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Event Notification Report for January 20, 2010

U.S. Nuclear Regulatory Commission
Operations Center

EVENT REPORTS FOR
01/19/2010 - 01/20/2010

EVENT NUMBERS
45642460744564145639

Fuel Cycle Facility
Event Number: 45642
Facility: NUCLEAR FUEL SERVICES INC.
Region: 2     State: TN
Unit: [] [] []
RX Type: URANIUM FUEL FABRICATION
Comments: HEU CONVERSION & SCRAP RECOVERY
NAVAL REACTOR FUEL CYCLE
LEU SCRAP RECOVERY
NRC Notified By: RANDY SHACKELFORD
HQ OPS Officer: DONG HWA PARK
Notification Date: 01/20/2010
Notification Time: 20:16 [ET]
Event Date: 01/20/2010
Event Time: 19:35 [EST]
Last Update Date: 03/18/2010
Emergency Class: NON EMERGENCY
10 CFR Section:
PART 70 APP A (a)(4) - ALL SAFETY ITEMS UNAVAILABLE
Person (Organization):
MARVIN SYKES (R2DO)
BRIAN SMITH (NMSS)
WILLIAM GOTT (IRD)
FUELS OUO GROUP
Event Text
POTENTIALLY OVERPRESSURIZED UF6 CYLINDERS

"UF6 cylinders are in storage. The cylinders consist of 1s/2s, hoke tubes, and 5A cylinders. The UF6 is contained in the cylinders, which are in DOT shipping containers (20PF1 and 6M containers). Calculations were performed that indicated that the theoretical pressure in some of the cylinders exceeds the service pressure (200psi) and some exceed the hydrostatic test pressure (400psi). DOE literature indicates that the burst pressure for a 5A cylinder is [approximately] 8,000 psi. The age of the cylinders is 1950s [to] 1980s. The potential pressure in the cylinders is estimated to be by liberation of fluorine gas in the cylinders. Access to the areas has been restricted. The path forward consists of further analysis, evaluation, and understanding of the issue. The cylinders potentially contain fluorine gas.

"There were no actual safety consequences to workers, the public, or the environment. The potential consequences are minimal due to restricted access to the areas and the stable condition of the cylinders (i.e., cylinders, shipping containers, building containment).

"UF6 cylinders, shipping containers, building containment provide mitigation. Area sprinklers and smoke detection also provide mitigation. Area security cameras provide assistance for monitoring. Security fire patrols [have been] implemented. Other compensatory measures are being considered that include providing uncharged fire hoses to the areas."

Licensee has informed the NRC Resident Inspector.


* * * UPDATE FROM RANDY SHACKELFORD TO DONG PARK @ 2231 EST ON 01/20/10 * * *

"These are additional compensatory actions that have been and will be put in place:

"1. Verified operability of smoke detection
2. Verified operability of sprinkler system
3. Established fire patrol inspection. (minimum of 1 inspection per hour)
4. Restricted access
5. Hot work restriction in the restricted areas
6. Verified Fire Brigade members on each shift. (minimum of 5 members each shift)
7. Staging one (1) 150 pound dry chemical extinguisher
8. Staging a fire response vehicle
9. Briefing plant superintendent on status with a superintendent turnover each shift."

The licensee has informed the NRC Resident Inspector.

Notified R2DO (Sykes), NMSS EO (Smith), and IRD (Gott).


* * * UPDATE ON 1/22/2010 AT 1609 FROM RIK DROKE TO MARK ABRAMOVITZ * * *

"With regard to the compensatory actions listed in the e-mail dated January 20, 2010, Nuclear Fuel Services, Inc. (NFS) is modifying its commitment to have at least five Fire Brigade members on each shift. Thus, compensatory action No. 6 is being replaced with the following compensatory action:

"NFS has developed a specific pre-fire response plan for the areas where the UF6 cylinders are stored. This plan has been reviewed with the Erwin City Fire Chief. NFS plans to provide one trained Fire Brigade member on each shift who will coordinate the Erwin Fire Department response to a fire incident involving a UF6 cylinder."

Notified R2DO (Sykes), NMSS EO (Smith), and IRD (Gott).


* * * UPDATE ON 3/18/10 AT 1559 EDT FROM JENNIFER WHEELER TO DONALD NORWOOD * * *

Following an extensive review by both NFS and independent experts, the analysis of the issue of UF6 cylinders in storage is now complete. The analysis concluded that the likelihood of a release from the cylinders is low, but even if a release were to occur, the consequences to workers, the public, and the environment would be low. Therefore, the additional compensatory actions that have been in place since January 20, 2010, are being discontinued.

The licensee notified the NRC Resident Inspector.

Notified R2DO (Franke), NMSS EO (McCartin), IRD (McDermott), and Fuels OUO Group via E-mail.


Hospital
Event Number: 46074
Rep Org: WEST VIRGINIA UNIVERSITY HOSPITAL
Licensee: WEST VIRGINIA UNIVERSITY HOSPITAL
Region: 1
City: MORGANTOWN   State: WV
County:
License #: 47-23066-02
Agreement: N
Docket:
NRC Notified By: NASSER RAZMIANFAR
HQ OPS Officer: MARK ABRAMOVITZ
Notification Date: 07/07/2010
Notification Time: 11:37 [ET]
Event Date: 01/20/2010
Event Time: 00:00 [EDT]
Last Update Date: 07/07/2010
Emergency Class: NON EMERGENCY
10 CFR Section:
35.3045(a)(1) - DOSE <> PRESCRIBED DOSAGE
Person (Organization):
ANTHONY DIMITRIADIS (R1DO)
ANGELA MCINTOSH (FSME)
Event Text
MEDICAL TREATMENT TERMINATED PRIOR TO ADMINISTERING FULL DOSE

A patient's liver was being treated using SIR-Spheres through a catheter. During the administration of the Y-90 SIR-Spheres, the physician believed that there was leakage around the stopper and halted the medical procedure with only 21.9 mCi administered instead of the complete dose of 30.7 mCi i.e. 71% of the prescribed dose. The manufacturer was notified of the potential manufacturing defect and the hospital was directed to ship the delivery apparatus (as is) back to the manufacturer after the Y-90 had decayed. The equipment was returned to the manufacturer on April 5, 2010 and a report was received from the manufacturer on June 21, 2010. "The manufacturer noted that there was leaking but could not conclude that it was a manufacturer defect or if the physician applied too much pressure to the V-vial during the procedure." The patient was notified of the dose received.

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
Event Number: 45641
Facility: PRAIRIE ISLAND
Region: 3     State: MN
Unit: [1] [2] []
RX Type: [1] W-2-LP,[2] W-2-LP
NRC Notified By: STEVE INGALLS
HQ OPS Officer: DONG HWA PARK
Notification Date: 01/20/2010
Notification Time: 17:10 [ET]
Event Date: 01/20/2010
Event Time: 13:17 [CST]
Last Update Date: 01/20/2010
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(2)(xi) - OFFSITE NOTIFICATION
Person (Organization):
PATTY PELKE (R3DO)
MARK CUNNINGHAM (NRR)
WILLIAM GOTT (IRD)
Power Reactor Unit Info
Unit SCRAM Code RX Crit Initial PWR Initial RX Mode Current PWR Current RX Mode
1 N Y 100 Power Operation 100 Power Operation
2 N Y 100 Power Operation 100 Power Operation
Event Text
OFFSITE FIREFIGHTING ASSISTANCE FOR FIRE IN A NON-SAFEGUARDS DIESEL GENERATOR

"While testing, a fire occurred in the D3 Non-Safeguards Diesel Generator at 1317 [CST]. CO2 was applied and at 1337 [CST], the fire was extinguished. A re-flash occurred at 1413 [CST] requiring further fire brigade and fire department action and was extinguished at 1455 [CST].

"No injuries resulted from this fire and it was contained to the D3 Building. The D3 Building is not adjacent or contiguous to any vital areas, and therefore, entry into Emergency Action Levels was not required. This fire did not pose a threat to the safe operation of the plant.

"The Red Wing Fire Department was called and arrived on site to assist the plant fire brigade. This resulted in declaring a media sensitive event requiring government agency notifications, and therefore, the need for this report.

"The investigation of the cause and extent of damage is ongoing. The [NRC] Resident Inspector has been informed."


General Information or Other
Event Number: 45639
Rep Org: FLORIDA BUREAU OF RADIATION CONTROL
Licensee: GFA INC.
Region: 1
City: DORAL   State: FL
County:
License #: 3021-1
Agreement: Y
Docket:
NRC Notified By: STEVE FURNACE
HQ OPS Officer: VINCE KLCO
Notification Date: 01/20/2010
Notification Time: 13:22 [ET]
Event Date: 01/20/2010
Event Time: 00:00 [EST]
Last Update Date: 02/16/2010
Emergency Class: NON EMERGENCY
10 CFR Section:
Person (Organization):
RONALD BELLAMY (R1DO)
ANGELA MCINTOSH (FSME)
MATTHEW HAHN (ILTA)
Event Text
AGREEMENT STATE REPORT- STOLEN TROXLER MOISTURE DENSITY GAUGE

According to the Radiation Safety Officer, the operator was at a Kinko's store making copies. The Troxler gauge was locked in a case which was locked and chained to the truck in the parking lot. The chain was cut and the gauge was stolen. The licensee will offer a reward. The theft has been reported to the local police department. The incident has been assigned to the Miami Inspection Office for investigation.

The gauge is a Troxler model 3430, serial number 34898, containing 40 mCi of Am-241/Be and 8 mCi of Cs-137.

Florida Incident Number FL10-007.

* * * UPDATE FROM STEVE FURNACE TO JOE O'HARA AT 0935 ON 2/16/10 * * *

"[The] gauge [was] found on 2/15/10 in Miami, FL. The gauge will be operationally checked and leak tested. This office [state] will take no further action on this incident."

Notified R1DO (Jackson), FSME Day EO(McIntosh), and ILTAB(Pearson).

THIS MATERIAL EVENT CONTAINS A "LESS THAN CAT 3" LEVEL OF RADIOACTIVE MATERIAL

Sources that are "Less than IAEA Category 3 sources," are either sources that are very unlikely to cause permanent injury to individuals or contain a very small amount of radioactive material that would not cause any permanent injury. Some of these sources, such as moisture density gauges or thickness gauges that are Category 4, the amount of unshielded radioactive material, if not safely managed or securely protected, could possibly - although it is unlikely - temporarily injure someone who handled it or were otherwise in contact with it, or who were close to it for a period of many weeks. For additional information go to http://www-pub.iaea.org/MTCD/publications/PDF/Pub1227_web.pdf

This source is not amongst those sources or devices identified by the IAEA Code of Conduct for the Safety & Security of Radioactive Sources to be of concern from a radiological standpoint. Therefore is it being categorized as a less than Category 3 source