Event Desc|En No|Site Name|Licensee Name|Region No|City Name|State Cd|County Name|License No|Agreement State Ind|Docket No|Unit Ind1|Unit Ind2|Unit Ind3|Reactor Type|Nrc Notified By|Ops Officer|Notification Dt|Notification Time|Event Dt|Event Time|Time Zone|Last Updated Dt|Emergency Class|Cfr Cd1|Cfr Descr1|Cfr Cd2|Cfr Descr2|Cfr Cd3|Cfr Descr3|Cfr Cd4|Cfr Descr4|Staff Name1|Org Abbrev1|Staff Name2|Org Abbrev2|Staff Name3|Org Abbrev3|Staff Name4|Org Abbrev4|Staff Name5|Org Abbrev5|Staff Name6|Org Abbrev6|Staff Name7|Org Abbrev7|Staff Name8|Org Abbrev8|Staff Name9|Org Abbrev9|Staff Name10|Org Abbrev10|Scram Code 1|RX CRIT 1|Initial PWR 1|Initial RX Mode1|Current PWR 1|Current RX Mode 1|Scram Code 2|RX CRIT 2|Initial PWR 2|Initial RX Mode 2|Current PWR 2|Current RX Mode 2|Scram Code 3|RX CRIT 3|Initial PWR 3|Initial RX Mode 3|Current PWR 3|Current RX Mode 3|Event Text| Power Reactor|55172|Perry|Firstenergy Nuclear Operating Company|3|Perry|OH|Lake||Y|05000440|1|||[1] GE-6|Clifford Jones|Donald Norwood|04/06/2021|4:32:00|04/05/2021|21:49:00|EDT|5/4/2023 5:44:00 AM|Non Emergency|50.72(b)(3)(iv)(A)|Valid Specif Sys Actuation|||||||PELKE, PATRICIA|R3|||||||||||||||||||M/R|N|0|Startup|0|Hot Standby||N|0||0|||N|0||0||EN Revision Imported Date: 5/4/2023

EN Revision Text: MANUAL REACTOR PROTECTION SYSTEM (RPS) ACTUATION AT ZERO PERCENT POWER "At 2149 EDT on April 5, 2021, with the power plant in Mode 2 at zero percent power, an actuation of the RPS system occurred following the decision to abort plant start-up. The reason for the RPS actuation was to align the plant to Mode 3, from Mode 2, following manually inserting all control rods using the Rod Control System. The RPS system initiated as designed when the mode switch was taken from 'Start-up' to 'Shutdown' to align the plant to Mode 3 from Mode 2. "This event is being reported in accordance with 10 CFR 50.72(b)(3)(iv)(A) as an event that results in a valid actuation of the RPS system. "There was no impact on the health and safety of the public or plant personnel. The NRC Resident Inspector has been notified. * * * RETRACTION ON 5/12/21 AT 1345 EDT FROM JOHN NAKEL TO KERBY SCALES * * * "This is a retraction of an event notification made on 4/6/2021 at 0432 EST (EN#55172). This event was initially reported in accordance with 10 CFR 50.72(b)(3)(iv)(A) as an event that results in a valid actuation of the RPS System. This event was later determined to be pre-planned, in accordance with Technical Specifications, and not the result of a significant event, therefore not meeting the reporting criteria of 10 CFR 50.72(b)(3)(iv)(A). "On the evening of April 4, 2021, while commencing reactor start up, it was determined that control rod withdrawal to add positive reactivity for the start-up would not overcome the negative reactivity of plant heat up. The control room team determined that the proper course of action would be to insert all control rods . The control room briefed and notified the Outage Control Center about its decision, then proceeded to insert all control rods. The control room manually inserted all control rods using the control rod hydraulic system. "Following insertion of all control rods, the mode switch was taken to the shutdown position to meet the prerequisites of the procedure for maintaining hot shutdown. This action establishes Mode 3 in accordance with Technical Specifications and aligns the plant to perform the necessary work prior to a plant restart. By placing the mode switch in the shutdown position, a scram signal is generated for 10 seconds. "NUREG-1022 offers guidance that states 'Actuations that need not be reported are those initiated for reasons other than to mitigate the consequences of an event.' The actions the operating crew took that night are accurately described by this statement in NUREG-1022 'shifting alignment of makeup pumps or closing a containment isolation valve for normal operational purposes would not be reportable.' In this situation, the Mode switch was taken to shutdown to align the plant to mode 3 for normal operational purposes, and not to mitigate a significant event. "When the mode switch was taken to shut-down, RPS initiated as designed, there was no mis-operation or unnecessary actuation. "This actuation was determined to be pre-planned, in accordance with Tech Specs, and not the result of a significant event, therefore not meeting the reporting criteria of 10 CFR 50.72(b)(3)(iv)(A)." The NRC Resident has been notified. Notified R3DO (McGraw). | Power Reactor|55421|Sequoyah|Tennessee Valley Authority|2|Soddy-Daisy|TN|Hamilton||Y|05000327|1|2||[1] W-4-LP,[2] W-4-LP|Jeffery Blaine|Thomas Kendzia|08/20/2021|16:00:00|08/20/2021|9:05:00|EDT|5/4/2023 5:44:00 AM|Non Emergency|50.72(b)(3)(v)(C)|Pot Uncntrl Rad Rel|50.72(b)(3)(v)(D)|Accident Mitigation|||||MILLER, MARK|R2|||||||||||||||||||N|Y|100|Power Operation|100|Power Operation|N|Y|100|Power Operation|100|Power Operation||N|0||0||EN Revision Imported Date: 5/4/2023

EN Revision Text: AUXILIARY BUILDING GAS TREATMENT SYSTEMS INOPERABLE "At 0905 EDT, it was discovered both trains of Auxiliary Building Gas Treatment System (ABGTS) were simultaneously INOPERABLE due to the auxiliary building secondary containment enclosure (ABSCE) being inoperable; therefore, this condition is being reported as an eight-hour, non-emergency notification per 10 CFR 50.72(b)(3)(v). "There was no impact on the health and safety of the public or plant personnel. The NRC Resident Inspector has been notified." ABSCE and ABGTS were returned to operable. * * * RETRACTION ON 10/14/2021 AT 0756 EDT FROM TRACY SUDOKO TO THOMAS HERRITY * * * "This is a retraction of the 8-hour Immediate notification (EN55421) made to the NRC by Sequoyah Nuclear Plant on August 20, 2021. "Sequoyah is retracting this event notification based on the following: Regulatory Guidance in NUREG-1022, Revision 3, 'Event Reporting Guidelines 10 CFR 50.72 and 50.73', Sections 2.8 'Retraction and Cancellation of Event Reporting', and 4.2.3 'ENS Notification Retraction'. "On August 20, 2021 personnel found door A-118 open. This door is part of the ABSCE. During the initial investigation, it was found that other personnel had the door open using Precaution A of 0-TI-SXX-000-016.0 which allows material access through ABSCE doors if the door is closed within three minutes. It was found that A-118 door had been open for greater than three minutes. With this door open the ABSCE was beyond its capability for ABGTS fan to maintain the required pressure during an Aux. Building Isolation. Thus, the site declared the ABSCE and both Trains of ABGTS inoperable per LCO 3.7.12 Conditions A, B and E. With the ABSCE being a single train system, this caused a condition that "could have prevented the fulfillment of the safety function" which requires an Immediate Notification to the NRC within eight hours under 10 CFR 50.72 (b)(3)(v)(C) and 10 CFR 50.72 (b)(3)(v)(D). This Immediate Notification was reported on August 20, 2021 at 1600 EDT. "It was later determined that at 'Time of Discovery', although Door A-118 was open, it was not obstructed, the door was open by normal means, was capable of being closed and was now attended. The time requirement per 0-TI-SXX-000-016.0 for closure of an open ABSCE door is within three minutes of notification. Although the individual found holding the door was unaware of the requirement of 0-TI-SXX-000-016.0 to close the door, communications were established and the Main Control Room (MCR), upon discovery of the 'Open Door', could have directed closure starting at the Time of Discovery if required. Since the MCR was aware the door was open, had communications established with personnel at the door, the door was capable of closure and not restricted, the three minute closure requirement of 0-TI-SXX-000-016.0 was met. Subsequently, the door was closed within approximately two minutes of notification to close. The closure of the door with these procedural measures met confirmed the integrity of the ABSCE and therefore Operability of ABGTS. "Based on the above critical thinking, entry into LCO 3.7.12 Condition A, B, and E was retracted on August 22, 2021 at 2044 EDT. With the LCO conditions retracted and the above determination that at the Time of Discovery safety function was maintained, the Immediate Notification per 10 CFR 50.72 (b)(3)(v)(C) and 10 CFR 50.72 (b)(3)(v)(D) was not required. The issue of Past Operability remains for instances in time that the door did not have appropriate compensatory measures in place. Any further notification required for this event will be submitted as a Licensee Event Report." Notified R2DO (Miller) | Power Reactor|56241|Fermi|Detroit Edison Co.|3|Newport|MI|Monroe||N|05000341|2|||[2] GE-4|Whitney Hemingway|Adam Koziol|11/28/2022|8:38:00|11/28/2022|4:00:00|EST|5/4/2023 5:44:00 AM|Non Emergency|50.72(b)(3)(v)(D)|Accident Mitigation|||||||Stoedter, Karla|R3DO|||||||||||||||||||N|Y|100|Power Operation|100|Power Operation||N|0||0|||N|0||0||EN Revision Imported Date: 5/4/2023

EN Revision Text: HIGH PRESSURE COOLANT INJECTION SYSTEM INOPERABLE The following information was provided by the licensee via email: "At 0400 EST on November 28, 2022, during the performance of Division 2 Residual Heat Removal (RHR) cooling tower fan operability and RHR Service Water valve lineup verification, it was reported that the Mechanical Draft Cooling Tower (MDCT) Fan 'B' was making a loud metallic noise. The cause of the metallic noise is unknown at this time. The MDCT fans are required to support operability of the Ultimate Heat Sink (UHS). The UHS is required to support operability of the Division 2 Emergency Equipment Cooling Water (EECW) system. The EECW system cools various safety related components including the High Pressure Coolant Injection (HPCI) system room cooler. An unplanned HPCI inoperability occurred based on inoperable cooling water to the HPCI room cooler, per LCO 3.0.6. "Investigation into the Division 2 MDCT Fan 'B' abnormal noise is in progress. "This report is being made pursuant to 10 CFR 50.72(b)(3)(v)(D) based on an unplanned HPCI inoperability. "The NRC Resident Inspector has been notified." * * * RETRACTION FROM JEFF MYERS TO LLOYD DESOTELL AT 1615 EST ON 12/09/2022 * * * The following information was provided by the licensee via email: "The purpose of this notification is to retract a previous Event Notification 56241 reported on 11/28/2022. On 11/28/22, an event notification to the NRC was made when mechanical draft cooling tower (MDCT) Fan B was declared inoperable and issued Limited Condition of Operation (LCO) 2022-0428 for Division 2 MDCT Fan B abnormal noise. The MDCT fans are required to support operability of the Ultimate Heat Sink (UHS) (Technical Specification [TS] 3.7.2). The UHS is required to support operability of the Division 2 Emergency Equipment Cooling Water (EECW) system (TS 3.7.2), which cools various safety related components, including the High-Pressure Coolant Injection (HPCI) system room cooler (TS LCO 3.0.6). "Subsequent inspection and evaluation determined that the brake noise is expected while fans are running at low speeds. This is supported by plant technical procedure, 24.205.10 `Div. 2 RHR Cooling Tower Fan Operability and RHRSW Valve Line-up Verification' (line item 2.2 in Precautions and Limitations) which states `Chatter from the brakes of the MDCT Fans is expected and no cause for discontinuing the test.' The equipment vendor stated that brake chatter is possible and common given that the internal components are free to move along the splined connections. Internal Operating Experience from experienced station operators and maintenance technicians confirmed that the condition is normal and expected. Both Division 2 MDCTs exhibited the same behavior at low speed and passed surveillance testing satisfactorily. "No other concerns were noted during fan operation. Therefore, HPCI remained operable and there was no loss of safety function. The event did not involve a condition that could have prevented the fulfillment of the safety function of structures or systems that are needed to mitigate the consequences of an accident under 10 CFR 50.72(b)(3)(v)(D). "EN 56241 is retracted and no Licensee Event Report under 10 CFR 50.73(a)(2)(v)(D) is required to be submitted." The NRC Resident Inspector has been notified. Notified R3DO (Stoedter). | Power Reactor|56295|Fermi|Detroit Edison Co.|3|Newport|MI|Monroe||N|05000341|2|||[2] GE-4|Whitney Hemingway|Ian Howard|01/04/2023|8:28:00|01/04/2023|1:48:00|EST|5/4/2023 5:44:00 AM|Non Emergency|50.72(b)(3)(v)(D)|Accident Mitigation|||||||Edwards, Rhex|R3DO|||||||||||||||||||N|Y|100|Power Operation|100|Power Operation||N|0||0|||N|0||0||EN Revision Imported Date: 5/4/2023

EN Revision Text: HIGH PRESSURE COOLANT INJECTION INOPERABLE The following information was provided by the licensee via email: "At 0148 EST on January 4, 2023 it was identified that P4400F603B, Division 2 Emergency Equipment Cooling Water (EECW) Supply Isolation Valve, lost position indication. Division 2 EECW System was declared inoperable due to the potential that this valve may not be capable of performing its safety function to automatically isolate the safety related Division 2 EECW system from the non-safety related Reactor Building Closed Cooling Water (RBCCW) system. Because the Division 2 EECW system provides cooling to the High Pressure Coolant Injection (HPCI) room cooler, HPCI was also declared inoperable; therefore, this condition is being reported as an eight-hour, non--emergency notification per 10 CFR 50.72(b)(3)(v)(D). "At 0240 EST, position indication was restored and Division 2 EECW and HPCI was returned to operable following inspection of the associated motor control center (MCC) and testing of the associated fuses. The cause of the loss of indication is under investigation. "The Senior NRC resident inspector has been notified." * * * RETRACTION ON 3/6/23 AT 1740 EST FROM GREGORY MILLER TO KERBY SCALES * * * The following retraction was received from the licensee via email: "The purpose of this notification is to retract a previous Event Notification, EN 56295, reported on 1/4/2023. "Following the initial EN, further analysis of the condition was performed utilizing a gothic analysis model to perform HPCI room heat-up calculations. Based on the initial conditions at the time of the indication loss, specifically HPCI room and Suppression Pool temperature, it was determined that the resulting worst case post-accident room temperature was sufficiently low enough to provide margin to HPCI operability without the room cooler in service for the required mission time. "No other concerns were noted during the event. Therefore, HPCI remained operable and there was no loss of safety function. The event did not involve a condition that could have prevented the fulfillment of the safety function of structures or systems that are needed to mitigate the consequences of an accident under 10 CFR 50.72(b)(3)(v)(D). "Therefore, the NRC non-emergency 10 CFR 50.72(b)(3)(v)(D) report was not required and the NRC report 56295 can be retracted and no Licensee Event Report under 10 CFR 50.73(a)(2)(v)(D) is required to be submitted. "The NRC Senior Resident Inspector has been notified." Notified R3DO (Ruiz). | Agreement State|56348|SC Dept of Health & Env Control|WestRock Charleston Kraft, LLC|1|Charleston|SC||SC353|Y||||||Leland Cave|Karen Cotton-Gross|02/10/2023|9:21:00|02/09/2023|15:34:00|EST|5/2/2023 9:28:00 AM|Non Emergency| |Agreement State|||||||Cahill, Christopher|R1DO|NMSS_EVENTS_NOTIFICATION|EMAIL|||||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|EN Revision Imported Date: 5/3/2023

EN Revision Text: AGREEMENT STATE REPORT - STUCK SHUTTER GAUGE The following summary was obtained via phone and email from the South Carolina Department of Health & Environmental Control [the Department]: On February 9, 2023, at 1534 EST, the Department was notified by WestRock Charleston Kraft, LLC of a shutter on an Ohmart SH-F1 gauging device (serial number 67584) containing 10 mCi of Cs-137 that was stuck in the open position. The shutter was found during the licensee's six month inventory and shutter check. The gauge is in an isolated area not heavily trafficked. The vat that the gauge is attached to leaks directly onto the gauge, so it was previously recommended that the gauge be covered. The recommendation did not help. The contractor surveyed the gauge and got no higher than 2 mR/hr at a foot. The inspector concurred after using his [model] 14-C [detector] (serial number 99961). The numbers were approximately 4 mR/hr on the outside surface of the covering. It has been decided by the licensee that because it is in a very unobtainable location, they will leave it in the open and operating position until they remove the entire vat from service in March or April. South Carolina Event Number: EN56348 * * * UPDATE ON 3/9/23 AT 0836 EST FROM THE SOUTH CAROLINA DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL TO BILL GOTT VIA EMAIL * * * The following summary was obtained via email from the South Carolina Department of Health & Environmental Control: "The licensee submitted a 30-day written report on 03/09/23. The licensee reported no overexposures and that the gauging device will be disposed by 05/31/23. The licensee also reported that the gauging device contains 100 mCi of Cs-137 and not 10 mCi of Cs-137 as originally reported. This event is still under investigation." Notified R1DO (Young), and NMSS Events Notification (via email). * * * UPDATE ON 5/2/23 AT 0908 EDT FROM SOUTH CAROLINA DEPARTMENT OF HEALTH & ENVIRONMENTAL CONTROL TO SAM COLVARD * * * "The gauging device was transferred for disposal on 4/13/23. This event is considered closed." Notified R1DO (Dimitriadis), and NMSS Events Notification (via email). | Power Reactor|56350|Beaver Valley|Firstenergy Nuclear Operating Company|1|Shippingport|PA|Beaver||Y|05000334|1|2||[1] W-3-LP,[2] W-3-LP|Patrick Harris|Ian Howard|02/12/2023|14:41:00|02/12/2023|8:00:00|EST|5/4/2023 5:44:00 AM|Non Emergency|50.72(b)(3)(ii)(B)|Unanalyzed Condition|50.72(b)(3)(v)(D)|Accident Mitigation|||||Cahill, Christopher|R1DO|||||||||||||||||||N|Y|100|Power Operation|100|Power Operation|N|Y|100|Power Operation|100|Power Operation||N|0||0||EN Revision Imported Date: 5/4/2023

EN Revision Text: CONTROL ROOM EMERGENCY VENTILATION SYSTEM INOPERABLE The following information was provided by the licensee via phone call and email: "At 0800 on February 12, 2023, it was discovered that both trains of control room emergency ventilation system were simultaneously inoperable due to a safety injection relief valve discharging to a Unit 1 sump. This leakage in conjunction with design basis loss of coolant accident may result in radiological dose exceeding limits to the exclusion area boundary and to the control room, which is common to both Unit 1 and Unit 2. Therefore, this condition is being reported as an eight-hour, nonemergency notification per 10 CFR 50.72(b)(3)(ii)(B) and 10 CFR 50.72(b)(3)(v)(D) as an 'Unanalyzed Condition and a Condition that Could Have Prevented Fulfillment of a Safety Function.' "There was no impact on the health and safety of the public or plant personnel. "The NRC Resident Inspector has been notified." * * * RETRACTION FROM ROBERT TAYLOR TO DONALD NORWOOD AT 0530 EDT ON 3/17/2023 * * * "Retraction of EN56350, Control Room Emergency Ventilation System Inoperable: "Based on subsequent evaluation, it was determined that the control room emergency ventilation system remained operable due to the maximum measured leak rate being within the bounds of the analysis. The maximum measured leak rate of 32,594 cc/hr from the safety injection system did not challenge the calculated maximum engineered safety features leak rate of 45,600 cc/hr and remained within the current dose analysis limits. As such, this was not an unanalyzed condition and did not prevent the fulfillment of a safety function to mitigate the consequences of an accident. "The NRC Resident Inspector has been notified." Notified R1DO (Bickett). | Agreement State|56396|Texas Dept of State Health Services|Statewide Maintenance Company|4|Houston|TX||L06229|Y||||||Arthur Tucker|Bill Gott|03/09/2023|9:02:00|03/09/2023|0:00:00|CST|5/23/2023 12:28:00 PM|Non Emergency| |Agreement State|||||||Gepford, Heather|R4DO|NMSS_EVENTS_NOTIFICATION|EMAIL|MacDonald, Mark|ILTAB|Gupta Sarma, Trisha|NMSS DAY|Crouch, Howard|IR|Todd Smith|EMAIL|CNSNS (Mexico), - (EMAIL)|EMAIL|NMSS INES (EMAIL)|EMAIL|||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|EN Revision Imported Date: 5/24/2023

EN Revision Text: AGREEMENT STATE REPORT - STOLEN EXPOSURE DEVICE The following information was provided by the Texas Department of State Health Services (the Agency) via email: "On March 9, 2023, the Agency was notified by the licensee's radiation safety officer (RSO) that a Source Production and Engineering Company (SPEC) 150 exposure device containing a 121 curie iridium-192 source was stolen from one of the company's trucks. The radiography crew stated they left their job site to get some food at around midnight and stopped at a fast-food restaurant. They went into the restaurant to eat. The radiographers stated they failed to set the alarm on the dark room. They also stated they had left the key for the exposure device transport box in the dark room. The radiographers completed their meals and went back to the job site. "When they went to get the exposure device they found it was missing. The radiographers contacted the RSO and a search was conducted for the device. It was not found. The RSO reviewed security footage at the location the radiographers were working and confirmed the exposure device was not on the tailgate of the truck. They reviewed security footage at the fast-food restaurant, but the cameras were not pointed in the right direction to see the truck. The RSO stated there is a restaurant across the street from where they believe the exposure device was stolen that has security cameras. They will go there when it opens to see if the theft was captured by their cameras. The RSO stated that personnel will be sent back to the area where they believe the theft occurred for additional searches. The RSO stated they have sent people out to contact local pawn shops and scrap dealers and notify them of the theft and provide their contact information. Local law enforcement have been notified of the event. Additional information will be provided as it is received in accordance with SA-300." Texas Incident number: I-10000 Notified DHS SWO, FEMA Operations Center, CISA Central, USDA Operations Center, HHS Operations Center, DOE Operations Center, EPA Emergency Operations Center, FDA EOC (email), FEMA NWC (email), and NuclearSSA (email). * * * UPDATE ON 03/11/23 AT 0652 EST FROM ART TUCKER TO KERBY SCALES * * * The following update was provided by the Texas Department of State Health Services (the Agency) via email: "On March 9, 2023, at 1935 [EST], the Agency's radiation safety officer and an incident investigator arrived in the area where the exposure device was reported stolen. They searched the area using the Agency's [Radiation Solution Inc] (RSI) RS-700 mobile radiation monitoring system. They did not find the missing device or source. They intend to meet with the licensee's RSO this morning and search a broader area." Notified R4DO (Gepford), and NMSS Events Notification, ILTAB (MacDonald), IRMOC (Ulses), INES Coordinator (Smith), CNSNS (Mexico) via email. * * * UPDATE ON 03/11/23 AT 1929 EST FROM ART TUCKER TO OSSY FONT * * * The following update was provided by the Texas Department of State Health Services (the Agency) via email: "The Agency personnel have completed their search in the Houston area and are returning to Austin. They did not locate the missing exposure device. The licensee will continue looking for the device." Notified R4DO (Gepford), and NMSS Events Notification, ILTAB (MacDonald), IRMOC (Ulses), INES Coordinator (Smith), CNSNS (Mexico) via email. * * * UPDATE ON 03/16/23 AT 1730 EST FROM ART TUCKER TO BILL GOTT * * * The following update was provided by the Texas Department of State Health Services (the Agency) via email: "On March 15, 2023, the Agency conducted interviews with the licensee and individuals involved in the event. Using the licensee's GPS records, it was determined that the theft occurred between 2314 and 2355 CST the night of March 8, 2023." Notified R4DO (Kellar), and NMSS Events Notification, ILTAB (MacDonald), IRMOC (Crouch), INES Coordinator (Smith), CNSNS (Mexico) via email. * * * UPDATE ON 05/23/23 AT 1108 EDT FROM ART TUCKER TO BRIAN SMITH * * * The following update was provided by the Texas Department of State Health Services (the Agency) via email: "On May 23, 2023, the Agency received a phone call from an apartment manager in Houston, Texas. The manager stated that he was cleaning an apartment when he found the exposure device on the balcony of the apartment. The manager provided the serial number of the device which matched the number of the stolen device. The Agency contacted the licensee who drove to the location and recovered the device. The licensee reported that the source was still fully shielded and that dose rates on the device were normal. The Agency notified the Federal Bureau of Investigation (FBI) Special Agent who has been involved with this event that the device had been located and recovered. The licensee reported that it had been in phone contact with the FBI agent. Additional information will be provided as it is received in accordance with SA-300." Notified R4DO (Vossmar), NMSS (Rivera), NMSS Events Notification (email), ILTAB (MacDonald), IRMOC (Grant), INES Coordinator (Smith), CNSNS (Mexico) via email, DHS SWO, FEMA Operations Center, CISA Central, USDA Operations Center, HHS Operations Center, DOE Operations Center, EPA Emergency Operations Center, FDA EOC (email), FEMA NWC (email), and Nuclear SSA (email). 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* | Power Reactor|56411|Browns Ferry|Tennessee Valley Authority|2|Decatur|AL|Limestone||Y||2|||[1] GE-4,[2] GE-4,[3] GE-4|Courtney Rose|Kerby Scales|03/15/2023|4:27:00|03/14/2023|22:57:00|CDT|5/4/2023 6:22:00 AM|Non Emergency|50.72(b)(3)(ii)(A)|Degraded Condition|||||||Miller, Mark|R2DO|||||||||||||||||||N|N|0|Hot Shutdown|0|Hot Shutdown||N|0||0|||N|0||0||EN Revision Imported Date: 5/4/2023

EN Revision Text: REACTOR COOLANT SYSTEM (RCS) BOUNDARY DEGRADED CONDITION The following information was provided by the licensee via email: "At 2257 [CDT] on 3/14/2023 during the 2R22 refueling outage on Browns Ferry Nuclear Plant Unit 2, it was determined there was RCS boundary leakage from five of eight sensing lines that pass through containment penetrations X-30 and X-34 that did not meet the requirements of Section XI, of the ASME Boiler and Pressure Vessel Code. The condition will be resolved prior to plant startup. This event is being reported as an eight-hour, non-emergency notification per 10 CFR 50.72(b)(3)(ii)(A). "There was no impact on the health and safety of the public or plant personnel. The NRC Resident Inspector has been notified." * * * RETRACTION ON 03/28/2023 AT 1059 EST FROM CASEY CARTWRIGHT TO THOMAS HERRITY * * * The following information was provided by the licensee via email: "The purpose of this notification is to retract a previous Event Notification, EN 56411 reported on 3/14/23. "Following the initial notification, further analysis of the condition was performed. It was determined that the leaking pipe weld was ASME Section XI Code Class 2 piping which falls under the requirements of ASME Section XI Subsection IWC and not Subsection IWB. Therefore, this condition does not represent a serious degradation of the nuclear power plant, including its principle safety barriers. Based upon the above, the leaks identified on the ASME Section XI Code Class 2 equivalent Main Steam sense lines are not reportable under 10 CFR 50.72(b)(3)(ii). "Therefore, the NRC non-emergency 10 CFR 50.72(b)(3)(ii) report was not required and the NRC report 56411 can be retracted and no Licensee Event Report under 10 CFR 50.73(a)(2)(ii) is required to be submitted." Notified R2DO (Miller) | Power Reactor|56428|River Bend|Entergy Nuclear|4|St Francisville|LA|West Feliciana||Y|05000458|1|||[1] GE-6|Devin Wilson|Donald Norwood|03/23/2023|16:46:00|03/14/2023|9:26:00|CDT|5/4/2023 5:26:00 AM|Non Emergency|26.719|Fitness For Duty|||||||O'Keefe, Neil|R4DO|FFD Group, |EMAIL|||||||||||||||||N|N|0|Power Operation|0|Power Operation||N|0||0|||N|0||0||EN Revision Imported Date: 5/4/2023

EN Revision Text: FITNESS-FOR-DUTY REPORT - SUBVERSION OF THE FFD PROCESS A non-licensed contract supervisor was confirmed to have violated the FFD policy by attempting to subvert the testing process. The individual's authorization for site access was immediately terminated. The licensee notified the R4 Branch Chief (Josey) * * * RETRACTION FROM TITUS FOLDS TO JOHN RUSSELL AT 1606 EDT ON 05/03/2023 * * * The following information was provided by the licensee via email: "The Medical Review Officer [MRO] was provided with additional information on the collection process in question. Based on this additional information, the MRO was unable to conclude with a high degree of certainty that an attempt to subvert the FFD collection process had occurred." Notified R4DO (Gaddy) and via email the FFD Group. | Power Reactor|56459|Palo Verde|Arizona Nuclear Power Project|4|Wintersburg|AZ|Maricopa||Y|05000528|1|||[1] CE,[2] CE,[3] CE|Yolanda Good|Donald Norwood|04/09/2023|4:42:00|04/08/2023|21:44:00|MST|5/3/2023 8:21:00 PM|Non Emergency|50.72(b)(2)(iv)(B)|RPS Actuation - Critical|50.72(b)(3)(iv)(A)|Valid Specif Sys Actuation|||||Warnick, Greg|R4DO|||||||||||||||||||A/R|Y|100|Power Operation|0|Hot Standby|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|EN Revision Imported Date: 5/4/2023

EN Revision Text: AUTOMATIC REACTOR TRIP DUE TO LOSS OF REACTOR COOLANT PUMPS The following information was provided by the licensee via email: "The following event description is based on information currently available. If through subsequent reviews of this event additional information is identified that is pertinent to this event or alters the information being provided at this time a follow-up notification will be made via the ENS or under the reporting requirements of 10 CFR 50.73. "At 2144 MST on April 8, 2023, the Unit 1 reactor automatically tripped due to the loss of reactor coolant pumps stemming from the loss of 13.8 kV power to the pumps. "Prior to the reactor trip, the main turbine tripped due to a loss of hydraulic pressure. The main generator output breakers did not automatically open on the turbine trip as expected so the control room operators opened the breakers per procedural guidance. Once the breakers were opened, the two 13.8 kV electrical distribution buses failed to complete a fast bus transfer, which resulted in the loss of power to the reactor coolant pumps, initiating the reactor trip. The control room operators manually actuated a main steam isolation signal per procedure, requiring use of the atmospheric dump valves. "Following the reactor trip, all control element assemblies inserted fully into the core. No automatic specified system actuation was required or occurred. No emergency plan classification was required per the Emergency Plan. Safety related buses remained powered from offsite power during the event and the offsite power grid is stable. Unit 1 is stable and in Mode 3. Decay heat is being removed by the atmospheric dump valves and the class 1E powered motor driven auxiliary feedwater pump. "The loss of hydraulic pressure, the main generator output breakers failing to automatically open and the fast bus transfer not actuating are being investigated. "This event is being reported as a reactor protection system actuation in accordance with the reporting criteria of 10 CFR 50.72(b)(2)(iv)(B). "The NRC Senior Resident Inspector has been informed. "Unit 2 is in a refueling outage in Mode 5 and Unit 3 is in Mode 1 at 100 percent power." * * * UPDATE ON 4/9/23 AT 0835 EDT FROM TANNER GOODMAN TO ADAM KOZIOL * * * "This update is being made to report the manual actuation of the B-train auxiliary feedwater pump and manual main steam isolation signal (MSIS) actuation affecting multiple main steam isolation valves (MSIVs) following the reactor trip. "This event is being reported as a reactor protection system actuation in accordance with the reporting criteria of 10 CFR 50.72(b)(2)(iv)(B) and a specified system actuation in accordance with 10 CFR 50.72(b)(3)(iv)(A). "The NRC Senior Resident Inspector has been informed of the update." Notified R4DO (Warnick) * * * UPDATE ON 5/3/23 AT 1945 EDT FROM LORRAINE WEAVER TO JOHN RUSSELL * * * "This update is intended to clarify the initial description of the event that occurred on 4/8/2023. "Prior to the reactor trip, the main turbine tripped due to a loss of hydraulic pressure. The main generator output breakers did not automatically open on the turbine trip. The control room operators manually opened the breakers per procedural guidance. Once the breakers were opened, the two 13.8 kV electrical distribution buses de-energized. A fast bus transfer did not occur per design, which resulted in the loss of power to the reactor coolant pumps, initiating the reactor trip. The control room operators manually actuated a main steam isolation signal per procedure, requiring use of the atmospheric dump valves. "The NRC Senior Resident Inspector has been informed of the update." Notified R4DO (Gaddy) | Agreement State|56470|Maryland Dept of the Environment|Univ. of Maryland Medical Center|1|Baltimore |MD||MD-07-014-01|Y||||||Paul Kovach|Ernest West|04/14/2023|18:29:00|02/28/2023|0:00:00|EDT|5/23/2023 3:19:00 PM|Non Emergency| |Agreement State|||||||Lilliendahl, Jon|R1DO|NMSS_EVENTS_NOTIFICATION|EMAIL|Burgess, Michele (NMSS DAY)|NMSS DAY|||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|EN Revision Imported Date: 5/24/2023

EN Revision Text: AGREEMENT STATE REPORT - DOSE MISADMINISTRATION The following information was provided by the Maryland Department of the Environment (MDE) via email: On 04/14/2023 at 0951 [EDT], the MDE discovered an unsigned, undated report from the University of Maryland Medical Center, Baltimore, MD, that a medical misadministration had occurred on 02/28/2023. [After] contacting a health physicist and the Radiation Safety Officer (RSO) [at the University of Maryland], they confirmed that the event had actually occurred. A dose of 104.73 mCi of Ludotadipep [Lu-177] was being administered to a patient as part of a phase 1 clinical trial to treat metastasis. During the procedure, catheter infiltration (catheter movement) occurred resulting in a significant portion of the dose remaining in the upper left arm. The study sponsor was informed. Subsequent gamma scans showed that within 24 to 48 hours the dose had migrated to the intended treatment site. MDE is following up with the RSO and medical staff to confirm that the actual dose delivered to the treatment site was within 20 percent of the dose prescribed in the written directive. The University of Maryland staff has determined that an unintended dose estimated at 157 Rem had been delivered to the upper arm tissue. As of 04/14/2023, no ill effects have been observed, and the patient has been scheduled to resume subsequent treatment. This event is being reported under 10CFR 35.3045 (a)(1)(ii) B `. a dose that exceeds 50 Rem to an organ or tissue from administration of a radioactive drug containing byproduct material by the wrong route of administration'." * * * RETRACTION ON 5/23/23 AT 1501 EDT FROM PAUL KOVACH TO BILL GOTT * * * The following information was provided by the Maryland Department of the Environment (MDE) via email: "[The MDE] has been informed that the NRC medical team has reviewed this event notification and determined that this is not a reportable event under 10 CFR 35.3045. The medical team determined that, although not explicitly named as such, this event notification describes an extravasation. Extravasations are currently exempted from medical event reporting due to Commission policy, however this may change in the near future. Please note that the NRC does not consider extravasations as 'wrong route of administration,' as stated in 10 CFR 35.3045(a)(1)(ii)(B). "On May 19, 2023, the patient's physician at [University of Maryland Baltimore] (UMB) confirmed to [the MDE] that this event can be considered as an extravasation." Notified R1DO (Jackson), NMSS (Rivera), and NMSS Events Notification via email. 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.| Hospital|56481|Southern Arizona VA Health Care|Southern Arizona VA Health Care|3|Little Rock|AR||03-23853-01VA|N||||||Kim Wiebeck|Sam Colvard|04/20/2023|17:20:00|04/19/2023|12:30:00|CDT|5/2/2023 5:18:00 PM|Non Emergency|35.3045(a)(1)|Dose <> Prescribed Dosage|||||||NMSS_EVENTS_NOTIFICATION|EMAIL|Orth, Steve|R3DO|Werner, Greg|EMAIL|||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|EN Revision Imported Date: 5/3/2023

EN Revision Text: MEDICAL EVENT - PATIENT UNDERDOSE The following information was provided by the licensee via phone and email: "Per 10 CFR 35.3045(c), Veterans Health Administration (VHA) National Health Physics Program (NHPP) is reporting a possible medical event. "Southern Arizona VA Health Care System [the facility], Tucson, Arizona, which holds Permit Number 02-06186-01 under the VA master materials license, reported discovery of a 'possible' medical event to NHPP at approximately [1500] CDT, April 19, 2023. "A yttrium-90 microsphere therapy administration for liver cancer was performed on April 19, 2023. The intended treatment site was hepatic segment 4 of the right lobe of the liver. During the administration, performed under fluoroscopy guidance, the Authorized User (AU) / administering Interventional Radiology physician noted a change in the catheter position and elected to stop the administration. Measurements and calculations indicated the patient received about 63 percent of the prescribed activity [15.06 mCi delivered vs. 21.6 mCi prescribed]. Post implant single-photon emission computerized tomography (SPECT) imaging verified that the dosage had been delivered to the correct location. "The AU believes that the movement of the catheter qualifies as an emergent patient condition. The written directive was modified to include the reason for not administering the intended activity, the signature of an AU for yttrium-90 microspheres, and the date signed. NHPP in coordination with the facility and NRC will conduct further evaluation of this event to determine if the regulatory definition of emergent patient condition was met. "The patient and the referring physician have been notified. "At this time, short term harm to the patient is not expected. "NHPP will follow up with a written report in accordance with NRC requirements in 10 CFR 35.3045. "NHPP has notified the NRC Region III Project Manager." 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 KIM WIEBECK TO BRIAN P. SMITH AT 1709 EDT ON 05/02/2023 * * * The following information was provided by the licensee via email: "Veterans Health Administration (VHA) National Health Physics Program (NHPP) placed a call to NRC Operations Center on May 2, 2023, to retract Event Number 56481 (NMED Item No. 230168). "NHPP reported discovery of a "possible" medical event at Southern Arizona VA Health Care System, Tucson, Arizona, Permit Number 02-06186-01, on April 19, 2023. "NHPP, in coordination with the facility and NRC, has conducted further evaluation and determined that the regulatory definition of emergent patient condition, in NRC's document, Yttrium-90 Microsphere Brachytherapy Sources and Devices TheraSphere and SIR-Spheres Licensing Guidance, was met. Therefore, this event is no longer classified as a "possible" medical event and the 15-day written reporting requirement of 10 CFR 35.3045(d) will not be completed." NHPP has notified the NRC Region III Project Manager. Notified R3DO (Peterson), R4DO (Gaddy), and NMSS Events Notification. | Agreement State|56486|Colorado Dept of Health|Denver Scrap Metal Recycle Center|4|Denver|CO||N/A|Y||||||Phillip Peterson|Ian Howard|04/24/2023|9:22:00|04/18/2023|0:00:00|MDT|4/24/2023 9:29:00 AM|Non Emergency| |Agreement State|||||||Drake, James|R4DO|NMSS_EVENTS_NOTIFICATION|EMAIL|||||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|AGREEMENT STATE REPORT - FOUND RADIOACTIVE SOURCE The following information was provided by the Colorado Department of Health via email: "On April 18, 2023, a recycling yard in Denver flagged a load of scrap metal as potentially radioactive. The load was returned to the point of origin and was separated. At that time, a radium-226:beryllium source was identified. The source container was mostly intact. The point of origin (facility name listed above) was able to construct a cement barrier for storing the source until further investigation could be conducted. Measured dose rates around the cement barriers show rates that are indistinguishable from background (gamma and neutron). The markings on the source container indicate the manufacturer as Nuclear Chicago; the model as P21; the activity as 5 mCi radium-226:beryllium; and the reference date as 04/30/1963." Event Report ID No.: CO230011 | Agreement State|56488|PA Bureau of Radiation Protection|MISTRAS Group, Inc. |1|Trainer|PA||PA-1138|Y||||||John Chippo|Ernest West|04/26/2023|8:37:00|04/25/2023|0:00:00|EDT|4/26/2023 9:23:00 AM|Non Emergency| |Agreement State|||||||Henrion, Mark|R1DO|NMSS_EVENTS_NOTIFICATION|EMAIL|||||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|AGREEMENT STATE REPORT - DAMAGED RADIOGRAPHY CAMERA The following information was provided by the Pennsylvania Department of Environmental Protection (the Department) via email: "On April 25, 2023, the licensee reported damage to a QSA 880D (number D7890, source serial number 72481M), camera containing 105.8 Ci of Ir-192. While using the device shooting a 3-inch pipe positioned on a cart, the pipe fell off the cart and landed on the guide tube. The guide tube was damaged and left the source capsule in the exposed position unable to retract or to be placed back in the collimator. Lead blankets were placed on the damaged area of the guide tube. Dose rate at the established boundary was confirmed to be 0 mR/hr. The licensee staff calculated doses received to the 4 employees involved in the retrieval as 98, 310, 570, and 750 millirem. Badges have been sent to Landauer for emergency processing. The source was able to be secured safely in the device, locked in the licensee's vault, and tagged out of service. The device will be sent to the manufacturer to be inspected. "The Department will perform a reactive inspection. More information will be provided upon receipt." PA NMED Event Number: PA230014 | Agreement State|56490|Georgia Radioactive Material Pgm|Complete Cardiology|1|Atlanta|GA||GA 1337-1|Y||||||Kaamilya Najeeullah|Sam Colvard|04/26/2023|14:48:00|04/20/2023|0:00:00|EDT|4/26/2023 3:32:00 PM|Non Emergency| |Agreement State|||||||Henrion, Mark|R1DO|NMSS_EVENTS_NOTIFICATION|EMAIL|||||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|AGREEMENT STATE REPORT - LEAKING SOURCE The information below was provided by the Georgia Department of Natural Resources via email: "During a routine sealed source inventory and subsequent leak test performed on April 20, 2023, a physicist discovered that a Cs-137 vial source (initial calibration activity was 0.224 mCi, Cs-137, with serial number: 1710-68-15) was leaking. The source was wiped several times and counted in a Capintec CRC-55t well counter (serial number 561108) to ensure reproducibility of counts in the 662 keV window. Repeat wipe samples yielded the same counts and conclusively confirmed that the source was leaking. A picture was taken to document the visible damage of the vial. Area surveys and wipe tests performed in the location where the source was stored indicated no signs of contamination. The source has been taken out of service. As such, the leaking source has been fully contained and is currently secure in a hot lab. The licensee is currently in the process of obtaining quotes from several hazardous waste disposal companies in their region." Georgia Radioactive Materials Program incident number: 64. | Agreement State|56492|Louisiana Radiation Protection Div|Acuren Inspection Inc |4|Baton Rouge |LA||LA-7072-L01, Amdt. 129, AI# 126755|Y||||||Richard Blackwell|Thomas Herrity|04/26/2023|17:15:00|12/31/2022|0:00:00|CDT|4/26/2023 5:44:00 PM|Non Emergency| |Agreement State|||||||Drake, James|R4DO|NMSS_EVENTS_NOTIFICATION|EMAIL|||||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|AGREEMENT STATE REPORT - POSSIBLE OVEREXPOSURE TO RADIOGRAPHER The following information was provided by the LA Department of Environmental Quality (the Department) via email: "[The Department] was notified by Acuren Inspection Radiation Safety Officer (RSO) via the Department radiation hotline at approximately 1400 [CDT] on April 26, 2023, concerning a possible excessive exposure. According to the RSO, a radiographer that has been working in Pennsylvania had his December badge come back with a dose of 8000 mrem. The December badge was sent to Landauer with the March badges and the reading was just received by Acuren. The RSO states that the radiographer works in the dark room processing film and leaves his badge in his bag with other tools. The radiographer believes his bag was used by someone else while performing industrial radiography and that is how the badge got exposed. Acuren will be performing an investigation." LA event report ID No.: LA 20230007 | Agreement State|56493|Minnesota Department of Health||3|East Grand Forks |MN|||Y||||||Tyler Kruse|Thomas Herrity|04/27/2023|16:53:00|04/20/2023|0:00:00|CDT|4/27/2023 5:15:00 PM|Non Emergency| |Agreement State|||||||Stoedter, Karla|R3DO|NMSS_EVENTS_NOTIFICATION|EMAIL|||||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|AGREEMENT STATE REPORT - FOUND SOURCE The following information was received from the Minnesota Department of Health (MDH), Radioactive Materials Unit via email: "An unlicensed engineering company found a portable nuclear density gauge in their storage garage while cleaning. They state that they have never been licensed and have never acquired a gauge. [The company] estimates that it has been in the garage since the early 1990s without their knowledge. The gauge is currently being stored in the locked garage. The company has been instructed to place a second tangible barrier on the device while [MDH] continues to investigate and discuss next steps. The licensee reported this discovery to MDH on 4/25/2023, and MDH was able to verify the gauge make, model and activity on 4/27/2023. Below is the information we [MDH] currently have: "- Company name: Widseth Engineering, Inc. (formerly Floan-Sanders, Inc.) 1600 Central Avenue NE, East Grand Forks MN "- Gauge manufacturer: Soiltest, Inc. 2205 Lee Street, Evanston IL "- Gauge Model: NIC-5 DT "- Gauge Serial Number: 75C047 "- Sources (assay date August 1975): Am-241/Be: 60 mCi (decayed to 55 mCi); Cs-137: 10 mCi (decayed to 3.3 mCi) "MDH is conducting an investigation and will provide more information in a report within 30 days." MN State Event Report ID No. MN230002 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| Power Reactor|56494|Hope Creek|Pseg Nuclear Llc|1|Hancocks Bridge|NJ|Salem||Y|05000354|1|||[1] GE-4|Christopher Furst|Karen Cotton-Gross|04/30/2023|2:30:00|04/30/2023|1:00:00|EDT|4/30/2023 2:50:00 AM|Non Emergency|50.72(b)(3)(v)(D)|Accident Mitigation|50.72(b)(3)(ii)(A)|Degraded Condition|||||Henrion, Mark|R1DO|||||||||||||||||||N|Y|100|Power Operation|100|Power Operation||N|0||0|||N|0||0||PRIMARY CONTAINMENT INTEGRITY DEGRADED The following information was provided by the licensee via email: "At 0100 EDT on 04/30/23, it was determined that the primary containment integrity did not meet [Technical Specification] TS 4.6.1.1.d requirement, suppression chamber in compliance with TS 3.6.2.1 due to the inability to establish test conditions for the bypass leakage test in accordance with TS 4.6.2.1.f. "This event is being reported as an eight-hour, non-emergency notification per 10 CFR 50.72(b)(3)(v)(D) & 10 CFR 50.72(b)(3)(ii)(A). "There was no impact on the health and safety of the public or plant personnel. "The NRC Resident Inspector has been notified." | Power Reactor|56495|Hope Creek|Pseg Nuclear Llc|1|Hancocks Bridge|NJ|Salem||Y|05000354|1|||[1] GE-4|Christopher Furst|Karen Cotton-Gross|04/30/2023|2:30:00|04/30/2023|2:00:00|EDT|4/30/2023 5:11:00 AM|Non Emergency|50.72(b)(2)(i)|Plant S/D Reqd By Ts|||||||Henrion, Mark|R1DO|||||||||||||||||||N|Y|100|Power Operation|100|Power Operation||N|0||0|||N|0||0||TECHNICAL SPECIFICATION REQUIRED SHUTDOWN The following information was provided by the licensee via email: "At 0200 EDT on 04/30/23, a Technical Specification required shutdown was initiated at Hope Creek Unit 1. Technical Specification Action 3.6.1.1 Primary Containment Integrity was entered on 04/30/23 at 0100 with a required action to restore primary containment integrity within 1 hour. This required action was not completed within the allowed outage time; therefore, a Technical Specification required shutdown was initiated, and this event is being reported as a four-hour, non-emergency notification per 10 CFR 50.72(b)(2)(i). "There was no impact on the health and safety of the public or plant personnel. "The NRC Resident Inspector has been notified." | Agreement State|56496|Florida Bureau of Radiation Control|Atkins North Americal|1|Tampa|FL||0689-2|Y||||||Reno Fabii|Kerby Scales|04/30/2023|23:14:00|04/30/2023|0:00:00|EDT|4/30/2023 11:25:00 PM|Non Emergency| |Agreement State|||||||Henrion, Mark|R1DO|NMSS_EVENTS_NOTIFICATION|EMAIL|ILTAB, (EMAIL)|EMAIL|||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|AGREEMENT STATE REPORT - STOLEN TROXLER GAUGES The following information was received from the Florida Bureau of Radiation Control via email: "[The Florida Bureau of Radiation Control] received a call from the [Radiation Safety Officer] RSO at Atkins North America, reporting the theft of five Troxler gauges from their facility in Tampa, FL. Tampa Police report number 23-18111075. "1) Model 3440, serial number 27848, source serial number Cs 750-1764, AmBe 47-24477 "2) Model 3440, serial number 23089, source serial number Cs 75-4899, AmBe 47-18903 "3) Model 3430, serial number 27128, source serial number Cs 750-846, AmBe 47-23647 "4) Model 3440, serial number 32293, source serial number Cs 750-7450, AmBe 47-10058 "5) Model 3440, serial number 29466, source serial number Cs 750-3720, AmBe 47-26413" Activity for each gauge: Cesium-137 8mCi Am-Be 40mCi Florida Incident Number: FL23-061 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| Power Reactor|56497|Vogtle 3/4|Southern Nuclear Operating Company|2|Waynesboro|GA|Burke||Y|05200025|3|||[3] W-AP1000,[4] W-AP1000|Chad Everitt|Sam Colvard|05/02/2023|7:57:00|05/02/2023|4:23:00|EDT|5/2/2023 8:19:00 AM|Non Emergency|50.72(b)(2)(iv)(B)|RPS Actuation - Critical|||||||Miller, Mark|R2DO|||||||||||||||||||M/R|Y|14|Power Operation|0|Hot Standby||N|0||0|||N|0||0||MANUAL REACTOR TRIP The following information was provided by the licensee via email: "At 0423 EDT on 05/02/2023, with Unit 3 in Mode 1 at 14 percent power, the reactor was manually tripped due to securing all main feed pumps, due to sudden high differential pressure on their suction strainers. The trip was not complex, with all safety-related systems responding normally post-trip. No equipment was inoperable prior to the event that contributed to the event or adversely impacted plant response to the reactor trip. "Operations responded and stabilized the plant. Decay heat is being removed by discharging steam to the main condenser using the steam dumps, and startup feedwater is supplying the steam generators. Units 1, 2, and 4 were not affected. "Due to the Reactor Protection System actuation while critical, this event is being reported as a four-hour, non-emergency notification per 10 CFR 50.72(b)(2)(iv)(B). "There was no impact on the health and safety of the public or plant personnel. The NRC Resident Inspector has been notified." | Agreement State|56498|Texas Dept of State Health Services|Quantum Technical Services LLC|4|Houston|TX||06406|Y||||||Arthur Tucker|John Russell|05/02/2023|17:04:00|05/02/2023|0:00:00|CDT|5/2/2023 5:12:00 PM|Non Emergency| |Agreement State|||||||Gaddy, Vincent|R4DO|NMSS_EVENTS_NOTIFICATION|EMAIL|ILTAB, (EMAIL)|EMAIL|CNSNS (Mexico), -|FAX|||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|AGREEMENT STATE REPORT - LOST SOURCE The following information was received from the Texas Department of State Health Services [the Agency] via email: "On May 2, 2023, the Agency was notified by the licensee that they were unable to locate a 200 millicurie cobalt - 60 source. The licensee stated that the company had three locations in the United States, one in California, one in Louisiana, and one in Texas. In January of 2023, the company decided to close its offices. The company transferred all its sources to the Texas location. The sources were then sent to a source disposal company in Texas. During the last transfer of sources, the cobalt source could not be found. The licensee searched for the source at the Texas facility but could not find it. The process of locating where the source might be is complicated by the fact that the licensee had laid off most of the employees. The Radiation Safety Officer (RSO) was included in the layoff. "The individual tasked by the company to dispose of the sources contacted a few of the previous employees and was told that the source was transferred to the location in Louisiana. [The Agency] asked if they had the documents for the transfer. He stated they had given all the documents to the Louisiana location. He did not have a copy of the forms. "He said the source itself is about half the size of a magic marker. He said it is normally stored in a lead box in a sea van. He said that they would search their paperwork including the sign-out log in Louisiana to see if they can confirm the source was there. The Agency advised the individual to go to Louisiana and search for the source in and around the storage area. He was also advised to get someone added to their license as RSO. "Additional information will be provided as it is received in accordance with SA-300" Texas Incident Number: 10014 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|56499|Florida Bureau of Radiation Control|AE Engineering|1|Lake Placid|FL||4478-1|Y||||||John Williamson|Brian P. Smith|05/02/2023|18:09:00|05/02/2023|17:00:00|EDT|5/2/2023 6:25:00 PM|Non Emergency| |Agreement State|||||||Dimitriadis, Anthony|R1DO|NMSS_EVENTS_NOTIFICATION|EMAIL|ILTAB, (EMAIL)|EMAIL|||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|AGREEMENT STATE REPORT - STOLEN TROXLER GAUGES The following report was received from the State of Florida Bureau of Radiation Control [BRC] via email: "At 1720 [EDT], BRC received a call from [the licensee]. [The licensee] stated two Troxler [soil moisture density] gauges [Model Numbers 3440 and 3430; Serial Numbers 20750 and 77517; and sources 8mCi Cs-137 and 40mCi Am-241/Be] were stolen from their storage facility in Lake Placid, FL. [The] gauges were last signed in to the facility on the 28th of April and sat idle. [The] exact time of loss is not currently known, but [the licensee] went to retrieve the gauges on 5/2/23 at 1700 [EDT]. Law enforcement was notified prior to BRC's contact, however had not yet arrived on the scene at the writing of this report. [The licensee] has been provided department emails to send police reports when they are received." Florida Incident Number: FL23-064 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|56500|OR Dept of Health Rad Protection|Sacred Heart Medical Center|4|Springfield|OR||90270|Y||||||Hillary Haskins|John Russell|05/02/2023|19:20:00|05/01/2023|18:56:00|PDT|5/2/2023 7:20:00 PM|Non Emergency| |Agreement State|||||||Gaddy, Vincent|R4DO|NMSS_EVENTS_NOTIFICATION|EMAIL|||||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|AGREEMENT STATE REPORT - MEDICAL UNDERDOSE The following information was provided by the Oregon Health Authority via email: "Upon completion of [Yttrium] Y-90 Therasphere delivery [to a patient] and completion of post-treatment template measurements, it was noted that the delivery ratio appeared to be below 80%. The technologist who was involved in delivery contacted the authorized user who came and reviewed the information. Both the authorized user and Boston Scientific representative, who was present during delivery, felt that an error had been made in post-treatment measurements, so they were repeated both that day and the following. "Nuclear medicine staff performed [single photon emission computed tomography with a computed tomography] SPECT/CT imaging of the Nalgene container. This imaging was reviewed on 5/1/23 and it was determined that activity was remaining in the delivery set tubing. Imaging was reviewed with the Assistant [radiation safety officer] RSO, and it was determined that a Medical Event had occurred. Per [the assistant RSO], the Medical Event was reported to the Oregon Health Authority on 5/2/23. "The Authorized User, communicated the situation with the patient and is confident that no adverse effect has occurred based on calculated treatment thresholds and tumor burden. "The authorized user reviewed the SPECT/CT imaging and will participate in mitigation." 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. | Power Reactor|56501|Palisades|Nuclear Management Company|3|Covert|MI|Vanburen||N|05000255|1|||[1] CE|Jeffrey Lewis|Brian P. Smith|05/02/2023|22:41:00|05/02/2023|15:00:00|EDT|5/2/2023 11:11:00 PM|Non Emergency|50.72(b)(3)(xiii)|Loss Comm/Asmt/Response|||||||Peterson, Hironori|R3DO|||||||||||||||||||N|N|0|Defueled|0|Defueled||N|0||0|||N|0||0||LOSS OF COMMUNICATIONS The following information was provided by the licensee via email: "At approximately 1500 [EST] on 5/2/2023, it was determined that the commercial telecommunications capacity was lost to the Palisades Nuclear Plant (PNP) control room and technical support center due to an issue with the telecommunications provider. After discovery of the condition it was discovered that this loss also included the emergency notification system (ENS). Communications link via the satellite phone was tested satisfactorly. In addition, if needed, the satellite phone would be used to initiate call-out of the emergency response organization. The condition did not affect the ENS or commercial telecommunications capabilities at the offsite Emergency Operations Facility. The telecommunications provider has not provided an estimated repair time." PNP will be notifying the NRC resident inspector. | Power Reactor|56502|Limerick|Exelon Nuclear Co.|1|Philadelphia|PA|Montgomery||Y||2|||[1] GE-4,[2] GE-4|William F. Bulafka|Sam Colvard|05/04/2023|10:27:00|05/03/2023|12:30:00|EDT|5/4/2023 10:35:00 AM|Non Emergency|26.719|Fitness For Duty|||||||Dimitriadis, Anthony|R1DO|FFD Group, |EMAIL|||||||||||||||||N|N|0|Refueling|0|Refueling||N|0||0|||N|0||0||FITNESS FOR DUTY REPORT The following information was provided by the licensee via phone and email: "A non-licensed, non-supervisor contractor was found to be in possession of alcohol in the protected area. The individual's site access has been terminated." The NRC Senior Resident Inspector has been notified. | Power Reactor|56503|Indian Point|Holtec International|1|Buchanan|NY|Westchester||Y|05000247|2|3||[2] W-4-LP,[3] W-4-LP|Mathew Johnson|John Russell|05/04/2023|12:25:00|05/04/2023|11:45:00|EDT|5/4/2023 12:31:00 PM|Non Emergency|20.1906(d)(2)|External Rad Levels > Limits|||||||Dimitriadis, Anthony|R1DO|NMSS_Events_Notification, |EMAIL|||||||||||||||||N|N|0|Defueled|0|Defueled|N|N|0|Defueled|0|Defueled||N|0||0||EXTERNAL RADIATION ON RECEIVED PACKAGE GREATER THAN LIMITS The following summary was provided by the licensee via phone: On May 4, 2023 at 1145 EDT, the licensee found contact dose rates of 215 and 555 millirem-per-hour at 2 separate spots on the top of an exclusive use package during receipt survey. These dose rates are above the 200 millirem-per-hour allowable. No loose surface contamination was identified. The package contains tools from Holtec and was intact on delivery. The package has subsequently been secured in a locked radiation storage building. No overexposure or unauthorized exposure resulted to plant personnel. The licensee suspects shielding, internal to the package, may have shifted and the licensee will investigate further. Dose rates at one foot from the package were recorded at 65 millirem per hour. | Agreement State|56504|New York State Dept. of Health|Inficon, Inc.|1|East Syracuse|NY||C3113|Y||||||Daniel Samson|Brian Lin|05/05/2023|15:39:00|04/27/2023|0:00:00|EDT|5/5/2023 4:02:00 PM|Non Emergency| |Agreement State|||||||Dimitriadis, Anthony|R1DO|NMSS_EVENTS_NOTIFICATION|EMAIL|||||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|AGREEMENT STATE REPORT - LEAKING SEALED SOURCE The following information was received from the New York State Department of Health (NYSDOH) via email: "The New York State Department of Health conducted a routine inspection of lnficon, Inc. on May 5, 2023, and were made aware of Ni-63 (2.4 mCi) source that exceeded the 0.005 microcurie leak testing threshold and is considered leaking. Information on the source is below: Make: NRD, LLC Model: N1001 (SSDR: NY-0502-S-103-U) Serial Number: INF739 Date of Sample Collection: 4/27/2023 Leak Test Result: 1.82E-2 microcuries Analysis Report Date: 5/2/2023 "In accordance with lnficon's license, this source was obtained for secondary manufacturing and assembly into Micro Argon Ionization Detector (MAID) cells. lnficon detected this leaking source immediately following assembly prior to distribution in accordance with all regulatory requirements and the conditions of their license. Once it was determined that this source was leaking, personnel were notified, and the device was immediately quarantined. lnficon conducted removable contamination surveys around the device in question, however, they do not believe that any personnel or equipment may have been contaminated from this leaking source. Wipe test results are pending to date. As this is the second leaking source reported by lnficon (See NY-23-01 notification for the first leaking source notification), lnficon has hired an external consultant to review and audit their assembly process. This audit has been scheduled and lnficon has agreed to submit the findings of this audit to New York State Department of Health. "Following the results of these wipe tests, the facility plans to dispose of this source and equipment. New York State Department of Health is in continued discussion with lnficon regarding next steps for this event. "No further information on the device, source or incident is available at this time. Any updates to this event will be provided as soon as feasible. This incident is tracked under Incident No. 1436 by NYSDOH. "New York State report no.: NY-23-03"| Power Reactor|56505|Browns Ferry|Tennessee Valley Authority|2|Decatur|AL|Limestone||Y|05000259|1|2|3|[1] GE-4,[2] GE-4,[3] GE-4|Chase Hensley|Ernest West|05/05/2023|16:00:00|05/04/2023|20:34:00|CDT|5/5/2023 4:22:00 PM|Non Emergency|26.719|Fitness For Duty|||||||Miller, Mark|R2DO|FFD Group, |EMAIL|||||||||||||||||N|Y|100|Power Operation|100|Power Operation|N|Y|100|Power Operation|100|Power Operation|N|Y|100|Power Operation|100|Power Operation|FITNESS FOR DUTY REPORT The following information was provided by the licensee via email: "On 05/04/2023 at 2034 CDT, a Browns Ferry Nuclear Plant non-licensed employee supervisor had a confirmed positive drug test identified during random fitness-for-duty medical testing. Employee's unescorted access has been suspended. A review of the employee's work has been completed. "The [NRC] Resident Inspector has been notified." | Agreement State|56506|Texas Dept of State Health Services|Acuren Inspection Inc|4|La Porte|TX||L01774|Y||||||Randall Redd|Adam Koziol|05/06/2023|0:52:00|05/05/2023|0:00:00|CDT|5/6/2023 1:08:00 AM|Non Emergency| |Agreement State|||||||Gaddy, Vincent|R4DO|NMSS_EVENTS_NOTIFICATION|EMAIL|||||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|AGREEMENT STATE REPORT - STUCK SOURCE The following information was provided by the Texas Department of State Health Services (the Department) via email: "On May 5, 2023, the Department received a notification of a source retrieval incident. A team of radiographers was working at a fab shop late at night using a QSA Delta 880 camera with a 45 curie selenium-75 source. While the source was out, a small pipe fell onto the guide tube and crimped the line. The radiographers were unable to retract the source back into the camera and pushed it back out to the collimator. They then watched the barrier that was at slightly less than 2 mR/hr until the RSO [Radiation Safety Officer] arrived. The RSO, who is authorized on Texas license for source retrieval, then placed lead filled bags on the source that was still within the collimator. He then proceeded to uncrimp the line, and after the 5th attempt, he was able to retract the source back into the camera. The two radiographers did not receive additional dose, but the RSO who retrieved the source did receive 108 mrem. No one else was present because of the late hour. A survey of the camera was performed after the retrieval with no change compared to before the incident. "Further information will be provided per SA-300." Texas Incident Number: 10015 NMED Number: TX230020| Agreement State|56507|Texas Dept of State Health Services|Shell Chemical LP|4|Deer Park|TX||L04933|Y||||||Arthur L Tucker|John Russell|05/06/2023|15:34:00|05/04/2023|0:00:00|CDT|5/13/2023 7:20:00 PM|Non Emergency| |Agreement State|||||||Gaddy, Vincent|R4DO|NMSS_EVENTS_NOTIFICATION|EMAIL|||||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|AGREEMENT STATE REPORT - TWO SOURCES INVOLVED IN A FIRE The following information was provided by the Texas Department of State Health Services (the Agency) via email: "On May 5, 2023, the Agency received a phone call from the licensee's service provider who reported that yesterday (May 4, 2023) Shell Chemical LP in Deer Park, Texas, had a fire and explosion. Two nuclear gauges both containing 20 millicurie cesium-137 sources may have been involved in the event. The licensee has not been able to inspect the gauges due to structural safety concerns therefore the condition of the of the two gauges is unknown. The two gauges are located very close to each other. The licensee hopes to get eyes on the two gauges tomorrow or Monday. The gauges do not present an exposure risk to any individual. "Additional information will be provided as it is received in accordance with SA-300." Texas Incident number: I-10016 NMED number: TX230021 * * * UPDATE ON 5/8/2023 AT 1338 EDT FROM ART TUCKER TO BRIAN LIN * * * The following information was provided by the Texas Department of State Health Services (the Agency) via email: "On May 8, 2023, the Agency was notified that the licensee has not been able to inspect the gauges. The licensee is still working on isolating hydrocarbon gasses that are being released in the area. There is a concern that the fire could reignite. The licensee does not know when they will be able to access the area. Additional information will be provided as it is received in accordance with SA-300." Notified R4DO (Werner) and NMSS Events Notification via email. * * * UPDATE FROM ART TUCKER TO DONALD NORWOOD ON 5/10/2023 AT 1256 EDT * * * The following information was provided by the Agency via email: "On May 6, 2023, the Agency received a phone call from the licensee's service provider who reported that yesterday (May 5, 2023) Shell Chemical LP in Deer Park, Texas, had a fire and explosion. "On May 10, 2023, the Agency was notified by the licensee's service provider (SP) that the licensee was able to use a drone to inspect the area of the fire. The SP stated that they were able to see one of the gauges which was still located in the same position it was in before the fire. The second gauge could not be located due to all the debris in the area. The SP stated the gauges original position was on a pipe six feet above the ground. They believe the pipe may have fallen to the ground and the gauge went with it. The SP stated the licensee did perform a radiation survey outside the exclusion area in the area where the gauges are located, and the readings were background. The SP did not know how close they would have been to the gauges. The licensee is making plans to enter the area, but the weather is causing delays as they have to shut down outside activities anytime there is lightning within 10 miles of the plant. The SP stated they did not have a date or time when they will be able to access the gauges. The SP stated they have discussed how they will conduct contamination surveys and radiation surveys once they gain access to the area. Additional information will be provided as it is received in accordance with SA-300." Notified R4DO (Werner) and NMSS Events Notification via email. * * * UPDATE FROM ART TUCKER TO DONALD NORWOOD ON 5/11/2023 AT 1729 EDT * * * The following information was provided by the Agency via email: "On May 6, 2023, the Agency received a phone call from the licensee's service provider who reported that yesterday (May 5, 2023) Shell Chemical LP in Deer Park, Texas, had a fire and explosion. "On May 11, 2023, the Agency was contacted by the licensee's service provider (SP). The SP stated the licensee had made an entry into the area affected by the fire and was able to visually inspect the gauges from an unknown distance. One gauge (unknown which one) was free of soot and was still the same color as it was before the fire. The other gauge had soot on it. The gauge that was mounted 6 feet off the ground on a pipe was observed in the same location as it was before the fire and had not been knocked to the ground with debris as previously thought. The dose rates in the areas the individuals were in were reported as background. The licensee plans to reenter the area tomorrow afternoon and perform radiation surveys and take swipes on the gauges. Additional information will be provided as it is received in accordance with SA-300." Notified R4DO (Werner) and NMSS Events Notification via email. * * * UPDATE ON 5/13/23 AT 1916 EDT FROM ART TUCKER TO ADAM KOZIOL * * * The following information was provided by the Agency via email: "On May 6, 2023, the Agency received a phone call from the licensee's service provider who reported that yesterday (May 5, 2023) Shell Chemical LP in Deer Park, Texas, had a fire and explosion. "On May 13, 2023, the licensee reported both sources had no removable contamination and they have both been safely removed and placed in a low occupancy and secure temporary storage location. The licensee reported the gauge shielding had been degraded and the gauges were wrapped in lead before they were placed in the storage location. Additional information will be provided as it is received in accordance with SA-300." Notified R4DO (Werner) and NMSS Events Notification via email. | Agreement State|56508|Louisiana Radiation Protection Div|Shell Chemical LP|4|Geismar|LA||LA-2132-L01|Y||||||James Pate|Lloyd Desotell|05/07/2023|11:50:00|05/06/2023|0:00:00|CDT|5/7/2023 1:15:00 PM|Non Emergency| |Agreement State|||||||Gaddy, Vincent|R4DO|NMSS_EVENTS_NOTIFICATION|EMAIL|||||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|AGREEMENT STATE REPORT - STUCK SHUTTER The following information was provided by the LA Department of Environmental Quality (the Department) via email: "[On] May 6, 2023, Shell Chemical LP notified the Department that a fixed gauge has a stuck shutter in the open position. [Gauge information:] Vega Model SHF1 serial number: N0416 with Cs-137 50 mCi, source serial number: N/A. The facility has contacted BBP Sales to come out on Monday, May 8, 2023. The facility is planning to replace the nuclear gauge housing because of corrosion." Event Report ID No.: LA20230008| Power Reactor|56509|Cooper|Nebraska Public Power District|4|Brownville|NE|Nemaha||Y|05000298|1|||[1] GE-4|Curtis Martin|Adam Koziol|05/08/2023|6:25:00|05/08/2023|2:07:00|CDT|5/9/2023 3:03:00 PM|Non Emergency|50.72(b)(2)(i)|Plant S/D Reqd By Ts|50.72(b)(3)(v)(D)|Accident Mitigation|||||Gaddy, Vincent|R4DO|||||||||||||||||||N|Y|100|Power Operation|70|Power Operation||N|0||0|||N|0||0||EN Revision Imported Date: 5/10/2023

EN Revision Text: SHUTDOWN REQUIRED BY TECHNICAL SPECIFICATIONS DUE TO INOPERABLE CORE SPRAY The following information was provided by the licensee via fax: "At time 0207 CDT, Cooper Nuclear Station (CNS) entered Technical Specification [Limiting Condition for Operation] LCO 3.0.3 due to declaring core spray subsystems A and B inoperable. This declaration was based on an issue with relays installed from the same manufacturing batch. The ability of the relays to function correctly to annunciate loss of logic power was called into question and they were declared inoperable. The plant has initiated actions to repair/replace affected relays. "This event is reportable under 10 CFR 50.72(b)(2)(i) as an initiation of any nuclear plant shutdown required by Technical Specifications. In addition, this event Is reportable under 10 CFR 50.72(b)(3)(v) as a condition that could have prevented the fulfillment of a safety function for the core spray systems. "NRC Resident Inspector was notified." * * * UPDATE ON 5/8/2023 AT 1335 EDT FROM ANDREW ASKINS TO BRIAN LIN * * * The following information was provided by the licensee via email: "Technical Specification LCO 3.0.3 was exited at 0805 CDT on May 8, 2023. A reasonable expectation of operability was developed for the core spray subsystems A and B. There was no impact on the health and safety of the public or plant personnel. The NRC Resident Inspector has been notified. Shutdown was initiated and power was reduced approximately 45 percent. Reactor power is currently at 55 percent at the time of notification." Notified R4DO (Werner) via email. * * * UPDATE ON 5/9/2023 AT 1441 EDT FROM ANDREW ASKINS TO DONALD NORWOOD * * * The following information was provided by the licensee via email: "CNS is retracting the 8-hour 10 CFR 50.72(b)(3)(v) non-emergency notification, for a condition that could have prevented the fulfillment of a safety function, made on May 8, 2023, at 0207 CDT (EN# 56509). Subsequent evaluation concluded that the core spray subsystems remained operable in accordance with the Technical Specifications Requirements 3.5.1, ECCS - Operating. As a result of the core spray system remaining operable, no loss of safety function occurred. The NRC Senior Resident Inspector has been notified." Notified R4DO (Werner). | Agreement State|56510|Utah Division of Radiation Control|IHC Health Services, DBA Intermount|4|Murray|UT||UT1800494|Y||||||Phillip Goble|Thomas Herrity|05/08/2023|10:30:00|05/06/2023|9:30:00|MDT|5/8/2023 10:37:00 AM|Non Emergency| |Agreement State|||||||Werner, Greg|R4DO|NMSS_EVENTS_NOTIFICATION|EMAIL|||||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|AGREEMENT STATE REPORT - LIQUID RADIOACTIVE CONTAMINATION The following information was provided by Utah Department of Environmental Quality, Division of Waste Management and Radiation Control [the Division], via email: "The Division was notified of the incident at 7:38 AM on May 8, 2023, by email from the Utah Department of Environmental Quality's duty officer who was on call on Saturday May 6, 2023. "Information received from the on-call duty officer: The Radiation Safety Officer reported a radioactive material (rubidium-82) release of an unknown amount due to a leaking generator. She said that Cardiac Molecular Imaging found liquid in the bottom of a well chamber of the infusion system. Proper decontamination procedures were followed, the liquid was placed in radioactive waste storage, a wipe test was done, and everything was cleaned up. She said this has happened before. There was no impact to patient treatment. The generator will be shipped back to the manufacturer for investigation. The incident has been contained and there is no immediate threat. "This appears to be the exact same issue that we notified the NRC for the UT23-0002 and UT23-0003 incidents. "The Division will investigate this matter and update the record upon completion of the investigation." Utah Event Report ID No.: UT23-0005 | Agreement State|56511|North Dakota Department of Health|Minn-Dak Farmers Cooperative|4|Wahpeton|ND||33-05209-01|Y||||||Brooke Olson|Adam Koziol|05/09/2023|9:37:00|05/08/2023|0:00:00|MDT|5/9/2023 9:41:00 AM|Non Emergency| |Agreement State|||||||Werner, Greg|R4DO|NMSS_EVENTS_NOTIFICATION|EMAIL|||||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|AGREEMENT STATE REPORT - FAILED SHUTTER The following information was provided by the North Dakota Department of Health, Radiation Control Program via email: "On 5/8/2023, Minn-Dak Farmers Cooperative in Wahpeton, ND, had an equipment failure on a fixed nuclear gauge (Thermo MeasureTech Model No. 7062) with a 46.7 millicurie Cs-137 sealed source (General Radioisotope Products, Inc. Model No. 850233). The licensee was performing the required routine shutter checks and it was found that shutter on the gauge listed above failed to fully close. There was no visual damage to the shutter, gauge or source at the time of the shutter check. Licensee is in contact with the service provider Vega to replace the gauge." | Non-Agreement State|56512|Henry Ford Hospital|Henry Ford Hospital|3|Detroit|MI||21-04109-16|N||||||Alan Jackson|Ian Howard|05/09/2023|15:40:00|05/08/2023|0:00:00|EDT|5/10/2023 9:23:00 AM|Non Emergency|35.3045(a)(2)|Dose > Specified Eff Limits|||||||Feliz-Adorno, Nestor|R3DO|Clark, Theresa|NMSS DAY|NMSS_Events_Notification, |EMAIL|||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|POTENTIAL MEDICAL EVENT The following information was provided by the licensee via phone and email: "In accordance with 10 CFR 35.3045, [Henry Ford Hospital is] reporting a potential medical event. "On May 8, 2023, a patient was treated with Y-90 TheraSpheres. The total activity prescribed in the written directive was 11.5 mCi to the left lobe of the liver and 11.37 mCi was delivered (99.2 percent). The therapeutic dose was prescribed to be delivered to segment 4 of the left lobe of the liver. During treatment, the position of the catheter was verified and was determined by the physician to be in the correct position. However, post-treatment bremsstrahlung imaging reviewed today on 5/9/2023 indicated some activity was shunted unexpectedly to segments 2 and 3 of the left lobe of the liver. Based on preliminary calculations, this discrepancy could be categorized as a medical event." * * * RETRACTION FROM ALAN JACKSON TO BILL GOTT AT 0907 EDT ON 05/10/2023 * * * The following information was provided by the licensee via phone: Since the exposure was due to shunting, the licensee determined that this event is not reportable in accordance with the licensing guide. This event is being retracted. Notified R3DO (Feliz-Adorno), NMSS (Rivera-Capella), and NMSS Events Notification. 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. | Power Reactor|56513|Peach Bottom|Exelon Nuclear Co.|1|Philadelphia|PA|York & Lancaster||Y|05000277|2|3||[2] GE-4,[3] GE-4|Craig Taulman|Ian Howard|05/09/2023|17:41:00|05/09/2023|14:55:00|EDT|5/9/2023 8:12:00 PM|Non Emergency|50.72(b)(3)(xiii)|Loss Comm/Asmt/Response|||||||Deboer, Joseph|R1DO|||||||||||||||||||N|Y|100|Power Operation|100|Power Operation|N|Y|100|Power Operation|100|Power Operation||N|0||0||LOSS OF EMERGENCY PREPAREDNESS CAPABILITIES The following information was provided by the licensee via phone and email: "At 1455 [EST] on Tuesday May 9, 2023, Peach Bottom Atomic Power Station (PBAPS) technical support center (TSC) ventilation system lost power. Power loss was caused by a tree down on the 361 transmission line. Power was not able to be restored within an hour. At 1639 [EST], power was restored to TSC ventilation, and capability was restored. "This report is being submitted pursuant to 10 CFR 50.72(b)(3)(xiii) as a major loss of emergency preparedness capabilities due to a reduction in the effectiveness of the onsite TSC. "NRC Resident has been notified." | Agreement State|56514|Texas Dept of State Health Services|Chi St Lukes Hlth Baylor Clg of Med|4|Houston|TX||L-06661|Y||||||Art Tucker|Donald Norwood|05/10/2023|13:20:00|05/09/2023|0:00:00|CDT|5/10/2023 1:54:00 PM|Non Emergency| |Agreement State|||||||Werner, Greg|R4DO|NMSS_Events_Notification, |EMAIL|||||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|AGREEMENT STATE REPORT - MEDICAL EVENT The following information was received via email from the Texas Dept. of State Health Services (the Agency): "On May 9, 2023, the Agency was notified by the licensee that a medical event occurred earlier that day. The licensee stated a patient was prescribed two doses of SIR-Spheres yittrium-90 (Y-90). After the procedure, it was determined that the patient received doses differed from the prescribed doses by more than 20 percent. The patient was prescribed doses of 14.5 mCi and 21.7 mCi. The patient received 5.3 mCi (for the syringe dose of 14.2 mCi) and 12.31 mCi (for the syringe dose of 21.5 mCi). Delivered doses differed by 37.3 percent and 57.2 percent respectively. The prescribing physician and patient were notified of the error. Additional information will be provided as it is received in accordance with SA-300." Texas Incident No.: 10017 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. | Agreement State|56516|Arizona Dept of Health Services|Banner University Medical Center - Phoenix|4|Phoenix|AZ||07-478|Y||||||Brian Goretzki|Bill Gott|05/11/2023|0:18:00|05/09/2023|0:00:00|MST|5/11/2023 12:26:00 AM|Non Emergency| |Agreement State|||||||Werner, Greg|R4DO|NMSS_EVENTS_NOTIFICATION|EMAIL|||||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|AGREEMENT STATE REPORT - MEDICAL EVENT The following information was provided by Arizona Department of Health Services (the Department) via email: "The Department received notification from the licensee about a medical event involving Y-90 Theraspheres. A patient was prescribed 27.72 mCi but was delivered 17.38 mCi, a percent dose delivered of approximately 63 percent. The Department has requested additional information and continues to investigate the event. "Additional information will be provided as it is received in accordance with SA-300." Arizona incident number: 23-008 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. | Agreement State|56517|SC Dept of Health & Env Control|Suominen Nonwovens|1|Bethune|SC|||Y||||||Korina Koci|Bill Gott|05/12/2023|10:07:00|03/31/2023|0:00:00|EDT|5/12/2023 10:19:00 AM|Non Emergency| |Agreement State|||||||Deboer, Joseph|R1DO|NMSS_EVENTS_NOTIFICATION|EMAIL|||||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|AGREEMENT STATE REPORT - STUCK SHUTTER The following information was provided by the South Carolina Department of Health and Environmental Control (the Department) via email: "The licensee [Bethune Nonwovens, Inc., d/b/a Suominen Nonwovens] notified the Department in writing on April 21, 2023, that a generally licensed fixed gauging device had a failed shutter which had been repaired by the manufacturer on April 3, 2023. The licensee discovered that the event occurred on March 31, 2023, and reported that upon discovery of the stuck shutter, that the manufacturer arrived on site on the same day and placed the device out of service until repaired. The event involved a Mahlo fixed gauging device (model number: 11-200933, serial number 11-011985-AH-5783), which housed an Isotope Product Laboratories, krypton-85 sealed source (model number KAC.D3, serial number: AH-5783), with an activity of 9.62 GBq (260 mCi). The licensee reported that the cause of this equipment failure was attributed to corrosion around the shutter assembly. "On May 2, 2023, a Department inspector was dispatched to the facility to conduct an on-site investigation. All dose measurements were consistent with the Sealed Source Device Registry certificate for the device. Based on the resulting dose rate surveys conducted by the Department and the manufacturer, interviews with licensee representatives, and the removal of the device from service at the time that the failure was discovered, it does not appear that any radiation exposure to workers, or any other individual members of the public has occurred. "This event is considered closed." Internal ID number: SC230009 | Power Reactor|56519|Beaver Valley|Firstenergy Nuclear Operating Company|1|Shippingport|PA|Beaver||Y|05000334|1|||[1] W-3-LP,[2] W-3-LP|Kevin Morse|Sam Colvard|05/16/2023|8:09:00|05/15/2023|12:08:00|EDT|5/16/2023 8:17:00 AM|Non Emergency|26.719|Fitness For Duty|||||||Defrancisco, Anne|R1DO|FFD Group, |EMAIL|||||||||||||||||N|Y|100|Power Operation|100|Power Operation||N|0||0|||N|0||0||FITNESS FOR DUTY REPORT The following information was provided by the licensee via phone: "A licensed operator failed a test specified by the FFD testing program. The individual's site access has been terminated. "The NRC Resident Inspector has been notified." | Power Reactor|56520|Wolf Creek|Wolf Creek Nuclear Operating Corp.|4|Burlington|KS|Coffey||Y|05000482|1|||[1] W-4-LP|David Christiansen|Sam Colvard|05/16/2023|17:20:00|05/16/2023|11:27:00|CDT|6/5/2023 11:59:00 AM|Non Emergency|50.72(b)(3)(v)(C)|Pot Uncntrl Rad Rel|50.72(b)(3)(v)(D)|Accident Mitigation|||||Azua, Ray|R4DO|||||||||||||||||||N|Y|100|Power Operation|100|Power Operation||N|0||0|||N|0||0||EN Revision Imported Date: 6/6/2023

EN Revision Text: EMERGENCY EXHAUST INOPERABLE The following information was provided by the licensee via phone and email: "At 1127 CDT on 5/16/2023, during the reperformance of test procedure 'STS PE-006, Charcoal Adsorber In-Place Leak Test' due to a failure from the previous day, both trains of emergency exhaust were rendered inoperable due to incorrect performance of the procedure. Performers incorrectly de-energized the humidity control heating coil for the unit not under test, rendering it inoperable. This issue was identified and rectified at 1138 CDT on 5/16/2023, exiting the LCO [limiting condition of operation] for both trains inoperable at that time. There was no impact to the health and safety of the public." * * * RETRACTION ON 6/5/2023 AT 1132 EDT FROM JASON KNUST TO HOWIE CROUCH * * * "The initial failure of the STS PE-006 test was caused by a malfunction of the test equipment which initially injected excessive amounts of tracer gas and caused saturation of the charcoal. Using test equipment sourced from Callaway, and following guidance from the vendor, STS PE-006 test was successfully passed on 5/17/2023. No maintenance or intrusive testing was performed on the unit between initial test failure and satisfactory completion of the test. Because this train of emergency exhaust was not actually inoperable at the time the second train was rendered inoperable due to incorrect procedure performance, there was no loss of safety function. Therefore, this event notification is being retracted." The licensee has notified the NRC Resident Inspector. Notified R4DO (Gepford). | Power Reactor|56521|South Texas|Stp Nuclear Operating Company|4|Wadsworth|TX|Matagorda||Y|05000498|1|2||[1] W-4-LP,[2] W-4-LP|Dustin Janak|Brian P. Smith|05/17/2023|3:25:00|05/16/2023|16:30:00|CDT|5/17/2023 3:36:00 AM|Non Emergency|26.719|Fitness For Duty|||||||Azua, Ray|R4DO|FFD Group, |EMAIL|||||||||||||||||N|Y|100|Power Operation|100|Power Operation|N|Y|100|Power Operation|100|Power Operation||N|0||0||FITNESS-FOR-DUTY VIOLATION The following information was provided by the licensee via email: "On May 16, 2023, it was determined that a licensed operator violated the station's FFD policy. The employee's unescorted access at South Texas has been terminated. This event was determined to be reportable under 10 CFR 26.719(b)(2)(ii). "The NRC resident inspector has been notified." | Power Reactor|56522|Diablo Canyon|Pacific Gas & Electric Co.|4|Avila Beach|CA|San Luis Obispo||Y|05000275|1|||[1] W-4-LP,[2] W-4-LP|Don Townsend|Karen Cotton-Gross|05/17/2023|18:21:00|05/17/2023|6:49:00|PDT|5/17/2023 6:27:00 PM|Non Emergency|26.719|Fitness For Duty|||||||Azua, Ray|R4DO|FFD Group, |EMAIL|||||||||||||||||N|Y|100|Power Operation|100|Power Operation||N|0||0|||N|0||0||FITNESS-FOR-DUTY VIOLATION The following information was provided by the licensee via email: On May 17, 2023, at 0649 PDT, it was determined that a prohibited item had been found inside the protected area. The NRC Resident Inspector has been notified. | Fuel Cycle Facility|56523|Global Nuclear Fuel - Americas|Global Nuclear Fuel - Americas|2|Wilmington|NC|New Hanover|SNM-1097|Y|07001113||||Uranium Fuel Fabrication|Phillip Ollis|Sam Colvard|05/18/2023|14:50:00|05/18/2023|9:40:00|EDT|5/18/2023 3:15:00 PM|Non Emergency|PART 70 APP A (c)|Offsite Notification/News Rel|||||||Miller, Mark|R2DO|NMSS_EVENTS_NOTIFICATION|EMAIL|||||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|CONCURRENT REPORT - FIRE DOOR MALFUNCTION The following information was provided by the licensee via email: "At approximately 0940 EDT on May 18th, the New Hanover County Deputy Fire Marshal was notified that the fire door of the dry conversion process (DCP) elevator shaft malfunctioned and was in the open position. The DCP elevator is located on the south wall of the DCP which is a credited fire barrier. A fire watch was initiated and maintained until the elevator door was closed at approximately 1030 EDT. The elevator was restored to full operation at approximately 1330 EDT on May 18th. Because the New Hanover County Deputy Fire Marshall was notified, a concurrent notification to the NRC Operations Center is being made per 10 CFR 70, Appendix A(c)." The NRC region will be notified. | Agreement State|56524|Illinois Emergency Mgmt. Agency|Flexsys America, L.P.|3|Sauget|IL||IL-01229-01|Y||||||Whitney Cox|Sam Colvard|05/18/2023|15:44:00|02/23/2023|0:00:00|CDT|5/18/2023 4:19:00 PM|Non Emergency| |Agreement State|||||||Feliz-Adorno, Nestor|R3DO|NMSS_EVENTS_NOTIFICATION|EMAIL|||||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|AGREEMENT STATE REPORT - FAILED SHUTTER The following information is a summary provided by the Illinois Emergency Management Agency via email: During a routine inspection on May 17, 2023 at Flexsys America, L.P. in Sauget, IL, an inspector identified a February 2022 equipment failure involving a fixed gauge that resulted in a stuck-open condition of the shutter (300mCi Cs-137 sealed source, model A-2102, serial number 3654CP). This incident was reportable to ONS-RAM within 24 hours under 32 Ill. Adm. Code 340.1220(c)(2). No personnel exposures occurred as a result. Corrective action was taken with repairs to the mechanism performed by the manufacturer and the gauge was returned to operable condition. The initial reporting requirement was not met by the licensee and will be addressed through inspection correspondence. This matter was reported to the NRC within the required timeframe. Illinois report number: IL230010| Agreement State|56525|Texas Dept of State Health Services|Univ. TX MD Anderson Cancer Center|4|Houston|TX||L00466|Y||||||Randall Redd|Sam Colvard|05/18/2023|19:11:00|05/18/2023|0:00:00|CDT|5/18/2023 8:10:00 PM|Non Emergency| |Agreement State|||||||Azua, Ray|R4DO|NMSS_EVENTS_NOTIFICATION|EMAIL|||||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|AGREEMENT STATE REPORT - CONTAMINATED WORKER The following information was provided by Texas Department of State Health Services (the Department) via email: "On May 18, 2023, The University of Texas MD Anderson Cancer Center (the licensee) reported to this Department that they had discovered a technician and package with contamination of around 12,000 dpm [disintegrations per minute]. The licensee's technician picked up the bag (package) with their bare hands. They then did a wipe test of the bag and found that it was contaminated. They also discovered that both their hands were contaminated. They washed repeatedly which reduced the contamination on their hands but did not eliminate it. The licensee believes that the remaining contamination has been absorbed into their skin and that it is no longer removable. The technician has gone home with instructions to continue wearing gloves. The technician is pregnant, and the licensee plans to perform a thyroid check tomorrow. "The bag had elevated readings at the handle, but the contamination seemed to mostly be at the top right of the bag where the zipper handle was located. The licensee has not found contamination in any other areas of their facility. The licensee used a well counter to try to determine the isotope and believes it is either 5 microcuries of technetium-99m or 2 microcuries of iodine-123. A comparison of activities of the following day will determine which isotope it is since there is a significant difference in half-lives. The container with the ordered 10 millicuries of iodine-123, which was inside the bag, was wiped and found to not be contaminated. "The nuclear pharmacy that supplied the bag and material inside the bag did wipe tests of the driver's hands, the steering wheel, pedals, the rack the bag would sit on, and the hand truck that the package would have been placed on. They did not find any radiation above background. They also performed wipes and surveys within their facility and again did not find any contamination. "The worker who prepared the material at the pharmacy in the morning only drew iodine-123 for this single package. All other iodine-123 packages were pre-prepared. The pharmacy sent around 45 packages out in the morning to many medical facilities. None have reported contamination. The truck only carries packages from this single pharmacy. "The Department has asked both facilities to continue to look for contamination and has recommended that the technician wear cotton gloves inside of the other gloves to hopefully get the hands to sweat the material out into the cotton." Texas incident number: 10020.| Agreement State|56526|PA Bureau of Radiation Protection|Thomas Jefferson Univ. Hospital|1|Philadelphia|PA||PA-0130|Y||||||John Chippo|Kerby Scales|05/19/2023|12:03:00|04/11/2023|0:00:00|EDT|5/19/2023 12:14:00 PM|Non Emergency| |Agreement State|||||||Defrancisco, Anne|R1DO|NMSS_EVENTS_NOTIFICATION|EMAIL|||||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|AGREEMENT STATE REPORT - MEDICAL EVENT (PATIENT UNDERDOSE) The following information was received from the Pennsylvania Department of Radiation Protection via email: "On March 28, 2023, a patient was treated with a permanent Cs-131 implant with a prescribed dose of 60 Gy. On April 11, 2023, the patient presented with a serious medical condition which necessitated the immediate removal of the implant. The seeds were all accounted for and placed into storage for decay to background. The actual dose delivered is calculated to be 37 Gy. The referring physician and the patient have been informed." Event Report Identification Number: PA230015 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. | Power Reactor|56527|Beaver Valley|Firstenergy Nuclear Operating Company|1|Shippingport|PA|Beaver||Y||2|||[1] W-3-LP,[2] W-3-LP|Shawn Snook|Kerby Scales|05/19/2023|12:33:00|05/19/2023|8:52:00|EDT|5/19/2023 12:40:00 PM|Non Emergency|50.72(b)(3)(iv)(A)|Valid Specif Sys Actuation|||||||Defrancisco, Anne|R1DO|||||||||||||||||||N|N|0|Hot Standby|0|Hot Standby||N|0||0|||N|0||0||AUTOMATIC ACTUATION OF AUXILIARY FEEDWATER SYSTEM (AFW) The following information was provided by the licensee via email: "At 0852 [EDT] on May 19, 2023, with Unit 2 in Mode 3 at zero percent power, an actuation of the auxiliary feedwater system (AFW) occurred. The reason for the AFW auto-start was a failed start attempt of the 'B' main feedwater pump. The 'A' and 'B' motor driven auxiliary feedwater (MDAFW) pumps automatically started as designed when the 'Loss of Both Main Feedwater Pumps' signal was received. "This event is being reported in accordance with 10 CFR 50.72(b)(3)(iv)(A) as an event that results in a valid actuation of the AFW system. "There was no impact on the health and safety of the public or plant personnel. The NRC Resident Inspector has been notified."| Agreement State|56528|Georgia Radioactive Material Pgm|Cardiac Consultants of Central GA|1|Macon|GA||GA 1629-1|Y||||||Stacy Allman|Bill Gott|05/19/2023|12:23:00|05/11/2023|0:00:00|EDT|5/19/2023 12:47:00 PM|Non Emergency| |Agreement State|||||||Defrancisco, Anne|R1DO|NMSS_EVENTS_NOTIFICATION|EMAIL|||||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|AGREEMENT STATE REPORT - LEAKING SOURCE The information below was provided by the Georgia Department of Natural Resources via email: "During a routine sealed source inventory check, Cardiac Consultants of Central Georgia, LLC, license GA 1629-1 discovered that one of their Cs-137 vials (S/N 1615-4-2) appeared to display signs of moisture within. This source's current activity is 0.15078 mCi. A wipe test was then performed. Results of the wipe test confirmed that this source was leaking. The area surrounding the source was surveyed and wipe tested as well. No sign of contamination was discovered. The leaking source has been contained and is secured in the licensee's hot lab in an appropriate shielded container. The licensee waits for a hazardous waste disposal quote before properly disposing. This incident occurred on May 11, 2023, and the licensee reported to the State on May 15, 2023. The State is waiting for the licensee to provide a copy of leak test results for the source of concern and confirmation of source disposal." GA Incident Number: 65 | Agreement State|56529|Colorado Dept of Health|University of Colorado Hospital|4|Aurora|CO||CO 828-01|Y||||||Matt Gift|Kerby Scales|05/19/2023|13:49:00|05/18/2023|0:00:00|MDT|5/19/2023 1:55:00 PM|Non Emergency| |Agreement State|||||||Azua, Ray|R4DO|NMSS_EVENTS_NOTIFICATION|EMAIL|||||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|AGREEMENT STATE REPORT - MEDICAL EVENT (PATIENT UNDERDOSE) The following was received from the Colorado Department of Public Health and Environment via email: "On May 19, 2023, the associate radiation safety officer at the University of Colorado Hospital reported a medical event. The event occurred on May 18, 2023, during a Y-90 TheraSphere administration. The licensee reported that during the administration, there was an obstruction in a line/catheter causing the target to only receive 4.6 percent of the intended dose. The authorized user does not believe the obstruction was due to stasis. The prescribed dose for the treatment was 300 Gy (20.06 mCi) and the administered dose was calculated to be 13.87 Gy (0.93 mCi). The licensee is working with the manufacturer, and the exact cause of the obstruction resulting in the medical event is still under investigation." Colorado Event Report Number: CO230012 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. | Agreement State|56530|MA Radiation Control Program|Invicro LLC|1|Needham|MA||55-0692|Y||||||Kenath Traegde|Kerby Scales|05/19/2023|16:11:00|05/19/2023|10:00:00|EDT|5/19/2023 4:22:00 PM|Non Emergency| |Agreement State|||||||Defrancisco, Anne|R1DO|NMSS_EVENTS_NOTIFICATION|EMAIL|||||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|AGREEMENT STATE REPORT - PACKAGE EXCEEDED RADIATION LIMITS The following information was received from the Massachusetts Radiation Control Program (the Agency) via email: "A telephone call received by the Agency from the [Radiation Safety Officer] RSO of Invicro, LLC, at 1054 EDT on 5/19/2023. A package was received on 5/19/2023 at approximately 1000 EDT at the licensee's site that exceeded the dose rate limit of 200 mrem/hr on the external surface of the package. The radionuclide was fluorine-18 (F-18) in liquid form enclosed in a glass vial. The assayed dose was 499 mCi at 0930 at PETNET Solutions, Inc. in Woburn, MA, the distributor of the F-18. "The package was labeled Yellow II and the maximum surface dose rate should therefore not exceed 50 mrem/hour for a Yellow II labeled package. The package upon shipment was measured by the shipper to have a surface dose rate of 7 mrem/hour and a transport index (TI) of 0.4. "The licensee reported that 5 wipe samples were taken on the external surface of the package with no resultant removable contamination observed. It was reported that the glass vial contained approximately 350 mCi of F-18 at the time the package was opened. The external dose rates on all external surfaces continued to exceed 200 mR/hr, even with the vial removed from the package. "Surveys of areas where the package was opened, and where the vial was transported, are undergoing. The vial is currently stored in a hot cell. The external package is being stored in a shielded location. Personnel are being surveyed for contamination. At this time there is no indication of external contamination of the shipping package. "The Agency, Invicro LLC, and PETNET Solutions, Inc. are in communication working the details of the scenario and potential personnel exposer. "The Massachusetts Radiation Control Program considers this to be an open reportable event." | Power Reactor|56531|Browns Ferry|Tennessee Valley Authority|2|Decatur|AL|Limestone||Y|05000259|1|||[1] GE-4,[2] GE-4,[3] GE-4|Chris Wilson|Ian Howard|05/20/2023|7:45:00|05/20/2023|3:15:00|CDT|5/20/2023 8:05:00 AM|Non Emergency|50.72(b)(2)(iv)(B)|RPS Actuation - Critical|50.72(b)(3)(iv)(A)|Valid Specif Sys Actuation|||||Miller, Mark|R2DO|||||||||||||||||||A/R|Y|80|Power Operation|0|Hot Shutdown||N|0||0|||N|0||0||AUTOMATIC REACTOR SCRAM The following information was provided by the licensee via phone and email: "On 5/20/2023 at 0315 CDT, Browns Ferry Unit 1 was at 80 percent reactor power performing, 'Turbine control valve fast closure turbine trip and RPT [recirculation pump trip] initiate logic testing'. During performance of this test, Unit 1 received a full reactor scram. An investigation is in progress to determine the cause of the scram. All systems responded as expected, and Unit 1 is stable at zero percent power in mode 3. "All control rods fully inserted into the core. Main steam isolation valves remained open with main turbine bypass valves controlling pressure. Reactor feedwater pumps remained in service to control reactor water level. Primary containment isolation signals groups 2, 3, 6, and 8 were received with expected system actuations. "This event is reportable per 10 CFR 50.72(b)(2)(iv)(B), 'Any event or condition that results in actuation of the reactor protection system (RPS) when the reactor is critical except when the actuation results from and is part of a pre-planned sequence during testing or reactor operation'. "The event is also reportable within 8 hours per 10 CFR 50.72(b)(3)(iv)(A), 'Specified System Actuation'. "The NRC Resident has been notified."| Power Reactor|56532|Susquehanna|Ppl Susquehanna Llc|1|Allentown|PA|Luzerne||Y|05000387|1|2||[1] GE-4,[2] GE-4|Samuel Adams|John Russell|05/22/2023|16:24:00|05/22/2023|9:59:00|EDT|5/22/2023 4:51:00 PM|Non Emergency|26.719|Fitness For Duty|||||||Jackson, Don|R1DO|FFD Group, |EMAIL|||||||||||||||||N|Y|97|Power Operation|97|Power Operation|N|Y|92|Power Operation|92|Power Operation||N|0||0||FITNESS-FOR-DUTY VIOLATION The following information was provided by the licensee via email: A non-licensed contract supervisor had a confirmed positive for alcohol during a random fitness-for-duty test. The employee's access to the plant has been terminated. The NRC Resident Inspector has been notified. | Agreement State|56533|Texas Dept of State Health Services|Nextier Completion Solutions, Inc|4|Pleasanton|TX||L 06712|Y||||||Art Tucker|Ian Howard|05/23/2023|15:00:00|05/23/2023|0:00:00|CDT|5/23/2023 3:10:00 PM|Non Emergency| |Agreement State|||||||Vossmar, Patricia|R4DO|NMSS_EVENTS_NOTIFICATION|EMAIL|||||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|AGREEMENT STATE REPORT - SHUTTER MISSING The following information was provided by the Texas Department of State Health Services (the Agency) via phone and email: "On May 23, 2023, the Agency was notified by the licensee's radiation safety officer (RSO) that while conducting routine shutter checks, the shutter for a Thermo Fisher model 5190 gauge was missing. The shutter is a block of lead that slides across the radiation beam. The RSO stated they believe the lead block (shutter) must have vibrated off the slide. The gauge has been removed and placed in storage and will be disposed of. The gauge contains a 200 millicurie (original activity) [Cs-137] source. No individual received an exposure that exceeded any limit. Additional information will be provided as it is received in accordance with SA-300." Texas Incident No.: 10022 Texas NMED No.: TX230025 | Non-Power Reactor|56534|Univ Of Missouri-Columbia (MISC)|University Of Missouri|0|Columbia|MO|Boone|R-103|N|05000186||||10000 Kw Tank|Ronald Astrino|Ian Howard|05/23/2023|18:08:00|05/23/2023|8:45:00|CDT|5/23/2023 7:15:00 PM|Non Emergency||Non-Power Reactor Event|||||||Geoffrey Wertz|NRR|Andrew Waugh|NRR|||||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|TECHNICAL SPECIFICATION VIOLATION The following information was provided by the University of Missouri-Columbia Research Reactor (MURR) via phone and email: "During a normal reactor start up on 5/23/2023, while still approaching criticality, reactor power peaked slightly above 100 kW with a single control blade 1.4 inches below the other three control blades. This is a violation of Technical Specification (TS) 3.2.b which states that above 100 kW, the reactor shall be operated so that the maximum distance between the highest and lowest shim blade shall not exceed 1 inch. "As part of a normal reactor startup, three control blades were at 23 inches and the core was approaching criticality. As the fourth control blade was being pulled to the bank height, the Lead Senior Reactor Operator stated power was approaching 100 kW, alerting the Reactor Operator to the TS of no more than a one-inch height differential between control blades. Reactor power slowly increased. The Reactor Operator stopped shimming out on Control Blade 'A' and shimmed the other three rods inward individually to stop the power rise. He continued to then pull Control Blade 'A' out while leveling power by shimming the other three rods in. The control room continued the startup. No other issues occurred during the approach to full power (10 MW). "After the startup, the Lead Senior Reactor Operator raised a concern that it was possible power peaked slightly above 100 kW with Control Blade 'A' at 1.4 inches below the other three control blades. Strip charts confirmed power peaked at 103.5 kW during this time. Total duration in this unapproved control blade configuration was less than one minute. "The Reactor Manager was informed of the problem, and he informed the Interim Facility Director. MURR Licensee Event Report (LER) 13-03 discusses a similar event. Calculations performed for that event show that a control blade can differ by as much as 4 inches from the bank with no adverse effects to the core. MURR reactor operations were continued. "MURR will follow up with an LER to address this issue." | Power Reactor|56535|Monticello|Nuclear Management Company|3|Monticello|MN|Wright||Y|05000263|1|||[1] GE-3|Peter Bruggeman|Ian Howard|05/23/2023|22:13:00|05/22/2023|18:38:00|CDT|5/23/2023 10:39:00 PM|Non Emergency|50.72(b)(2)(xi)|Offsite Notification|||||||Benjamin, Jamie|R3DO|||||||||||||||||||N|Y|100|Power Operation|100|Power Operation||N|0||0|||N|0||0||NOTIFICATION TO ANOTHER GOVERNMENT AGENCY The following information was provided by the licensee via phone and fax: "On 5/22/23, Xcel Energy performed a notification to the state of Minnesota Duty Officer, in accordance with Minnesota Statute 115.061, regarding 300-600 gallons of pumped ground water that overflowed from a holding tank and returned to the ground area from which it was pumped. The groundwater being pumped is related to recovery activities associated with the event reported on November 22, 2022 (EN 56236). This notification is being made solely as a four-hour, non-emergency report for notification to other government agency. An update is being provided to the Monticello community and published on Xcel Energy's website. This event is reportable in accordance with 10 CFR 50.72(b)(2)(xi). There was no impact on the health and safety of public or plant personnel. The NRC Resident Inspector has been notified." | Agreement State|56536|PA Bureau of Radiation Protection|Earth Engineering, Inc.|1|East Norriton|PA||PA-1040|Y||||||John Chippo|Ernest West|05/24/2023|8:37:00|05/23/2023|0:00:00|EDT|5/24/2023 2:19:00 PM|Non Emergency| |Agreement State|||||||Jackson, Don|R1DO|NMSS_EVENTS_NOTIFICATION|EMAIL|ILTAB, (EMAIL)|EMAIL|CNSC (Canada), -|FAX|||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|STOLEN NUCLEAR DENSITY GAUGE The following information was provided by the Pennsylvania Department of Environmental Protection, Bureau of Radiation Protection (the Department) via email: "On May 24, 2023, the Department was notified of a stolen nuclear density gauge. This event is reportable within 24-hours per 10 CFR 20.2201(a)(1)(i). "On May 23, 2023, an employee of the licensee reported to police that their vehicle, with a nuclear density gauge in it, was stolen earlier that day. Local, Regional, and State Police are aware of the incident and a bulletin has been issued. [The Department] has been in contact with the licensee and will update this event as soon as more information is provided. "The Department will perform a reactive inspection." Stolen gauge details: Troxler Model Number: 3440 Serial Number: 33833 Sources: Cesium 137, 9 millicuries; Americium 241:Be, 44 millicuries * * * UPDATE ON 5/24/2023 AT 1340 EDT FROM JOHN CHIPPO TO IAN HOWARD * * * The following information was provided by the Department via email: "The vehicle has been recovered with the device still secure and intact in the trunk." Notified R1DO (Jackson), NMSS Events Notification (email), ILTAB (email), CNSC Canada (email). PA Event Report Number: PA230016 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|56537|Colorado Dept of Health|U. of Colorado, Memorial Hospital|4|Colorado Springs|CO||CO 234-01|Y||||||Matthew Gift|Brian P. Smith|05/24/2023|11:37:00|05/19/2023|0:00:00|MDT|5/24/2023 11:51:00 AM|Non Emergency| |Agreement State|||||||Vossmar, Patricia|R4DO|NMSS_EVENTS_NOTIFICATION|EMAIL|ILTAB, (EMAIL)|EMAIL|||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|AGREEMENT STATE REPORT - LOST AND RECOVERED SOURCE The following report was received via email by the Colorado Department of Health: "On May 19, 2023, the RSO [Radiation Safety Officer] at Memorial Hospital, University of Colorado Health, reported a missing 1.2 mCi germanium-68 sealed source. The source was determined to be an internal quality control source of a PET/CT [Positron Emission Tomography/Computed Tomography] camera. The source was identified as missing during a routine 6-month inventory performed on April 21, 2023. "The PET/CT camera was purchased by Siemens Medical Solutions USA, Inc. in December 2022. Siemens subcontracted the decommissioning of the camera to a 3rd party (Clinical Imaging Systems), however, they failed to remove the source prior to transporting/shipping the camera to a Clinical Imaging System's warehouse. The source has been removed from the camera and is currently secured in a locked room at the warehouse. Memorial Hospital has been working with Siemens to have a licensed service provider ship the source back to Memorial Hospital or directly to a licensed recipient for disposal." Colorado Event Number: CO230013 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| Part 21|56538|Engine Systems, Inc|Engine Systems, Inc|1|Rocky Mount|NC|||Y||||||Dan Roberts|Ian Howard|05/24/2023|15:32:00|03/28/2023|0:00:00|EDT|5/24/2023 4:29:00 PM|Non Emergency|21.21(d)(3)(i)|Defects And Noncompliance|||||||Miller, Mark|R2DO|Part 21/50.55 Reactors, -|EMAIL|||||||||||||||||N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|N|N|0|Power Operation|0|Power Operation|PART 21 - DEFECT IDENTIFIED IN EMERGENCY DIESEL GENERATOR GOVERNOR The following is a synopsis of information provided by the Engine Systems, Inc (ESI) via fax: Component Description: Woodward Governor, Part No. 9903-722, Serial No. 18847017 Problem Description: An EGB-35P governor/actuator (governor) installed on a customer's emergency diesel generator failed soon after installation. Investigation revealed a piece of foreign material, a loose buffer plug, inside the governor that caused the failure. Since the governor is used to maintain fuel rack position of the diesel engine, failure of the governor would prevent the emergency diesel generator from performing its safety-related function during an event. Affected Plants: Brunswick Nuclear Plant Corrective Actions for Brunswick Nuclear Plant: No action required. The affected governor has been returned to ESI. Corrective Actions for ESI: The governor will be refurbished under ESI's 10 CFR 50 Appendix B program and certified for continued use at Brunswick Nuclear Plant. To prevent reoccurrence, ESI will revise the dedication requirements to enhance existing foreign material inspection practices to include a visual inspection where the buffer plug was located within the governor. The revisions are expected to be complete within 30 days but in all cases prior to future shipments. | Power Reactor|56539|Palo Verde|Arizona Nuclear Power Project|4|Wintersburg|AZ|Maricopa||Y|05000528|1|2|3|[1] CE,[2] CE,[3] CE|Lorraine Weaver|Ian Howard|05/24/2023|19:58:00|05/24/2023|7:10:00|MST|5/24/2023 7:58:00 PM|Non Emergency|26.719|Fitness For Duty|||||||Vossmar, Patricia|R4DO|FFD Group, |EMAIL|||||||||||||||||N|Y|100|Power Operation|100|Power Operation|N|N|0|Cold Shutdown|0|Cold Shutdown|N|Y|100|Power Operation|100|Power Operation|FITNESS-FOR-DUTY REPORT The following information was provided by the licensee via phone and email: "On May 24th, 2023, at approximately 0710 MDT, a non-licensed contract supervisor had a confirmed positive for alcohol during a for-cause fitness-for-duty test. The individual's plant access has been terminated in accordance with station procedures. "The NRC Resident Inspector has been notified." | Power Reactor|56541|Watts Bar|Tennessee Valley Authority|2|Spring City|TN|Rhea||Y||2|||[1] W-4-LP,[2] W-4-LP|Joanne Dehay|Ian Howard|05/25/2023|17:02:00|05/25/2023|13:45:00|EDT|5/25/2023 5:34:00 PM|Non Emergency|50.72(b)(3)(ii)(B)|Unanalyzed Condition|||||||Miller, Mark|R2DO|||||||||||||||||||N|Y|100|Power Operation|100|Power Operation||N|0||0|||N|0||0||UNANALYZED CONDITION OF EMERGENCY DIESEL GENERATOR The following information was provided by the licensee via phone and email: "At 1345 EDT on May 25, 2023, it was determined that a fire barrier for area 737-A1B was not installed, and would render the 2A Emergency Diesel Generator (EDG) not operable in the event of a fire on the Unit 2 side of elevation 737 in the Auxiliary Building. The 2A EDG is the credited power source for fire safe shutdown for a fire located in this area. Without the credited source of power, this places WBN U2 [Watts Bar Nuclear Unit 2] in an unanalyzed condition. A fire watch has been established in the area until the issue is resolved. Therefore, this event is being reported as an eight-hour non-emergency notification per 10 CFR 50.72(b)(3)(ii)(B). "The NRC Resident Inspector has been notified." | Power Reactor|56542|Fermi|Detroit Edison Co.|3|Newport|MI|Monroe||N|05000341|2|||[2] GE-4|Eric Frank|Donald Norwood|05/26/2023|14:16:00|05/25/2023|0:00:00|EDT|5/26/2023 3:30:00 PM|Non Emergency|21.21(a)(2)|Interim Eval Of Deviation|||||||Benjamin, Jamie|R3DO|Part 21/50.55 Reactors, -|EMAIL|||||||||||||||||N|Y|100|Power Operation|100|Power Operation||N|0||0|||N|0||0||PART 21 INTERIM EVALUATION - MECHANICAL DRAFT COOLING TOWER FAN BRAKES DESIGN FLAW The following is a summary of the information provided by the licensee via email: "As previously reported under Fermi LER 2023-001-00, submitted on May 22, 2023, at 1145 EDT on March 23, 2023, it was determined that all mechanical draft cooling tower (MDCT) fan brakes would not perform their design function during a tornado due to the speed switch not functioning over its published voltage and frequency ranges. The MDCT fan brakes are required to prevent fan overspeed from a design basis tornado. On May 25, 2023, Fermi completed its 10 CFR Part 21 discovery process and determined the need to perform a 10 CFR Part 21 evaluation. The vendor (Engine Systems Inc. (ESI)) was contacted and the purchaser (Fermi) assumed responsibility for performing the Part 21 evaluation for the supplied mechanism. This Part 21 evaluation is being tracked by Fermi CARD 23-20075. "It has been determined the direct cause of the event was due to the Dynalco speed switch model SST-2400A-1, supplied by ESI, not functioning over its published voltage and frequency ranges. Corrective actions were taken to develop a design change to correct MDCT fan speed control system returning the MDCT fans, ultimate heat sink, and the service water subsystems to service on March 24, 2023. The root cause evaluation is ongoing, and written follow-up will be provided in 30 days by providing a supplement to the original LER by June 24, 2023. "No new commitments are being made in this submittal." | Power Reactor|56543|Prairie Island|Nuclear Management Company|3|Welch|MN|Goodhue||Y||2|||[1] W-2-LP,[2] W-2-LP|Chris Baartman|Donald Norwood|05/27/2023|20:28:00|05/27/2023|18:34:00|CDT|5/28/2023 2:12:00 AM|Non Emergency|50.72(a) (1) (i)|Emergency Declared|50.72(b)(2)(iv)(B)|RPS Actuation - Critical|50.72(b)(3)(iv)(A)|Valid Specif Sys Actuation|||Benjamin, Jamie|R3DO|Geissner, John|R3RA|Veil, Andrea|DNRR|Grant, Jeffery|IRMOC|Gavrilas, Mirela|DNSIR|Walker, Shakur|NRREO|||||||||A/R|Y|100|Power Operation|0|Hot Standby||N|0||0|||N|0||0||NOTIFICATION OF UNUSUAL EVENT DUE TO MULTIPLE FIRE ALARMS IN CONTAINMENT NOT VERIFIED WITHIN 15 MINUTES The following information was provided by the licensee via email: "Notification of Unusual Event, HU4.1 declared based on multiple fire alarms in the containment building not verified within 15 minutes. "Turbine trip causing reactor trip due to fault on 2GT transformer. "At 1845 CDT, verification of no fire in the containment building." Notified DHS Senior Watch Officer, FEMA Operations Center, CISA Central watch officer, DOE Operations Center (email), HHS Operations Center (email), EPA Emergency Operations Center (email), USDA Operations Center (email), FDA EOC (email), FEMA NWC (email) and DHS Nuclear SSA (email), FEMA NRCC (email) and CWMD watch desk (email). * * * UPDATE AT 0148 EDT ON 5/28/23 FROM CHRIS BAARTMAN TO BILL GOTT * * * The following information was provided by the licensee via email: "This update is being made to report the actuation of the auxiliary feedwater system following the reactor trip at 1819 CDT. This event is being reported as a specified system actuation in accordance with the reporting criteria of 10 CFR 50.72(b)(3)(iv)(A). "This update is also being made for the termination of the notification of unusual event at 2304 CDT on 5/27/2023. The basis for the termination was that there was no indication of a fire. "Upon lockout of 2GT transformer, main to reserve power transfer did not occur on 3 of 4 non-safeguards buses. Subsequently, operator action successfully restored power to all non-safeguards buses at 1925 CDT. "There was no impact to the health and safety of the public or plant personnel. "The NRC resident inspector has been notified of the update." Notified R3DO (Benjam¡n), NRR EO (Walker), IRMOC (Grant), DHS Senior Watch Officer, FEMA Operations Center, CISA Central watch officer, DOE Operations Center (email), HHS Operations Center (email), EPA Emergency Operations Center (email), USDA Operations Center (email), FDA EOC (email), FEMA NWC (email) and DHS Nuclear SSA (email), FEMA NRCC (email) and CWMD watch desk (email). | Power Reactor|56544|Millstone|Dominion Generation|1|Waterford|CT|New London||N||3|||[1] GE-3,[2] CE,[3] W-4-LP|Jon Daskam|Bill Gott|05/30/2023|8:34:00|05/30/2023|4:46:00|EDT|5/31/2023 6:30:00 AM|Non Emergency|50.72(b)(2)(iv)(B)|RPS Actuation - Critical|50.72(b)(3)(iv)(A)|Valid Specif Sys Actuation|||||Cahill, Christopher|R1DO|||||||||||||||||||A/R|Y|100|Power Operation|0|Hot Standby||N|0||0|||N|0||0||EN Revision Imported Date: 6/1/2023

EN Revision Text: REACTOR TRIP The following information was provided by the licensee via email: "At 0446 EDT on 5/30/2023, with Millstone Power Station Unit 3 operating at approximately 100 percent reactor power, an automatic reactor trip occurred due to a turbine trip caused by electrical protection. The reactor trip was uncomplicated and decay heat is being removed via steam dumps to the condenser. All systems responded as expected to the trip. "Auxiliary feedwater actuated automatically as expected following the trip due to low-low levels in the steam generators. "There was no risk to the public. There was no impact to Millstone Unit 2. "This event is being reported as a four hour report under 10CFR50.72(b)(2)(iv)(B) as a condition that resulted in actuation of the reactor protection system while the reactor was critical, and as an eight hour report under 10CFR50.72(b)(3)(iv)(A) and 10CFR50.72(b)(3)(iv)(B) for actuation of the auxiliary feedwater system. "The NRC Resident Inspector has been notified." |