Event Notification Report for April 18, 2006

AGREEMENT STATE - LOSS OF 20 TRITIUM FILLED SAFETY MARKERS DURING TRANSPORT

The State of North Carolina reported that 20 "Safety Markers" (Model #SM145), each containing 0.53 Curies of Tritium (Serial #s 803205 through 803224) have been lost by United Parcel Service during transport. The markers were shipped from SRB Technologies, Inc of Winston-Salem, NC, on March 22, 2006, to a customer in Houston, TX. On April 10, SRB was notified by the customer that the shipment was never received. SRB contacted UPS for a trace of the package. On April 18, 2006, UPS notified SRB that the shipment was lost.

The State did not have information on a UPS tracking number or trace number. No information on a point of contact at UPS was available. In addition, there was no information on the last known location of the package.

North Carolina Report #06-14

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.

PART 21 NOTIFICATION - NDT EQUIPMENT FAILURE

The State provided the following information via facsimile:

"Per the requirements of 10 CFR Part 21 this letter has been written to inform you of a reportable condition in regards to a Crankout Assembly Failure Reported by Team Industrial Services on April 18, 2006, Event# 42508, and on May 08, 2006, Event# 42561.

"On May 8, 2006, NDT Repair Service was notified, by Team Industrial Services, of an equipment failure during radiographic operations using one of our Control Assemblies (PN# RT1117 25ft Control Assembly For Use with AEA-QSA 6608 Exposure Device). It was noted to us that the Control Assembly could be connected to the exposure device without connecting the drive cable to the source assembly. The Exposure Device could then be put into the operation mode and the source could then be cranked out therefore causing a misconnect; which violates the ANSI N432-1981, Section 6.1.4, as required by 10 CFR Part 34.

"NDT Repair Service immediately halted distribution of Control Assemblies for the AEA-QSA 6608 Exposure Device pending investigation of the probable cause of the failure. After further investigating into the cause of the failure it was found, that, the basic component that caused the failure was the Control Adapter, which is part of the Control Assembly that connects to the Exposure Device.

"Through further internal investigation, NDT Repair Service was able to limit the potential problem to 1 lot of 25 Control Adapters that we took delivery of on November 13, 2003 and it was noted that 9 of the 25 adapters were out of tolerance and needed rework. The Root Cause of the defect in the control adapter was found to be that back stops for the drive cables were drilled too deep allowing the adapter to hook up to the exposure device without connecting to the source assembly, therefore allowing the source to be cranked out and causing a misconnect."

RECEIPT OF PACKAGE WITH SURFACE CONTAMINATION

"Licensee called pursuant to 10 CFR 20.1906, to report the receipt of a package of radioactive material with removable surface contamination slightly exceeding the limits of 10 CFR 71.87(i). The package was received at approximately 1245 CT today by the VA Medical Center in Birmingham, AL.

"Several wipe tests were performed on the package. The one showing the greatest removable contamination indicated 283 dpm/cm2, slightly exceeding the regulatory limit of 220 dpm/cm2. The package was received from a commercial nuclear radiopharmacy, Birmingham Nuclear Pharmacy, in Birmingham AL. The final delivery carrier has been notified."

The radionuclide is Technetium-99m.

HOO NOTE: The Department of Veterans Affairs coordinates all reports to the NRC from their NHPP Director's Office located in Little Rock, AR. NRC oversight for the VA Master Materials licensee is assigned to NRC Region III. Permittee: VA Medical Center, 700 South 19th Street, Birmingham, Alabama, 35233, Permit Number 01-00643-02.

EQUIPMENT MALFUNCTION CAUSED RADIOACTIVE SOURCE TO BE STUCK IN UNSHIELDED POSITION

The licensee reported that there was a stuck source at a temporary job site [Motiva Refinery] in Perth Amboy, NJ. The exposure device involved was an Amersham-660B [Model A424-9] which contained a 17-Curie Iridium-192 source.

When the source stuck in the extended position, the crew tried unsuccessfully to retract it. The workers then secured the area of concern and put up a controlled boundary to limit personnel exposure to 2 mr/hr or less. Licensee notified AEA-QSA [aka QSA-Global, Inc.] to come to the work site and repair or replace the defective equipment. It is unknown if any of the workers were overexposed due to this incident, however, licensee suspects they were not. Licensee will be evaluating the workers personal dosimeters, and other instruments, to ensure accurate readings of personnel exposure.


* * * UPDATE FROM QSA-GLOBAL TO KNOKE AT 21:03 EDT ON 04/18/06 * * *

QSA-Global, Inc. is going to Motiva Refinery in Perth Amboy, NJ, to perform an "emergency source retrieval" on the Amersham-660B [Model A424-9] which contained the 17-Curie Iridium-192 source. This work is being performed for their client Team Cooperheat located in Aston, PA.

Notified R1DO (Holody), NMSS EO (Janosko and Pangburn)

SHIELD BUILDING VENTILLATION SYSTEM DECLARED INOPERABLE

"On 4/18/2006, at 1200 hours, while the plant was operating at full power, the plant entered a 12 hour Technical Specification (TS) action statement for both trains of the Shield Building Ventilation (SBV) System being declared inoperable. The SBV System action statement was entered when the plant declared Relay Flacks RR-119 and RR-120 inoperable due to non-qualified fuses and cables being installed in six (6) of the boxes contained in these racks. The instruments associated with the six (6) boxes were not found in Technical Specification required instruments or alarms. The issue was that a downstream failure on the non-qualified Instruments may not have qualified fault protection, therefore a fault could impact safety related equipment. Other Technical Specification equipment affected by the inoperability of RR-119 and RR-120 include both trains of Inadequate Core Cooling Monitoring System (ICCMS), Reactor Vessel Level Indication (RVLIS), Pressurizer Safety Valve Outlet Temperature, and Pressurizer Power Operated Relief Valve Outlet Temperature.

"At 1611 actions taken by plant staff returned RR-120 to operable and the 12 hour action statement for SBV was exited. The plant remains in a 7 Day Limiting Condition of Operation (LCO) pending the return of RR-119. Due to the fact that Train B of SBV has been made operable, a plant shutdown was not commenced.

"This event is being reported under 10CFR50.72(b)(3)(v)(C) 'Any event that at the time of discovery could have prevented the fulfillment of the safety function of systems that are needed to control the release of radioactive material'."

The licensee notified the NRC Resident Inspector.

PART 21 NOTIFICATION INVOLVING FAILURE OF AMERSHAM-660B CRANK ASSEMBLY

The licensee provided the following information via email:

"This report is being submitted by Team Industrial Services, Inc. (TISI), as required by 10CFR Part 21. This report is to serve as notification of a nonconforming condition encountered by TISI, when using crank assemblies, manufactured or serviced by the supplier shown below, with Amersham-660B radiographic exposure devices.

"NDT Repair Service and Supply, Inc.
7874 Highway 90 East
Morgan City, LA 70380

"An initial failure of these crank assemblies (s/n NDT-267) was noted by TISI personnel performing industrial radiography at a jobsite in Sewaren, NJ on 04/18/06. Specifically, the radiography crew was able to connect the drive cable assembly to the exposure device, without connecting the drive cable to the source connector. As a result, the radiography crew was unable to return the source assembly to the exposure device, and emergency source retrieval was required. Based on our understanding of the specifications established in ANSI N432-1981, section 6.1.4, these controls should not have allowed exposure of the source assembly if the drive cable was not properly connected.

"Subsequent evaluation of other crank assemblies purchased from the supplier noted the same failure. As a result, all TISI branches have been directed to identify these assemblies as nonconforming and to remove them from service. A Supplier Corrective Action Request (SCAR) has been issued, per TISI's Quality Assurance Program, against this supplier as a result, requesting a determination of the root cause of this nonconformance, action to correct, and action to prevent recurrence."

See related EN#42508.