperable. Given that HPCI is a single train system, this notification is being made in accordance with 10CFR50.72(b)(3)(v)(D). HPCI will remain inoperable until system repairs are complete."

The NRC Resident Inspector has been informed.

* * * RETRACTION AT 1216 EDT ON 8/17/2012 FROM DALE STEEL TO MARK ABRAMOVITZ * * *

"The purpose of this notification is to retract the ENS Report made on July 15, 2012, at 1030 hours (ENS Report # 48108).

"Further evaluation performed by Quad Cities Station confirms the Unit 1 HPCI system would have performed its safety function. Based on this subsequent evaluation, ENS Report # 48108 is being retracted.

"Note: On July 21, the 1-2301-29 valve (HPCI Steam Line to Main Condenser Isolation Valve) was successfully repaired and HPCI was returned to Operable status."

The licensee notified the NRC Resident Inspector.

Notified the R3DO (Giessner).

To top of page
Agreement State Event Number: 48160
Rep Org: MISSISSIPPI DIV OF RAD HEALTH
Licensee: GRENADA LAKE MEDICAL CENTER
Region: 4
City: GRENADA State: MS
County:
License #: MS-410-01
Agreement: Y
Docket:
NRC Notified By: JASON MOAK
HQ OPS Officer: PETE SNYDER
Notification Date: 08/06/2012
Notification Time: 12:59 [ET]
Event Date: 05/18/2012
Event Time: [CDT]
Last Update Date: 08/14/2012
Emergency Class: NON EMERGENCY
10 CFR Section:
AGREEMENT STATE
Person (Organization):
MICHAEL VASQUEZ (R4DO)
FSME EVENT RESOURCE (EMAI)
ILTAB (EMAI)

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

Event Text

AGREEMENT STATE REPORT - UNACCOUNTED FOR BARIUM-133 SOURCES

The following information was received from the Mississippi Department of Radiation Health via e-mail:

"Two (2) Ba-133 [3.86 mCi each] attenuation sources were discovered missing from a quarterly health physics audit at Grenada Lake Medical Center by their consultant. It was discovered by the health physics consultant in early July that documentation regarding the receipt of the sources was not available.

"On 5-18-2012, Bayshore Medical, a third party company was contracted by Philips Healthcare to disassemble and remove a Marconi Axis gamma camera from Grenada Lake Medical Center. The sources were encased inside tungsten holders that were installed inside beacon devices attached to each head of the camera. The nuclear medicine technologist at Grenada Lake Medical Center showed the service engineer for de-installation of the camera the location of the camera and explained to him that Grenada Lake Medical Center would need a receipt record for the two (2) sources removed. The technologist left work for a week during the time the gamma camera was being disassembled and removed from the facility. Upon returning back to the facility the technologist forgot to verify receipt of the sources from the service company.

"Bayshore Medical claimed there was no radioactive sources installed on the Marconi camera removed from Grenada Lake Medical Center. Neither Bayshore Medical or the company that de-installed / bought the camera has a radioactive materials license. Grenada Lake Medical Center has been in contact with Bayshore Medical to track the location of the beacon devices and return them to their facility. The licensee has contacted Philips Healthcare for copies of service records to show the sources were previously installed in the camera. DRH [Mississippi Department of Radiation Health] was contacted by Grenada Lake Medical Center's health physics consultant on 8-3-2012 with a scheduled return date of 8-6-2012, for the beacon devices and sources in question.

"DRH [Mississippi Department of Radiation Health] received a written report of the incident on 8-3-2012. Grenada Lake Medical Center's Radiation Safety Committee has discussed the issue and has developed a policy for future source transfers to prevent a reoccurrence of this incident. Grenada Lake Medical Center will have a person physically verify the removal of any radioactive source along with completing a transfer record prior to any source transfer. Also, Grenada Lake Medical Center will verify that a service company has a radioactive material license to possess and transfer radioactive material."

MS Event: 120002

* * * UPDATE ON 8/14/12 AT 1237 EDT FROM JAYSON MOAK TO DONG PARK * * *

The following information was received from the Mississippi Department of Radiation Health via e-mail:

"Between 5-18-2012 and 5-28-2012, a service engineer from IRS disassembled and removed a Marconi Axis gamma camera from Grenada Lake Medical Center. The camera was previously sold to Philips Healthcare by the licensee. Philips Healthcare then sold the camera to Bayshore Medical who then sold the camera to IRS. The camera remained at the licensee's location throughout the multiple transactions.

"On 8-10-2012, IRS, the company who bought the camera from Bayshore Medical and de-installed the camera from the licensee's location on 5-18-2012, was contacted by DRH [Mississippi Department of Radiation Health]. IRS claimed there were no sources present prior to de-installation of the camera from the licensee's facility."

Notified R4DO (Hagar) and FSME Resources Events via email.

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.

To top of page
Agreement State Event Number: 48176
Rep Org: MA RADIATION CONTROL PROGRAM
Licensee: STERIS ISOMEDIX SERVICE
Region: 1
City: NORTHBOROUGH State: MA
County:
License #: 28-7911
Agreement: Y
Docket:
NRC Notified By: ROBERT GALLAGHAR
HQ OPS Officer: JOHN SHOEMAKER
Notification Date: 08/10/2012
Notification Time: 11:07 [ET]
Event Date: 07/23/2012
Event Time: [EDT]
Last Update Date: 08/11/2012
Emergency Class: NON EMERGENCY
10 CFR Section:
AGREEMENT STATE
Person (Organization):
LAWRENCE DOERFLEIN (R1DO)
CHRISTINE LIPA (R3DO)
ANGELA MCINTOSH (FSME)

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

Event Text

AGREEMENT STATE REPORT - SOURCE UNACCOUNTED FOR IN SHIPMENT

The following information was received from the State of Massachusetts Radiation Control Program via e-mail:

"Containers from REVISS Services, Inc were used to ship return Co-60 sources from Steris Isomedix Services, Northborough, MA to REVISS's UK facility. When the container arrived on 8/7/12 and was opened by the REVISS (UK) staff, they identified that the basket contained only 52 sources rather than the 53 that were expected. When the container arrived the tamper proof seals that were installed by engineers at the plant were intact. A review of the documentation for the operations at the plant indicate that only 52 sources were loaded into the basket. A positive check of the serial numbers confirmed that the one source that was unaccounted for was a Nordion model C-188, Co-60 source, serial number 41313.

"Steris Isomedix Services was contacted and at their earliest chance will inspect the pool to ensure that the source was not dropped onto the floor of the pool. There were no abnormal radiation readings that would indicate that the source was removed from the pool during operations. Because the documentation does not indicate that the source was ever removed from the source module, Steris Isomedix Services has a high level of confidence that the source is still in the irradiator pool.

"Steris Isomedix Services, Northborough, MA and REVISS will continue updating as information is acquired.."

* * * UPDATE AT 1047 EDT ON 8/11/12 FROM JOSH DAEHLER TO HUFFMAN * * *

The subject missing Co-60 source, serial # 41313, was discovered this morning (8/11/12) to be located in module 10, position 23, in the Steris (Northborough) pool irradiator. The serial number of the source was visually confirmed by Steris, REVISS, and a State of Massachusetts Inspector. The source is no longer missing. The State is continuing its investigation into the circumstances of this event.

Notified R1DO (Burritt), R3DO (Lipa), FSME (Henderson), and IRD MOC (Marshall).


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

To top of page
Agreement State Event Number: 48177
Rep Org: PA BUREAU OF RADIATION PROTECTION
Licensee: NLMK PENNSYLVANIA
Region: 1
City: FARRELL State: PA
County:
License #: PA-1074
Agreement: Y
Docket:
NRC Notified By: JOE MELNIC
HQ OPS Officer: JOHN KNOKE
Notification Date: 08/10/2012
Notification Time: 13:41 [ET]
Event Date: 08/09/2012
Event Time: [EDT]
Last Update Date: 08/10/2012
Emergency Class: NON EMERGENCY
10 CFR Section:
AGREEMENT STATE
Person (Organization):
ART BURRITT (R1DO)
FSME RESOURCES (EMAI)

Event Text

AGREEMENT STATE REPORT - STUCK SHUTTER ON GAUGE

The following information was provided by the Commonwealth of Pennsylvania via facsimile:

"On Thursday, August 9, 2012, the licensee informed the Department's [Department of Environmental Protection (DEP)] Southwest Regional Office about the discovery of a shutter failure. It is reportable within 24- hours under 10CFR 30.50(b)(2).

"During a semi-annual leak test being performed by a consultant, the shutter was found inoperable and stuck in the open position. No dose is believed to have been received by any personnel.

"The device is identified as: Manufacturer: LFE, Model #: SS-3A, Device Serial #: 300-483L, Sealed Source Model #: SS-3A, Sealed Source SN: 02311, Isotope: Am-241, Activity: (1 Ci).

"The cause of the event was equipment malfunction. Licensee continued running the mill with permission granted by DEP until the consultant arrived later that same day. Repairs were made to the shutter mechanism, followed by a radiation survey, wipe test, and function check of the gauge. The gauge is now operating properly. DEP scheduled a reactive inspection for August 10, 2012."

PA Event Report No. PA120024

To top of page
Power Reactor Event Number: 48197
Facility: FERMI
Region: 3 State: MI
Unit: [2] [ ] [ ]
RX Type: [2] GE-4
NRC Notified By: JEFF GROSS
HQ OPS Officer: JOHN SHOEMAKER
Notification Date: 08/16/2012
Notification Time: 21:02 [ET]
Event Date: 08/16/2012
Event Time: 14:58 [EDT]
Last Update Date: 08/17/2012
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(3)(xiii) - LOSS COMM/ASMT/RESPONSE
Person (Organization):
JOHN GIESSNER (R3DO)

Unit SCRAM Code RX CRIT Initial PWR Initial RX Mode Current PWR Current RX Mode
2 N Y 68 Power Operation 68 Power Operation

Event Text

INTEGRATED PLANT COMPUTER FAILURE

"At approximately 1458 EDT on 8/16/12, a portion of the Fermi 2 Integrated Plant Computer System (IPCS) failed. This resulted in a loss of approximately 60 percent of data on the Safety Parameters Display System (SPDS).

"While IPCS and SPDS are not fully functional, the Emergency Plan can still be implemented if a plant emergency does occur, as assessment capabilities are available under alternate means.

"Repairs are in progress. A follow up message will be made when IPCS and SPDS are restored to fully functional status.

"This notification is being made pursuant to the requirements 10 CFR 50.72(b)(3)(xiii), any event that results in a major loss of emergency assessment capability."

The licensee has notified the NRC Resident Inspector.

* * * UPDATE FROM GROFF TO KLCO ON 8/17/12 AT 0429 EDT* * *

"At approximately 1458 EDT on 8/16/12, a portion of the Fermi 2 Integrated Plant Computer System (IPCS) failed. This resulted in a loss of approximately 60 percent of data on the Safety Parameters Display System (SPDS).

"At 2340 [EDT], plant personnel were able to restore full functionality of IPCS and SPDS, restoring full Emergency assessment capabilities to all onsite emergency response facilities."

The licensee notified the NRC Resident Inspector.

Notified the R3DO (Giessner).

To top of page
Power Reactor Event Number: 48199
Facility: ROBINSON
Region: 2 State: SC
Unit: [2] [ ] [ ]
RX Type: [2] W-3-LP
NRC Notified By: BRIAN DALE
HQ OPS Officer: STEVE SANDIN
Notification Date: 08/17/2012
Notification Time: 06:32 [ET]
Event Date: 08/17/2012
Event Time: 05:52 [EDT]
Last Update Date: 08/17/2012
Emergency Class: UNUSUAL EVENT
10 CFR Section:
50.72(a) (1) (i) - EMERGENCY DECLARED
Person (Organization):
EUGENE GUTHRIE (R2DO)
ERIC THOMAS (NRR)
WILLIAM GOTT (IRD)
BRUCE BOGER (NRR)
VICTOR McCREE (R2 R)

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

Event Text

UNUSUAL EVENT DECLARED DUE TO THE UNPLANNED LOSS OF ANNUNCIATORS > 15 MINUTES

At 0552 EDT Control Room Operators experienced a Loss of Annunciators. At 0607 EDT, the licensee declared an Unusual Event per EAL SU4.1, " Unplanned loss of most or all Annunciators or Indicators associated with Safety Systems on the RTGB [Remote Turbine Gage Board] Sections A and B, Primary System Annunciators and Indicators > 15 minutes." During an alarm test, the annunciators lit up as expected but did not clear at the completion of the test.

Exit criteria for the Unusual Event will be restoration of the annunciator functions. The licensee has compensatory measures in effect. ERFIS [Emergency Response Facility Information System] and the normal RTGB instruments are available.

The licensee notified the state and informed the NRC Resident Inspector. Notified Other FEDS (FEMA, DHS and NNSA via email).

* * * UPDATE FROM HILL TO KLCO ON 8/17/2012 AT 0954 EDT * * *

On August 17, 2012 at 0940 EDT, the licensee terminated the Unusual Event based on restoring annunciator capability. The licensee notified the NRC Resident Inspector and has terminated ERDS transmission.

Notified NRR-EO(Thomas), R2DO(Guthrie), IRD(Gott) and other FEDS (FEMA, DHS and NNSA via email)

To top of page
Power Reactor Event Number: 48200
Facility: BROWNS FERRY
Region: 2 State: AL
Unit: [ ] [2] [ ]
RX Type: [1] GE-4,[2] GE-4,[3] GE-4
NRC Notified By: JOHN RIDINGER
HQ OPS Officer: JOHN SHOEMAKER
Notification Date: 08/17/2012
Notification Time: 12:20 [ET]
Event Date: 08/17/2012
Event Time: 04:50 [CDT]
Last Update Date: 08/17/2012
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(3)(v)(D) - ACCIDENT MITIGATION
Person (Organization):
EUGENE GUTHRIE (R2DO)

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

Event Text

INADVERTENT ACTUATION OF PRIMARY CONTAINMENT ISOLATION SYSTEM

"On 08/17/2012, while performing 2-SR-3.3.6.1(3DFT) - HPCI [High Pressure Coolant Injection] Steam Line Space Temperature Functional Test, an inadvertent PCIS [Primary Containment Isolation Signal] Group 4 (HPCI) isolation signal occurred. All automatic actions occurred as designed. Cause of the isolation is unknown with investigation in progress.

"This incident is reportable as an 8-hour ENS notification under 10 CFR 50.72 (b)(3)(v)(D).

"The incident also requires a 60 day written report.

"The NRC [Resident] Inspector has been notified."

The steam supply valves to HPCI remain closed during trouble shooting and repair, however, HPCI remains available for use if needed.

To top of page
Fuel Cycle Facility Event Number: 48202
Facility: GLOBAL NUCLEAR FUEL - AMERICAS
RX Type: URANIUM FUEL FABRICATION
Comments: LEU CONVERSION (UF6 TO UO2)
                   LEU FABRICATION
                   LWR COMMERICAL FUEL
Region: 2
City: WILMINGTON State: NC
County: NEW HANOVER
License #: SNM-1097
Agreement: Y
Docket: 07001113
NRC Notified By: SCOTT MURRAY
HQ OPS Officer: MARK ABRAMOVITZ
Notification Date: 08/17/2012
Notification Time: 13:36 [ET]
Event Date: 08/17/2012
Event Time: 12:39 [EDT]
Last Update Date: 08/17/2012
Emergency Class: NON EMERGENCY
10 CFR Section:
PART 70 APP A (a)(5) - ONLY ONE SAFETY ITEM AVAILABLE
Person (Organization):
EUGENE GUTHRIE (R2DO)
MICHAEL WATERS (NMSS)

Event Text

ONLY ONE IROFS AVAILABLE FOR A SPILL IN THE CERAMICS AREA

"At 12:39 PM (EDT) it was discovered that only one Items Relied On For Safety (IROFS) remained in place to prevent a Criticality Event in the ceramics area of the Fuel Manufacturing Operations facility. The failed IROFS was Fuel Business System (FBS) Control of Mass of Uranium Transportable Container (IROFS 900-01), due to an overweight pellet boat. The IROFS that remained in place at all times was Spill Identification and Cleanup (IROFS 900-11). The initiating event for the accident sequences (spill of a pellet boat) did not occur."

The licensee notified the NRC Resident Inspector.

* * * UPDATE AT 1456 EDT ON 8/17/2012 FROM SCOTT MURRAY TO MARK ABRAMOVITZ * * *

"The pellets have been removed from the overweight boat and placed into an approved container; the IROFS for these accident sequences have been restored. The extent of condition is being evaluated and at this time no other overweight boats have been identified.

"Region II and NMSS HQ and other notifications have been completed."

Notified the R2DO (Guthrie) and NMSS (Waters).

To top of page
Power Reactor Event Number: 48204
Facility: WATTS BAR
Region: 2 State: TN
Unit: [1] [ ] [ ]
RX Type: [1] W-4-LP,[2] W-4-LP
NRC Notified By: MICHAEL BOTTORFF
HQ OPS Officer: MARK ABRAMOVITZ
Notification Date: 08/17/2012
Notification Time: 14:11 [ET]
Event Date: 06/18/2012
Event Time: 23:49 [EDT]
Last Update Date: 08/17/2012
Emergency Class: NON EMERGENCY
10 CFR Section:
50.73(a)(1) - INVALID SPECIF SYSTEM ACTUATION
Person (Organization):
EUGENE GUTHRIE (R2DO)

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

Event Text

INVALID ACTUATION OF CONTAINMENT VENTILATION ISOLATION

"Watts Bar Nuclear Plant's (WBN's) containment ventilation isolation systems provide the means of isolating ventilation systems that pass through containment penetrations to confine to the containment any radioactivity that may be released following a design basis event. The containment ventilation system isolates following a manual or automatic safety injection signal, high containment purge exhaust radiation levels, or manual actuation.

"On 6/18/12 at 2349 EDT, a B train containment ventilation isolation signal was received in the Main Control Room due to an invalid high radiation signal from a containment purge exhaust radiation monitor (1-RM-131). Corrective action replaced the 1-RM-131 ratemeter following the 6/18/12 B train containment ventilation isolation. However, on 7/2/12 at 1252 EDT, a second B train containment ventilation isolation signal was received in the Main Control Room due to another invalid high radiation signal from 1-RM-131. An investigation found that 1-RM-131 was spiking repeatedly due to a defective Power On indicating light socket which affected the 120 VAC power circuit that is common with the 24 volt power supply. 120 VAC signal fluctuations could affect the 24 volt power supply signal to the rate meter causing output spikes. Corrective action replaced the defective Power On indicating light socket on 7/3/12.

"This event notification is being made in accordance with 10 CFR 50.73(a)(2)(iv)(A) as a 60 day telephone notification of the invalid initiation of a containment isolation signal. The specific system and train that was actuated was B train containment ventilation isolation. The system functioned as designed and the complete train operated.

"WBN's NRC Resident Inspector has been notified."

Page Last Reviewed/Updated Monday, August 20, 2012
Monday, August 20, 2012