Event Notification Report for October 20, 2009

U.S. Nuclear Regulatory Commission
Operations Center

Event Reports For
10/19/2009 - 10/20/2009

** EVENT NUMBERS **


45435 45439 45444 45445

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General Information or Other Event Number: 45435
Rep Org: TEXAS DEPARTMENT OF HEALTH
Licensee: HOTWELL US LTD
Region: 4
City: HOUSTON State: TX
County:
License #: 06145
Agreement: Y
Docket:
NRC Notified By: RAY JISHA
HQ OPS Officer: STEVE SANDIN
Notification Date: 10/15/2009
Notification Time: 15:55 [ET]
Event Date: 10/15/2009
Event Time: 14:15 [CDT]
Last Update Date: 10/15/2009
Emergency Class: NON EMERGENCY
10 CFR Section:
AGREEMENT STATE
Person (Organization):
CHUCK CAIN (R4DO)
MARK DELLIGATTI (FSME)

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

Event Text

POTENTIAL LOST SEALED SOURCE CONTAINING 1.8 CURIES TRITIUM

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

"On June 29, 2009 Hotwell US LTD received a new shipment of two tritium well logging tools from their manufacturer in Austria. The tools each contain a 1.8 Curies (Ci) tritium sealed source inside a 15,000 psi pressure housing. These tools were slated for sale and delivery to Competition Wireline (NRC License No. 25-27802-1) out of Billings, Montana. After arriving at the facility in Houston, Texas, the tools were checked and shipped via [common carrier] to Competition Wireline. One tool (No. 33264) arrived at Competition Wireline on July 1, 2009. On July 6, 2009, Competition Wireline verified to Hotwell US LTD that the other tool (No. 33284) had been received. On October 13, 2009 Competition Wireline reported to Hotwell US LTD that after a general inventory of equipment, they could not locate one of the tools (No. 33284). The licensee has alleged that [the common carrier] never delivered the tool and found that it was last tracked to Memphis, Tennessee. [The common carrier] now shows the package as 'In Transit'. Competition Wireline has notified [the common carrier], and [the common carrier] is conducting an investigation into the location of the package.

The missing tool is described as follows:

" Tool No. 33284
Monoblock No.: 99448
Model No.: ING-10-50-120-TBT
Description: 84 x12 x8 Black Crate

"Texas Incident Number I-8677."

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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General Information or Other Event Number: 45439
Rep Org: TEXAS DEPARTMENT OF HEALTH
Licensee: FUGRO CONSULTANTS INC.
Region: 4
City: PASADENA State: TX
County:
License #: 4322
Agreement: Y
Docket:
NRC Notified By: RAY JISHA
HQ OPS Officer: STEVE SANDIN
Notification Date: 10/15/2009
Notification Time: 18:04 [ET]
Event Date: 10/14/2009
Event Time: [CDT]
Last Update Date: 10/16/2009
Emergency Class: NON EMERGENCY
10 CFR Section:
AGREEMENT STATE
Person (Organization):
CHUCK CAIN (R4DO)
MARK DELLIGATTI (FSME)

Event Text

AGREEMENT STATE REPORT INVOLVING A RADIOGRAPHY CAMERA SOURCE DISCONNECT

Received a call from State of Texas concerning an incident that occurred 10/14/09 at a temporary jobsite in Texas (location unknown). The company (not identified in the call) is located in Pasadena, TX. The State of Texas representative said that the Radiographer failed to follow procedures and connect the guide tube before cranking out the source. The source subsequently struck the wall and disconnected. The company RSO who is qualified for source retrieval recovered and secured the source. His extremity dosimetry indicated 57 mrem with a whole body dose of about 90 mrem. Details of the incident including licensee name and license number will be provided by update.

* * * UPDATE FROM ART TUCKER TO VINCE KLCO AT 1049 ON 10/16/2009 * * *

The following information was received by e-mail:

"On October 15, 2009, the Agency [State] was notified by the licensee that on October 14, 2009, they experienced a source disconnect while using an Amersham model 660 radiography camera containing a 45.3 curie Iridium (Ir) 192 source. The Radiation Safety Officer (RSO) stated that two radiographers were setting up for their first shot of the day. The guide tube they had was too short, so one of the radiographers connected an additional guide tube to the end of the existing guide tube, while the other radiographer prepared to perform the shot. Neither of the radiographers attached the guide tube to the camera. They then cranked the source out of the camera to perform their first shot. This caused the source to be pushed out of the camera, onto the floor of the shooting bay, and against the wall of a shooting bay. The camera operator felt that he had cranked the source out farther than it should have traveled for the shot and stopped cranking the source. He then tried to return the source to the camera. When the radiographer retracted the drive cable, the source was left loose on the shooting bay floor. The radiographer approached the shooting area with his dose rate meter and found the dose rates were elevated. The radiographer then secured the area and notified the RSO, who is specifically authorized on the license for source retrieval. The RSO developed a strategy to reconnect the source, and then successfully cranked the source back into the camera. No one involved with this event received an exposure exceeding any regulatory limit.

"The RSO stated that their investigation into the event determined that the root cause for the event was the failure of the two radiographers to follow procedure. He also noted a failure of the two radiographers to communicate adequately. The RSO stated that they will retrain all of their radiographers regarding their procedures for the proper connecting and disconnecting of equipment to their exposure devices. He also stated that this training would be repeated in their annual training in 2010."

Texas Incident: I-8678

Notified R4DO(Cain) and FSME (McIntosh).

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General Information or Other Event Number: 45444
Rep Org: DEFENSE DISTRIBUTION CENTER
Licensee: DEFENSE DISTRIBUTION CENTER
Region: 4
City: SAN DIEGO State: CA
County:
License #: 37-30062-01
Agreement: Y
Docket:
NRC Notified By: DAVID COLLINS
HQ OPS Officer: CHARLES TEAL
Notification Date: 10/19/2009
Notification Time: 10:13 [ET]
Event Date: 10/19/2009
Event Time: [PDT]
Last Update Date: 10/19/2009
Emergency Class: NON EMERGENCY
10 CFR Section:
20.2201(a)(1)(i) - LOST/STOLEN LNM>1000X
Person (Organization):
LAWRENCE DOERFLEIN (R1DO)
NEIL OKEEFE (R4DO)
ANGELA MCINTOSH (FSME)
MEXICO VIA FAX ()

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

Event Text

STRONTIUM-90 PRESSURE INDICATORS MISSING DURING AN ANNUAL INVENTORY

"While conducting the Annual Radioactive Inventory [of pressure indicators], a discrepancy was noted in the on-hand balance of the subject NIIN (National Item Identification Number). The current electronic inventory balance was 138 ea, but a physical check of the location could only locate 136 for a shortage of 2 ea. An initial search of the Radioactive Materiel Storage Area did not locate the item. The Service Provider and Continuing Government Activity personnel will begin a review of all transaction since the last reconciled inventory in an attempt to identify potential transaction errors.

"The pressure indicator in its shipping container is authorized to ship as an expected package with an external dose rate of less than 0.5 mrem /hr on contact."

The pressure indicators contained 500 microcuries of Sr-90.

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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Power Reactor Event Number: 45445
Facility: WATERFORD
Region: 4 State: LA
Unit: [3] [ ] [ ]
RX Type: [3] CE
NRC Notified By: JOE WILLIAMS
HQ OPS Officer: PETE SNYDER
Notification Date: 10/19/2009
Notification Time: 14:13 [ET]
Event Date: 10/19/2009
Event Time: 09:44 [CDT]
Last Update Date: 10/19/2009
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):
NEIL OKEEFE (R4DO)

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

Event Text

MANUAL REACTOR TRIP FOLLOWING STUCK OPEN MOISTURE SEPARATOR HEATER RELIEF VALVE

"At approximately 0915 CDT on 10/19/09 a Waterford 3 Moisture Separator Heater shell-slide relief valve (RS-203B) inadvertently opened, causing reactor power to increase from 100% to approximately 100.27% Rated Thermal Power (RTP). Operations reduced Main Turbine-Generator load by approximately 26 megawatts to restore reactor power to less than 100% RTP. At approximately 0942 CDT, Operations commenced a rapid plant shutdown because the relief valve would not re-close. At approximately 0944 CDT, Operations manually tripped the reactor due to a low condenser hot well level, just prior to reaching the Condensate Pumps Trip setpoint, to avoid a loss of Main Feedwater event. The Plant Protection System (PPS) responded as designed, resulting in an uncomplicated reactor trip.

"Emergency Feedwater Actuation Signal (EFAS) was received on low Steam Generator level as expected from reactor trip at or near full power. Steam Generator levels remained above the EFAS injection level setpoint so that actual injection of Emergency Feedwater did not occur. No other PPS actuation occurred. The plant is currently being maintained in Mode 3.

"Waterford 3 plans to commence refueling outage (RF16) at this time, approximately 1 - 2 days earlier than scheduled.

The licensee notified the NRC Resident Inspector.

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