Event Notification Report for November 12, 2003
U.S. Nuclear Regulatory Commission
Operations Center
EVENT REPORTS FOR
11/11/2003 - 11/12/2003
EVENT NUMBERS
4031540316403174031840386
Power Reactor
Event Number: 40315
Facility: BRUNSWICK
Region: 2 State: NC
Unit: [1] [2] []
RX Type: [1] GE-4,[2] GE-4
NRC Notified By: DANIEL HARDIN
HQ OPS Officer: MIKE RIPLEY
Region: 2 State: NC
Unit: [1] [2] []
RX Type: [1] GE-4,[2] GE-4
NRC Notified By: DANIEL HARDIN
HQ OPS Officer: MIKE RIPLEY
Notification Date: 11/12/2003
Notification Time: 14:03 [ET]
Event Date: 11/12/2003
Event Time: 10:03 [EST]
Last Update Date: 11/12/2003
Notification Time: 14:03 [ET]
Event Date: 11/12/2003
Event Time: 10:03 [EST]
Last Update Date: 11/12/2003
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(3)(xiii) - LOSS COMM/ASMT/RESPONSE
10 CFR Section:
50.72(b)(3)(xiii) - LOSS COMM/ASMT/RESPONSE
Person (Organization):
JOHN PELCHAT (R2)
JOHN PELCHAT (R2)
| Unit | SCRAM Code | RX Crit | Initial PWR | Initial RX Mode | Current PWR | Current RX Mode |
|---|---|---|---|---|---|---|
| 1 | N | Y | 93 | Power Operation | 93 | Power Operation |
| 2 | N | Y | 96 | Power Operation | 96 | Power Operation |
EMERGENCY SIREN TEST FAILURE
"On November 12, 2003, at approximately 1003 hours, during an annual emergency preparedness siren test, the five sirens from New Hanover County, NC, did not respond to the signal sent by the New Hanover County Emergency Operations Center (EOC). The sirens were subsequently tested from the Brunswick Nuclear Plant (BNP) Emergency Offsite Facility (EOF) and responded as required. Maintenance activities are in progress to restore New Hanover County EOC siren initiation capability. Initiation capability will be maintained at the BNP EOF until the capability is restored to New Hanover County. Of the remaining 31 sirens tested, 30 successfully passed the annual test and are considered to be operable. The additional failed siren blew a control power fuse during the test and has since been repaired, tested, and returned to operable status. The resident inspector has been notified.
"The safety significance of this event is considered to be minimal. Both Units 1 and 2 are operating in Mode 1 under normal parameters. Compensatory measures are in place to ensure the affected sirens will initiate if required.
"Activities to restore siren initiation capability are in progress."
* * * * UPDATE FROM DANIEL HARDIN TO MIKE RIPLEY 1706 ET 11/12/03 * * * *
Repairs and retesting have been completed and, as of 1530 ET 11/12/03, New Hanover County EOC siren initiation capability has been restored.
Notified R2DO (J. Pelchat)
"On November 12, 2003, at approximately 1003 hours, during an annual emergency preparedness siren test, the five sirens from New Hanover County, NC, did not respond to the signal sent by the New Hanover County Emergency Operations Center (EOC). The sirens were subsequently tested from the Brunswick Nuclear Plant (BNP) Emergency Offsite Facility (EOF) and responded as required. Maintenance activities are in progress to restore New Hanover County EOC siren initiation capability. Initiation capability will be maintained at the BNP EOF until the capability is restored to New Hanover County. Of the remaining 31 sirens tested, 30 successfully passed the annual test and are considered to be operable. The additional failed siren blew a control power fuse during the test and has since been repaired, tested, and returned to operable status. The resident inspector has been notified.
"The safety significance of this event is considered to be minimal. Both Units 1 and 2 are operating in Mode 1 under normal parameters. Compensatory measures are in place to ensure the affected sirens will initiate if required.
"Activities to restore siren initiation capability are in progress."
* * * * UPDATE FROM DANIEL HARDIN TO MIKE RIPLEY 1706 ET 11/12/03 * * * *
Repairs and retesting have been completed and, as of 1530 ET 11/12/03, New Hanover County EOC siren initiation capability has been restored.
Notified R2DO (J. Pelchat)
Power Reactor
Event Number: 40316
Facility: CALVERT CLIFFS
Region: 1 State: MD
Unit: [1] [2] []
RX Type: [1] CE,[2] CE
NRC Notified By: LAWRENCE BEAVERS
HQ OPS Officer: MIKE RIPLEY
Region: 1 State: MD
Unit: [1] [2] []
RX Type: [1] CE,[2] CE
NRC Notified By: LAWRENCE BEAVERS
HQ OPS Officer: MIKE RIPLEY
Notification Date: 11/12/2003
Notification Time: 20:11 [ET]
Event Date: 11/12/2003
Event Time: 18:15 [EST]
Last Update Date: 11/12/2003
Notification Time: 20:11 [ET]
Event Date: 11/12/2003
Event Time: 18:15 [EST]
Last Update Date: 11/12/2003
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(2)(xi) - OFFSITE NOTIFICATION
10 CFR Section:
50.72(b)(2)(xi) - OFFSITE NOTIFICATION
Person (Organization):
KENNETH JENISON (R1)
KENNETH JENISON (R1)
| Unit | SCRAM Code | RX Crit | Initial PWR | Initial RX Mode | Current PWR | Current RX Mode |
|---|---|---|---|---|---|---|
| 1 | N | Y | 100 | Power Operation | 100 | Power Operation |
| 2 | N | Y | 100 | Power Operation | 100 | Power Operation |
OFFSITE NOTIFICATION OF EMERGENCY SIREN ACTIVATION
Calvert County, Maryland was notified that, while "silent" testing the new St. Mary's County sirens (not yet in service), the Calvert County sirens were inadvertently activated. The sirens sounded for approximately 15 seconds.
The licensee will notify the NRC Resident Inspector.
Calvert County, Maryland was notified that, while "silent" testing the new St. Mary's County sirens (not yet in service), the Calvert County sirens were inadvertently activated. The sirens sounded for approximately 15 seconds.
The licensee will notify the NRC Resident Inspector.
Power Reactor
Event Number: 40317
Facility: CALLAWAY
Region: 4 State: MO
Unit: [1] [] []
RX Type: [1] W-4-LP
NRC Notified By: GARY OLMSTEAD
HQ OPS Officer: MIKE RIPLEY
Region: 4 State: MO
Unit: [1] [] []
RX Type: [1] W-4-LP
NRC Notified By: GARY OLMSTEAD
HQ OPS Officer: MIKE RIPLEY
Notification Date: 11/12/2003
Notification Time: 21:01 [ET]
Event Date: 11/12/2003
Event Time: 14:21 [CST]
Last Update Date: 11/12/2003
Notification Time: 21:01 [ET]
Event Date: 11/12/2003
Event Time: 14:21 [CST]
Last Update Date: 11/12/2003
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(3)(iv)(A) - VALID SPECIF SYS ACTUATION
10 CFR Section:
50.72(b)(3)(iv)(A) - VALID SPECIF SYS ACTUATION
Person (Organization):
WILLIAM JONES (R4)
WILLIAM JONES (R4)
| Unit | SCRAM Code | RX Crit | Initial PWR | Initial RX Mode | Current PWR | Current RX Mode |
|---|---|---|---|---|---|---|
| 1 | N | Y | 100 | Power Operation | 67 | Power Operation |
INADVERTENT ACTUATION OF ESSENTIAL SERVICE WATER SYSTEM
"On 11/12/03, Callaway Plant was restoring normal electrical power to electrical bus PB122 in the Circulating and Service Water Pumphouse. While attempting to restore the normal electrical power source to bus PB122, a Reactor Operator operated an incorrect switch. As a result of the incorrect switch operation, two other electrical feeder breakers opened and de-energized electrical busses PB121 and PB122. This resulted in a loss of the normal service water system which supplies cooling water to both safety related and non-safety related loads during normal operation. At 1421, operators manually initiated operation of the Essential Service Water system to restore cooling water to safety related loads. As a result of the loss of normal cooling water to non-safety related loads, a turbine runback occurred and power was stabilized at 68% reactor power. Initial plans are to perform inspections of affected electrical breakers plus circulating water and service water pumps. These inspections will not prevent a return to normal power.
"Essential Service Water is an alternate source of emergency feedwater but in this instance, it was actuated to supply cooling water to safety related loads, not to supply emergency feedwater. This event is voluntarily being reported as an 8-hour ENS call for a valid actuation of an emergency feedwater system."
The licensee notified the NRC Resident Inspector.
"On 11/12/03, Callaway Plant was restoring normal electrical power to electrical bus PB122 in the Circulating and Service Water Pumphouse. While attempting to restore the normal electrical power source to bus PB122, a Reactor Operator operated an incorrect switch. As a result of the incorrect switch operation, two other electrical feeder breakers opened and de-energized electrical busses PB121 and PB122. This resulted in a loss of the normal service water system which supplies cooling water to both safety related and non-safety related loads during normal operation. At 1421, operators manually initiated operation of the Essential Service Water system to restore cooling water to safety related loads. As a result of the loss of normal cooling water to non-safety related loads, a turbine runback occurred and power was stabilized at 68% reactor power. Initial plans are to perform inspections of affected electrical breakers plus circulating water and service water pumps. These inspections will not prevent a return to normal power.
"Essential Service Water is an alternate source of emergency feedwater but in this instance, it was actuated to supply cooling water to safety related loads, not to supply emergency feedwater. This event is voluntarily being reported as an 8-hour ENS call for a valid actuation of an emergency feedwater system."
The licensee notified the NRC Resident Inspector.
!!!!! THIS EVENT HAS BEEN RETRACTED !!!!!
!!!!! THIS EVENT HAS BEEN RETRACTED !!!!!
Power Reactor
Event Number: 40318
Facility: BRUNSWICK
Region: 2 State: NC
Unit: [] [2] []
RX Type: [1] GE-4,[2] GE-4
NRC Notified By: P. DUBROUILLET
HQ OPS Officer: GERRY WAIG
Region: 2 State: NC
Unit: [] [2] []
RX Type: [1] GE-4,[2] GE-4
NRC Notified By: P. DUBROUILLET
HQ OPS Officer: GERRY WAIG
Notification Date: 11/13/2003
Notification Time: 05:27 [ET]
Event Date: 11/12/2003
Event Time: 22:22 [EST]
Last Update Date: 12/04/2003
Notification Time: 05:27 [ET]
Event Date: 11/12/2003
Event Time: 22:22 [EST]
Last Update Date: 12/04/2003
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(3)(v)(D) - ACCIDENT MITIGATION
10 CFR Section:
50.72(b)(3)(v)(D) - ACCIDENT MITIGATION
Person (Organization):
JOHN PELCHAT (R2)
JOHN PELCHAT (R2)
| Unit | SCRAM Code | RX Crit | Initial PWR | Initial RX Mode | Current PWR | Current RX Mode |
|---|---|---|---|---|---|---|
| 2 | N | Y | 96 | Power Operation | 96 | Power Operation |
HIGH PRESSURE COOLANT INJECTION SYSTEM ISOLATION DURING TESTING
"During quarterly surveillance testing of the High Pressure Coolant Injection (HPCI) System the HPCI system isolated. The cause of the isolation is believed to be high turbine exhaust diaphragm pressure. HPCI is currently inoperable. The outboard steam line isolation valve closed automatically and the inboard steam line isolation valve was manually closed. The HPCI room carbon dioxide fire protection system actuated due to the high temperature spike. No fire was present. The Reactor Core Isolation Cooling (RCIC) System, Auto Depressurization System (ADS), Low Pressure Core Spray System and Low Pressure Coolant Injection System are operable.
"Initial Safety Evaluation - Low initial safety significance due to availability of alternate high and low pressure injection systems.
"Corrective Actions - HPCI will remain inoperable pending investigation. Determine and correct the cause of HPCI isolation. Determine if the inboard steam isolation valve should have automatically closed."
The licensee has notified the NRC Resident Inspector.
* * * UPDATE ON 12/04/03 @ 0945 BY STEVE TABOR TO C GOULD * * *
Upon further investigation of this event, it has been determined that the malfunction of the HPCI system was due to a condition which was introduced by the maintenance/testing activities while the system was declared inoperable. During the valve restoration/clearance cancellation process performed in support of HPCI system return to service, the 2-E41-F021, HPCI Exhaust Line Check Valve was inadvertently left in the locked closed position. In this configuration turbine exhaust over pressurization occurred resulting in actuation of the turbine exhaust diaphragm high pressure trip, subsequent generation of a Primary Containment Isolation system Division 1 Group 4 isolation signal, closure of the HPCI system outboard steam isolation valve 2-E41-F003, and rupture of the HPCI turbine exhaust rupture disc assembly. An evaluation of the impact of this event was performed and the necessary corrective actions and additional post-maintenance testing completed satisfactorily prior to declaring the HPCI system operable on November 16, 2003, at 2015 EST.
After further review of the event and event reporting guidance, this event is not reportable in accordance with 10 CFR 50.72 or 50.73. NUREG-1022, Revision 2 provides clarification of the reporting requirements contained within 10 CFR 50.72 and 50.73. Specifically, in discussions associated with events that could prevent fulfillment of a safety function, NUREG-1022, Revision 2, Section 3.2.7, provides the following example of a condition that is not reportable under these criteria:
removal of a system or part of a system from service as part of a planned evolution for maintenance or surveillance testing when done in accordance with an approved procedure and the plant's TS (unless a condition is discovered that could have prevented the system from performing its function)
In this case, HPCI was properly removed from service for planned maintenance/testing under TS Limiting Condition for Operation, A2-03-1190, and was not returned to service until HPCI system operability was restored. The intent of the qualifying statement in NUREC-1022 (i.e., unless a condition is discovered that could have prevented the system from performing its function) is to ensure that pre-existing operability concerns that are discovered during maintenance activities are reported. It is not intended to require reporting of conditions, introduced by the maintenance/testing activity that are identified and corrected prior to returning the system to service. In this case, post-maintenance testing performed prior to declaring the HPCI system operable, identified a problem that had been introduced by activities implemented in support of the maintenance activity prior to returning the HPCI system to service and which did not exist at any time when the HPCI system had been relied upon to fulfill its intended safety function.
Therefore the licensee is retracting this event.
The licensee notified the Resident Inspector
The Reg 2 RDO(Brian Bonser) was notified
"During quarterly surveillance testing of the High Pressure Coolant Injection (HPCI) System the HPCI system isolated. The cause of the isolation is believed to be high turbine exhaust diaphragm pressure. HPCI is currently inoperable. The outboard steam line isolation valve closed automatically and the inboard steam line isolation valve was manually closed. The HPCI room carbon dioxide fire protection system actuated due to the high temperature spike. No fire was present. The Reactor Core Isolation Cooling (RCIC) System, Auto Depressurization System (ADS), Low Pressure Core Spray System and Low Pressure Coolant Injection System are operable.
"Initial Safety Evaluation - Low initial safety significance due to availability of alternate high and low pressure injection systems.
"Corrective Actions - HPCI will remain inoperable pending investigation. Determine and correct the cause of HPCI isolation. Determine if the inboard steam isolation valve should have automatically closed."
The licensee has notified the NRC Resident Inspector.
* * * UPDATE ON 12/04/03 @ 0945 BY STEVE TABOR TO C GOULD * * *
Upon further investigation of this event, it has been determined that the malfunction of the HPCI system was due to a condition which was introduced by the maintenance/testing activities while the system was declared inoperable. During the valve restoration/clearance cancellation process performed in support of HPCI system return to service, the 2-E41-F021, HPCI Exhaust Line Check Valve was inadvertently left in the locked closed position. In this configuration turbine exhaust over pressurization occurred resulting in actuation of the turbine exhaust diaphragm high pressure trip, subsequent generation of a Primary Containment Isolation system Division 1 Group 4 isolation signal, closure of the HPCI system outboard steam isolation valve 2-E41-F003, and rupture of the HPCI turbine exhaust rupture disc assembly. An evaluation of the impact of this event was performed and the necessary corrective actions and additional post-maintenance testing completed satisfactorily prior to declaring the HPCI system operable on November 16, 2003, at 2015 EST.
After further review of the event and event reporting guidance, this event is not reportable in accordance with 10 CFR 50.72 or 50.73. NUREG-1022, Revision 2 provides clarification of the reporting requirements contained within 10 CFR 50.72 and 50.73. Specifically, in discussions associated with events that could prevent fulfillment of a safety function, NUREG-1022, Revision 2, Section 3.2.7, provides the following example of a condition that is not reportable under these criteria:
removal of a system or part of a system from service as part of a planned evolution for maintenance or surveillance testing when done in accordance with an approved procedure and the plant's TS (unless a condition is discovered that could have prevented the system from performing its function)
In this case, HPCI was properly removed from service for planned maintenance/testing under TS Limiting Condition for Operation, A2-03-1190, and was not returned to service until HPCI system operability was restored. The intent of the qualifying statement in NUREC-1022 (i.e., unless a condition is discovered that could have prevented the system from performing its function) is to ensure that pre-existing operability concerns that are discovered during maintenance activities are reported. It is not intended to require reporting of conditions, introduced by the maintenance/testing activity that are identified and corrected prior to returning the system to service. In this case, post-maintenance testing performed prior to declaring the HPCI system operable, identified a problem that had been introduced by activities implemented in support of the maintenance activity prior to returning the HPCI system to service and which did not exist at any time when the HPCI system had been relied upon to fulfill its intended safety function.
Therefore the licensee is retracting this event.
The licensee notified the Resident Inspector
The Reg 2 RDO(Brian Bonser) was notified
Hospital
Event Number: 40386
Rep Org: THOMAS JEFFERSON UNIV. HOSP.
Licensee: THOMAS JEFFERSON UNIV. HOSP.
Region: 1
City: PHILADELPHIA State: PA
County:
License #: 37-00148-06
Agreement: N
Docket:
NRC Notified By: JOHN KEKLAK
HQ OPS Officer: JOHN MacKINNON
Licensee: THOMAS JEFFERSON UNIV. HOSP.
Region: 1
City: PHILADELPHIA State: PA
County:
License #: 37-00148-06
Agreement: N
Docket:
NRC Notified By: JOHN KEKLAK
HQ OPS Officer: JOHN MacKINNON
Notification Date: 12/11/2003
Notification Time: 13:46 [ET]
Event Date: 11/12/2003
Event Time: 05:00 [EST]
Last Update Date: 12/11/2003
Notification Time: 13:46 [ET]
Event Date: 11/12/2003
Event Time: 05:00 [EST]
Last Update Date: 12/11/2003
Emergency Class: NON EMERGENCY
10 CFR Section:
20.2201(a)(1)(ii) - LOST/STOLEN LNM>10X
10 CFR Section:
20.2201(a)(1)(ii) - LOST/STOLEN LNM>10X
Person (Organization):
ANIELLO DELLA GRECA (R1)
TOM ESSIG (NMSS)
ANIELLO DELLA GRECA (R1)
TOM ESSIG (NMSS)
VIAL CONTAINING 1.07 MILLICURIES OF SULFUR-35 WAS ACCIDENTALLY PLACED IN TRASH.
On 11/10/03 a package containing two vials of P-32 and one vial of S-35 was delivered to Thomas Jefferson University Hospital Radiation Safety Office. The package was surveyed. The two vials of P-32 were picked up. The person who was to pick up the S-35 vial was not around. The trained Radiological Lab Tech obliterated the package radiation material markings thinking that the person picking up the S-35 was going to pick it up. The person to pick up the S-35 did not show up . A Lab person saw the open package without any radioactive material markings on the outside of the package and, not knowing that the S-35 vial was inside the package, placed the package in the trash, the afternoon of 11/10/03. The trash was removed by the custodian and placed in the dumpster the morning of 11/11/03. Later the trash was picked up by the trash collection company and eventually placed in a landfill.
Corrective action has been taken by the licensee to prevent this type incident from occurring in the future.
On 11/10/03 a package containing two vials of P-32 and one vial of S-35 was delivered to Thomas Jefferson University Hospital Radiation Safety Office. The package was surveyed. The two vials of P-32 were picked up. The person who was to pick up the S-35 vial was not around. The trained Radiological Lab Tech obliterated the package radiation material markings thinking that the person picking up the S-35 was going to pick it up. The person to pick up the S-35 did not show up . A Lab person saw the open package without any radioactive material markings on the outside of the package and, not knowing that the S-35 vial was inside the package, placed the package in the trash, the afternoon of 11/10/03. The trash was removed by the custodian and placed in the dumpster the morning of 11/11/03. Later the trash was picked up by the trash collection company and eventually placed in a landfill.
Corrective action has been taken by the licensee to prevent this type incident from occurring in the future.