Event Notification Report for November 12, 2013

MANUAL REACTOR TRIP DUE TO UNISOLABLE LEAK IN DIGITAL ELECTRO-HYDRAULIC SYSTEM

"At 0002 EST, Unit 1 Manually tripped the Reactor from 90% power due to an unisolable leak in the Digital Electro-Hydraulic [DEH] System. All CEAs fully inserted into the Reactor Core. All systems responded as expected on the trip. Decay Heat removal currently using Main Feedwater and Steam Bypass Control System. After the trip, DEH pumps were secured to stop the transfer of fluid from the DEH system to the Turbine Building. Investigation ongoing to determine exact location of the leak. This condition is reportable pursuant to 10CFR50.72(b)(2)(iv)(B)."

The was no impact on Unit 2. The NRC Resident Inspector has been notified.

AGREEMENT STATE REPORT - LOST PORTABLE GAUGE

The following information was provided by the State of Nevada via email:

"The RSO [Radiation Safety Officer] of GeoTek, in Las Vegas, reported the loss of a portable gauge - CPN Model MC1, S/N MD360603270 - containing 10 mCi of Cs-137 and 50 mCi of Am-241/Be. It was lost this morning between 0930 and 1000 [PST] in North Las Vegas, near Charleston and Lambert Blvds. It was not properly secured in the back of the truck and fell out. The user looked for it but could not find it. The RSO is going out to take a look for it. A police report, no. 131112-1703Z, was filed with the Las Vegas Metro at 1115 hrs. The RSO will call the North Las Vegas PD and let [Nevada Division of Radiation Health] know when that is done."

Reference number: NV 130021

* * * UPDATE FROM THE STATE OF NEVADA TO HUFFMAN VIA E-MAIL ON 11/15/13 AT 1237 EST * * *

"In response to the $500.00 reward offered for the missing gauge, a man came forward today and handed the gauge over to the RSO. Apparently he had found it on the Charleston on-ramp to US-95, which is the route which the technician had taken on the day he had lost the gauge. The gauge is not damaged and appears to be intact.

"The RSO used a survey meter and did not get any abnormal readings. He will perform a leak test and then put the gauge back into service. Corrective action will involve additional training to staff to prevent such incidents in the future. An incident report will be sent to the Radiation Control Program [State of Nevada] by the RSO, within 30 days."

"A member of staff from the Radiation Control Program visited the licensee and checked the gauge [to confirm] everything was normal. However, the licensee has been advised to send the gauge to the manufacturer (InstroTek), to be completely sure that there was no damage, before being put back into service."

Notified R4DO (Farnholtz) and sent e-mail copies to FSME Events Resource and ILTAB.

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

AGREEMENT STATE REPORT - ACCESS RESTRICTED DUE TO TECHNETIUM-99 SPILL

The following information was obtained from the Commonwealth of Massachusetts via email:

"On 11/12/13, licensee reported 10 mCi spill of medical Tc-99m (6-hour half-life) liquid during patient administration. Report based on the licensee's need to restrict access to the area of the spill for more than 24 hours. Licensee reported there was no occupational exposure to workers. Spill cleanup action was performed by licensee but enough residual contamination remained for licensee to restrict access to contaminated room until 10 half-lives (approximately three days) of radioactive decay have passed. Licensee will submit written follow-up report within 30 days.

"The Agency [Massachusetts Radiation Control Program] considers this matter to be OPEN pending results of ongoing investigation."

* * * RETRACTION ON 11/18/13 AT 1055 EST FROM ANTHONY CARPENITO TO DONG PARK * * *

"The Agency [Massachusetts Radiation Control Program] agrees with recent USNRC determination that this is not a reportable event, because it meets one but not all three of the requirements contained in 105 CMR 120.142 (B)(1) or 10 CFR 30.50 (b)(1)."

Notified R1DO (Bower) and FSME Events Resource via email.

AGREEMENT STATE REPORT - RADIOACTIVE MATERIAL UNACCOUNTED FOR

The following was received via email from the Washington Dept. of Health, Office of Radiation Protection:

"Tuesday, November 12, 2013, I [State of WA] received a call from the Radiation Safety Officer of the University of Washington. He informed me that his staff was unable to account for 3.3 mCi of C-14 and 7 mCi of H-3, the sum of several vials [unsealed sources used for research], when reconciling the inventory of an AUI [Authorized Investigator] after he died. The AUI had a radioactive materials authorization at the university for well over 20 years. A staff member investigated the problem and interviewed current and previous laboratory staff in an effort to find the documentation of disposition of the missing material. This is believed to be a paperwork/failure to document issue with no actual loss or release. It will be discussed at their next Radiation Safety Committee meeting which the state will attend on 26 November 2013. The licensee will provide us with a full report by then. It is the C-14 which exceeds the reporting activities."

State incident number WA-13-056

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

MISSING DEPLETED URANIUM-238 SHIELDS

Between October 2012 and May 2013, the two customers located in Ridgeland, SC and Tampa, FL shipped depleted shielded Tc-99m generators back to Mallinckrodt in Missouri using courier service companies. The Ridgeland, SC customer, Palmetto Isotopes, shipped three containers; one on 4/29/13 and two on 5/1/13 using the courier ACI. The Tampa, FL customer, West Coast Nuclear Pharmacy, shipped one container on 10/11/12 using the courier Medical Delivery Services. Mallinckrodt has no record of these shields being returned to their facility.

Each container has 3.09 mCi of depleted U-238 as a shield. Mallinckrodt uses between 4000 - 5000 total containers to support their customer's needs. A container is declared missing after performing a complete inventory, contacting their customers to verify the Bill of Laden (BOL) information and contacting the couriers who conduct a search and provide a written response to Mallinckrodt. The typical turn-around time for the above is approximately 100 days.

The serial numbers, i.e., DU tracking # on box and safe serial # stamped on shield, of the missing sources are as follows:

Palmetto - DU tracking # 2185528, safe s/n 608, DU tracking # 2186644, safe s/n 930, DU tracking # 2189415, safe s/n 4947

West Coast Nuclear Pharmacy - DU tracking # 2178372, safe s/n 2146

The licensee contacted R3 (Lambert).

This report is similar to EN #47106.

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

AGREEMENT STATE REPORT - CAMERA FAILED TO RETRACT SOURCE PROPERLY

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

"On March 26, 2014, the Agency [State of Texas - Department of State Health Services] received information that a source disconnect had occurred in November of the previous year. A subsequent report from the licensee received April 1, 2014 indicates that the disconnect occurred on November 12, 2013 at a temporary field site just west of Wink, Texas. The drive cable had become worn, allowing the source to be pushed out without being fully engaged with the pigtail. The source was pushed out of the guide tube but did not retract when the drive cable was cranked in. The camera was a QSA Model 880D S/N D6125, source QSA Global model A424-9 Ir-192 at 66.7 Ci, S/N 99589B. The source was recovered without further incident by attaching another drive cable. No exposure to the public resulted form this event. Additional information will be supplied as it is received in accordance with SA-300."

Texas Incident Number: I-9174