Event Notification Report for December 15, 2010

U.S. Nuclear Regulatory Commission
Operations Center

Event Reports For
12/14/2010 - 12/15/2010

** EVENT NUMBERS **


46446 46468 46470 46477 46480 46481

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Other Nuclear Material Event Number: 46446
Rep Org: GEOCONCEPTS ENGINEERING, INC
Licensee: GEOCONCEPTS ENGINEERING, INC
Region: 1
City: ASHBURN State: VA
County:
License #: 45-25467-01
Agreement: Y
Docket:
NRC Notified By: DREW THOMAS
HQ OPS Officer: ERIC SIMPSON
Notification Date: 12/02/2010
Notification Time: 16:25 [ET]
Event Date: 12/02/2010
Event Time: 14:00 [EST]
Last Update Date: 12/14/2010
Emergency Class: NON EMERGENCY
10 CFR Section:
20.2201(a)(1)(i) - LOST/STOLEN LNM>1000X
Person (Organization):
WAYNE SCHMIDT (R1DO)
JAMES DANNA (FSME)
ILTAB VIA EMAIL ()

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

Event Text

THEFT OF TROXLER MOISTURE DENSITY GAUGE

A Troxler moisture density gauge being used at Fort Meade (Maryland) was found to be stolen along with other industrial equipment at 1400 on 12/2/10. The Troxler gauge was last seen on Monday afternoon, 11/29/10, when it was secured in a temporary storage location inside a lock-box and chained to a sea container. Other items stolen included crane mats, a generator and miscellaneous tools.

The nuclear gauge is a Troxler Model 3430, S/N 37672, which contains two radioactive sources. One source is 44 mCi of Am-241/Be (S/N 78-2430). The other source is 9 mCi of Cs-137 (S/N 77-4907).

The licensee will notify base police to begin an investigation into the theft.

The licensee has notified the State of Maryland of the theft.

* * * UPDATE FROM DREW THOMAS TO JOE O'HARA AT 0948 ON 12/14/10 * * *

On 12/10/10, FT. Meade U.S. Army base police officers informed the licensee that the stolen container had been "dumped" back onto the jobsite. The licensee responded to the site and discovered the missing gauge inside the container. The source was in the locked and shielded position inside the gauge and the gauge doesn't appear to have been damaged. The gauge has been recovered and is now in the custody of the licensee. A leak test of the gauge is scheduled to be performed.

Notified R1DO(Holody), FSME(Reis) 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

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General Information or Other Event Number: 46468
Rep Org: NE DIV OF RADIOACTIVE MATERIALS
Licensee: THE SCHEMMER ASSOCIATES INC
Region: 4
City: LINCOLN State: NE
County:
License #: 01-124-01
Agreement: Y
Docket:
NRC Notified By: JIM DEFRAIN
HQ OPS Officer: DONG HWA PARK
Notification Date: 12/09/2010
Notification Time: 09:33 [ET]
Event Date: 12/08/2010
Event Time: 10:45 [CST]
Last Update Date: 12/09/2010
Emergency Class: NON EMERGENCY
10 CFR Section:
AGREEMENT STATE
Person (Organization):
MICHAEL HAY (R4DO)
ANGELA MCINTOSH (FSME)

Event Text

AGREEMENT STATE REPORT - DAMAGED NUCLEAR MOISTURE/DENSITY GAUGE

The following report was received via facsimile:

"Event date and time: December 8, 2010 - Time: 10:45 am

"Event location: 91st & Heritage Lake Drive, Lincoln, Nebraska, 685

"Event description: The licensee possesses a Humboldt Scientific, Inc. Model 5001-EZ 122 Nuclear Moisture/Density Gauge Serial Number 2027. On December 8, 2010, the gauge was being used at a construction site just east of Lincoln, NE. The operator of the gauge had started a test when he was distracted by another worker asking questions. During that time a front end loader backed into the gauge and broke the stationary guide rod. No other damage was observed to the gauge. The area was secured and radiation surveys as well as a leak test were performed. No unusual readings were observed. The source rod was secured in to safe position in the gauge housing and the gauge was place in the transport case for return to the licensee's office. No personnel were exposed to radiation during this event."

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!!!!! THIS EVENT HAS BEEN RETRACTED. THIS EVENT HAS BEEN RETRACTED !!!!!
Hospital Event Number: 46470
Rep Org: PIPE COUNTY MEMORIAL HOSPITAL
Licensee: PIPE COUNTY MEMORIAL HOSPITAL
Region: 3
City: LOUISIANA State: MO
County:
License #: 24-32776-01
Agreement: N
Docket:
NRC Notified By: DOUG SONNENBERG
HQ OPS Officer: BILL HUFFMAN
Notification Date: 12/09/2010
Notification Time: 18:05 [ET]
Event Date: 12/09/2010
Event Time: 12:00 [CST]
Last Update Date: 12/10/2010
Emergency Class: NON EMERGENCY
10 CFR Section:
35.3045(a)(3) - DOSE TO OTHER SITE > SPECIFIED LIMITS
Person (Organization):
ROBERT DALEY (R3DO)
DIANA DIAZ-TORO (FSME)

Event Text

TWO DIFFERENT PATIENTS RECEIVED INCORRECT DIAGNOSIC DOSES DUE TO VIAL MIX-UP

A representative of the licensee (the hospital rad tech) reported that two patients were administered doses of diagnostic Technetium-99m (Tc-99m) for the wrong organs due to a mixed-up of the dose vials. Specifically:

Patient #1 received a 25 millicurie Tc-99m dose for a bone scan instead of the prescribed 10 millicurie Tc-99m dose for a Hida scan (to the gall bladder).

Shortly thereafter, Patient #2 received the 10 millicurie Tc-99m dose for a Hida scan instead of the prescribed 25 millicurie Tc-99m dose for a bone scan.

Both errors were discovered when the actual diagnostic scans were performed.

The patients, their physicians, and the RSO have been notified of this event. The licensee representative stated that there should be no harm to the patient from the incorrect administration. The cause of this event was reported to be insufficient verification that the proper vial had been selected for injection. Both vials were reported to be identical in appearance.

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.

* * * RETRACTION FROM JOEL HASSIEN TO HUFFMAN AT 1549 EST ON 12/10/10 * * *

After further review of the event described above, the licensee determined that the event was not reportable to the NRC Operations Center. The retraction is based on a determination that the dose to the organs involved did not exceed the reportability limits. The licensee will log the details of this event. R3DO (Daley) and FSME (Diaz-Torro) notified.

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Power Reactor Event Number: 46477
Facility: COOK
Region: 3 State: MI
Unit: [1] [ ] [ ]
RX Type: [1] W-4-LP,[2] W-4-LP
NRC Notified By: BUD HINCKLEY
HQ OPS Officer: DONG HWA PARK
Notification Date: 12/14/2010
Notification Time: 02:02 [ET]
Event Date: 12/13/2010
Event Time: 21:19 [EST]
Last Update Date: 12/14/2010
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(3)(iv)(A) - VALID SPECIF SYS ACTUATION
Person (Organization):
LAURA KOZAK (R3DO)

Unit SCRAM Code RX CRIT Initial PWR Initial RX Mode Current PWR Current RX Mode
1 N Y 100 Power Operation 49 Power Operation

Event Text

MANUAL ACTUATION OF AUXILIARY FEEDWATER SYSTEM IN RESPONSE TO LOSS OF ONE MAIN FEEDWATER PUMP

"At 2119 EST on December 13, 2010, operators manually started all Auxiliary Feedwater (AFW) pumps in response to a loss of the Unit 1 East Main Feedwater Pump.

"Operators were responding to decreasing condenser vacuum on the East Main Feedwater Pump and reducing turbine load when the East Main Feedwater Pump was manually tripped at approximately 21 inches of vacuum Hg. Operators entered the abnormal operating procedure for Loss of One Main Feedwater Pump, which directs starting all three AFW pumps.

"Plant power was stabilized at approximately 49%.

"The licensee will be notifying the NRC Senior Resident Inspector.

"This notification is being made in accordance with 10CFR50.72(b)(3)(iv)(A) due to the valid actuation of the AFW system in response to equipment failure."

No maintenance was in progress, and the cause of the decreasing condenser vacuum in the MFP was due to debris in the traveling water screen.

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General Information or Other Event Number: 46480
Rep Org: HIRSCHFELD INDUSTRIES
Licensee: HIRSCHFELD INDUSTRIES
Region: 4
City: SAN ANGELO State: TX
County:
License #:
Agreement: Y
Docket:
NRC Notified By: DENNIS HIRSCHFELD
HQ OPS Officer: VINCE KLCO
Notification Date: 12/14/2010
Notification Time: 16:43 [ET]
Event Date: 12/10/2010
Event Time: [CST]
Last Update Date: 12/14/2010
Emergency Class: NON EMERGENCY
10 CFR Section:
21.21 - UNSPECIFIED PARAGRAPH
Person (Organization):
JAY HENSON (R2DO)
THOMAS HILTZ (NMSS)
21 MATERIALS- email ()

Event Text

STRUCTURAL STEEL BEAM FAULTS

The following information was received by facsimile:

"Several W16 x 67 [structural steel] beams have been discovered with a longitudinal crack in the web of the beam. The crack appears to run intermittently down the entire length of the beam. Each of the beams were found to be from the same heat (22536130).

"Procurement was notified and indicated that [Hirschfeld] purchased 15- 50 feet beams with this heat number. The location of all pieces of this heat were located. It was determined that some were in [the Hirschfeld] shop, some were at the fireproofer and three pieces had been delivered to the site [Eunice, NM] but were not erected. Arrangements have been [made] to have all pieces returned to [the Hirschfeld] facility. Customer, Baker Concrete Construction (National Enrichment Facility, Eunice, NM) has been notified as has the supplier of the steel, Gerdau Ameristeel, Midlothian, TX."

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Power Reactor Event Number: 46481
Facility: FARLEY
Region: 2 State: AL
Unit: [1] [2] [ ]
RX Type: [1] W-3-LP,[2] W-3-LP
NRC Notified By: WILLIAM ARENS
HQ OPS Officer: VINCE KLCO
Notification Date: 12/14/2010
Notification Time: 22:35 [ET]
Event Date: 12/14/2010
Event Time: 17:40 [CST]
Last Update Date: 12/14/2010
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(3)(xiii) - LOSS COMM/ASMT/RESPONSE
Person (Organization):
JAY HENSON (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
2 N Y 100 Power Operation 100 Power Operation

Event Text

ENS PHONE LINES OUT OF SERVICE DUE TO A FAILED RECTIFIER

"At 1740 CST the control room was notified by a commercial phone provider that they had received alarms indicating the ENS communications lines were out of service. Attempts to use the ENS lines confirmed that the ENS system is not functioning at the site. Commercial lines with an 899 prefix are also not functioning. Alternate commercial lines are available and have been verified functional. The vendor has determined that the loss of the ENS lines are the result of a failed rectifier. It is currently not known when the ENS lines will be returned to service. Farley Nuclear Plant may be contacted via commercial line."

The licensee will notify the NRC Resident Inspector.

* * * UPDATE FROM ARENS TO KLCO ON 12/14/10 AT 2318 * * *

ENS line at Farley was repaired and successfully tested.

The licensee will notify the NRC Resident Inspector.

Notified R2DO (Henson)

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