EA-04-096 - Westinghouse Electric Company

July 28, 2004

EA-04-096
NMED No. 040169

Westinghouse Electric Company
ATTN: Mr. M. Fecteau, Manager
Columbia Plant
Commercial Nuclear Fuel Division
Drawer R
Columbia, SC 29250

SUBJECT:

NOTICE OF VIOLATION AND PROPOSED IMPOSITION OF CIVIL PENALTY, $24,000 (NRC INSPECTION REPORT NO. 70-1151/2004-001)

Dear Mr. Fecteau:

This refers to the inspection conducted on April 12-16, 2004, at the Columbia Nuclear Fuel Plant. The purpose of the inspection was to determine whether activities authorized by the license were conducted safely and in accordance with NRC requirements. At the conclusion of this inspection, the findings were discussed with those members of your staff identified in the report. The inspection report documenting the findings, including the identification of nine apparent violations, was issued by NRC letter dated May 13, 2004. The inspection report documented the NRC's initial review of the circumstances surrounding your discovery of uranium ash deposits in the incinerator off-gas system at concentrations that exceeded the bounding assumptions of the approved safety basis. Westinghouse Electric Company (WEC) reported this condition to the NRC on March 5, 2004.

On June 3, 2004, a predecisional enforcement conference was conducted in the Region II office with you and members of your staff to discuss the apparent violations, their significance, their root causes, and your corrective actions. A listing of conference attendees, material presented by the NRC, and material presented by WEC were included in the meeting summary forwarded to you on June 15, 2004.

Based on the information developed during the inspection, the information you provided during the conference, and the information you provided subsequent to the conference, the NRC has determined that eight violations of NRC requirements occurred. The violations and the circumstances surrounding them are described in detail in the subject inspection report. The violations involved: (1) the failure to control the uranium concentration in the incinerator system within the sub-critical limit by allowing concentration of uranium in ash to exceed the minimum infinite critical concentration; (2) failure to implement a specifically identified control by failing to regularly perform radiological surveys of the incinerator cross-over pipe; (3) failure to incorporate sufficient margins of safety to require at least two unlikely, independent, and concurrent changes in process conditions in the incinerator system before a criticality accident was possible; (4) failure to establish controls to maintain concentration to ensure that incinerator ash was less than the minimum infinite critical concentration for uranium in the incinerator off-gas system; (5) failure to establish controls to maintain concentration to ensure that incinerator ash was less than the minimum infinite critical concentration for uranium in the incinerator ash handling system; (6) failure to communicate to appropriate operations personnel the bounding assumption of uranium concentration being limited to the minimum infinite critical concentration for uranium in the incinerator system; (7) failure of licensee personnel to perform an adequate independent technical review and confirmation of incinerator criticality safety evaluation conclusions during initial preparation or subsequent revisions; and (8) failure to identify that less than previously documented double contingency protection remained and to notify the NRC during a nuclear criticality safety (NCS) review of a 1998 event involving excess mass accumulation in the incinerator cross-over pipe. Based on the additional information provided by WEC at the conference regarding apparent violation 70-1151/2004-001-09, the NRC has concluded that this issue does not represent a violation of regulatory requirements.

There were no actual consequences as a result of the accumulation of uranium ash deposits in the incinerator system because the actual mass of ash would not support criticality at the concentration and geometry in which it was found. However, the potential consequences were significant because there was a failure to establish, implement, and maintain all criticality controls (or control systems) for a single nuclear criticality scenario when a critical mass of fissile material was reasonably available, such that a nuclear criticality accident was possible.

With regard to the lack of criticality controls, we note that because WEC concluded in its safety basis that criticality in the upper combustion chamber, cross-over pipe, and off-gas system was not credible, WEC did not establish uranium mass or concentration controls or controls on the available moderator for these areas of the incinerator. The lack of mass and concentration controls and the lack of any routine checking or cleaning of the upper combustion chamber and cross-over pipe allowed increasing accumulations of uranium ash in greater concentrations between each cleaning of the incinerator for a period of several years. In fact, at the time this condition was discovered, uranium ash accumulation had been progressing towards a critical mass for approximately 18 months, and this condition could have continued unabated for a significant time since there was no formal schedule to check for ash accumulation. It was also noted that there was no correlation between mass in the upper chamber and plugging of the cross-over piping (which would indicate the need for the initiation of cleaning) because there was more mass in the upper chamber at the time of this event than when the cross-over pipe was previously plugged.

With regard to the availability of a critical mass, the as-found mass in the cross-over pipe could have combined with the as-found masses in the upper and lower chambers such that the possibility for a criticality could not have been ruled out. Additionally, WEC's changes in incinerator operations did not adequately consider the effect of operational changes on uranium mass accumulation, uranium concentration changes, and the impact on the potential for inadvertent criticality. The physical configuration of the upper combustion chamber would allow uranium ash to accumulate in an unfavorable geometry, and this configuration, as well as the absence of controls on moderator, a large supply of which was available from city water, resulted in a significant increase in the likelihood of a nuclear criticality event.

Based on the above, the NRC concluded that there was a failure to establish, implement, and maintain all criticality controls (or control systems) for a single nuclear criticality scenario when a critical mass of fissile material was reasonably available, such that a nuclear criticality accident was possible. In that the violations discussed above contributed to the condition at issue, these violations are categorized collectively in accordance with the "General Statement of Policy and Procedure for NRC Enforcement Actions" (Enforcement Policy), NUREG-1600, as a Severity Level II problem.

In accordance with the Enforcement Policy, a base civil penalty in the amount of $24,000 is considered for a Severity Level II violation (problem). Because this issue has been characterized at Severity Level II, the NRC considered the factors of Identification and Corrective Action in accordance with the civil penalty assessment process in Section VI.C.2 of the Enforcement Policy. These issues were identified by WEC during its technical review of a proposed procedural change involving the incinerator off-gas system, and at the conference, WEC presented its corrective actions taken in response to these issues. Corrective actions included the shutdown of the incinerator pending an investigation and resolution of system and other issues that led to the event, training and qualification of process engineering personnel involved in the integrated safety analysis process, improved communications between work groups, enhancements to the NCS analysis program, design verification process improvements to ensure implementation of lessons learned through operating experience, and the development of a schedule for incinerator system design modifications including the favorable geometry off-gas and ash handling system modifications. Implementation of design modifications are underway, with the tentative completion of the operational verification and final design review by March of 2005. In addition, by letter of April 27, 2004, WEC committed to obtaining NRC concurrence prior to restart of the incinerator process. Additional corrective actions were presented at the conference by WEC including those to improve management oversight and control.

Notwithstanding your self identification of the issue and your corrective actions, the NRC also considers the exercise of discretion to propose a civil penalty for problems categorized at Severity Level II, in accordance with Section VII.A.1 of the Enforcement Policy. The NRC has concluded that the exercise of discretion is warranted in this case because the factors discussed above collectively resulted in a significant increase in the likelihood of a nuclear criticality event. Therefore, in recognition of the potential safety significance of this issue, I have been authorized, after consultation with the Director, Office of Enforcement, and the Deputy Executive Director for Materials, Research, and State Programs, to exercise discretion and to issue the enclosed Notice of Violation and Proposed Imposition of Civil Penalty in the base amount of $24,000 for the Severity Level II problem.

You are required to respond to this letter and should follow the instructions specified in the enclosed Notice when preparing your response. The NRC will use your response, in part, to determine whether further enforcement action is necessary to ensure compliance with regulatory requirements.

In accordance with 10 CFR 2.390 of NRC's "Rules of Practice," a copy of this letter and its enclosures will be available electronically for public inspection in NRC's Public Document Room or from the Publicly Available Records (PARS) component of the NRC's document system (ADAMS). ADAMS is accessible from the NRC Web site at the Public NRC Library. The NRC also includes Issued Significant Enforcement Actions on its Web site.

Should you have any questions concerning this letter, please contact us.

		Sincerely,
		/RA/
		William D. Travers Regional Administrator

Docket No. 70-1151
License No. SNM-1107

Enclosures:
1. Notice of Violation and Proposed Imposition of Civil Penalty
2. NUREG/BR-0254 Payment Methods (Licensee only)

cc w/encls:
Sam McDonald, Manager
Environment, Health and Safety
Commercial Nuclear Fuel Division
Westinghouse Electric Corporation
P. O. Box R
Columbia, SC 29250

Henry J. Porter, Assistant Director
Div. of Radioactive Waste Mgmt.
Dept. of Health and Environmental
Control
Electronic Mail Distribution

R. Mike Gandy
Division of Radioactive Waste Mgmt.
S. C. Department of Health and
Environmental Control
Electronic Mail Distribution

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NOTICE OF VIOLATION
AND
PROPOSED IMPOSITION OF CIVIL PENALTY

Westinghouse Electric Company Columbia, South Carolina

Docket No. 70-1151 License No. SNM-1107 EA-04-096

During an NRC inspection completed on April 16, 2004, violations of NRC requirements were identified. In accordance with the "General Statement of Policy and Procedure for NRC Enforcement Actions," NUREG-1600, the NRC proposes to impose a civil penalty pursuant to Section 234 of the Atomic Energy Act of 1954, as amended (Act), 42 U.S.C. 2282, and 10 CFR 2.205. The particular violations and associated civil penalty are set forth below:

	Safety Condition No. S-1 of Special Nuclear Material License (SNM) No. 1107 requires that material be used in accordance with statements, representations, and conditions in the License Application dated April 30, 1995, and supplements thereto.
	1.	Section 6.1.3 of the License Application states in part that nuclear criticality safety (NCS) will be achieved by controlling one or more parameters of a system within subcritical limits. Section 6.2.3(a) of the License Application states in part that with respect to credible abnormal conditions that could lead to single contingency protection, there will be sufficient margin of safety to ensure that, based on these parameters, the 95/95 keff is < 0.98 including all applicable biases and calculated parameters. The criticality safety analysis (CSA) for the incinerator contained in integrated safety analysis (ISA), Section 5.3.4.9 states in part that controlling the uranium concentration of the incinerator feed also serves the purpose of ensuring that the resulting ash is less than the 21.6 wt% minimum infinite critical concentration for mass. Contrary to the above, from September 1996 until March 2004, the licensee failed to control the uranium concentration in the incinerator system within the subcritical limit of keff < 0.98 by allowing concentration of uranium in ash to exceed 21.6 wt%, the minimum infinite critical concentration for mass. Specifically, the maximum concentration of uranium in incinerator ash was determined to be 28.9 wt% in December 1996, 23.3 wt% in November 1998, 27.2 wt% in September 2000, 24.1 wt% in November 2001, and 27.2 wt% in September 2002.
	2.	Section 6.1.1 of the License Application states in part that CSAs and evaluations are utilized to identify the specific limits and controls necessary for the safe and effective operation of a process. The CSA contained in ISA, Revision 1, "Incinerator," dated March 31, 1999, Section 5.3.4.5.3, states in part that, as a safety precaution, the cross-over pipe is surveyed regularly by the health physics function. Contrary to the above, from September 1996 until March 2004, the licensee health physics function failed to implement a specifically identified control by failing to regularly perform radiological surveys of the incinerator cross-over pipe.
	3.	Section 6.1.1 of the License Application states in part that the double contingency principle will be the basis for design and operation of processes using special nuclear material. Double contingency protection means that all process designs will incorporate sufficient margins of safety to require at least two unlikely, independent, and concurrent changes in process conditions before a criticality accident is possible. Contrary to the above, from September 1996 until March 2004, the licensee failed to incorporate sufficient margins of safety to require at least two unlikely, independent, and concurrent changes in process conditions in the incinerator system before a criticality accident was possible.
	4.	Section 6.1.3.e.1 of the License Application states in part that limiting concentration may be used for NCS control of systems within the facility and, when utilized, that controls will be established to ensure that the concentration level is maintained within the analyzed system defined limits. The CSA for the incinerator contained in ISA Section 5.3.4.9 states in part that controlling the uranium concentration of the incinerator feed also serves the purpose of ensuring that the resulting ash is less than the 21.6 wt% minimum infinite critical concentration for mass. Contrary to the above, from September 1996 until March 2004, the licensee used limiting concentration as a criticality safety control for the incinerator system but failed to establish controls to maintain concentration to ensure that incinerator ash was less than the minimum infinite critical concentration for mass in the incinerator off-gas system. Specifically, the maximum concentration of uranium in the incinerator off-gas system ash was determined to be 28.9 wt% in December 1996, 23.3 wt% in November 1998, 27.2 wt% in September 2000, 24.1 wt% in November 2001, and 27.0 wt% in September 2002.
	5.	Section 6.1.3.e.1 of the License Application states in part that controls will be established to ensure that the concentration level is maintained within the analyzed system defined limits. The CSA for the incinerator contained in ISA Section 5.3.4.9 states in part that controlling the uranium concentration of the incinerator feed also serves the purpose of ensuring that the resulting ash is less than the 21.6 wt% minimum infinite critical concentration for mass. Contrary to the above, from September 1996 until March 2004, the licensee failed to establish controls to maintain concentration to ensure that incinerator ash was less than the minimum infinite critical concentration for mass in the incinerator ash handling system. Specifically, the maximum concentration of uranium in the incinerator ash handling system ash was determined to be 22.6 wt% in September 2000, and 27.2 wt% in September 2002.
	6.	Section 6.1.3.j.1 of the License Application states in part that the bounding assumptions will be defined through the CSAs, criticality safety evaluations (CSE), or ISA process; that operational limits will be identified within each specific analysis; and that this will be communicated through training and procedures to appropriate operations personnel. The CSA for the incinerator contained in ISA Section 5.3.4.9 states in part that controlling the uranium concentration of the incinerator feed also serves the purpose of ensuring that the resulting ash is less than the minimum infinite critical concentration for mass. Contrary to the above, from September 1996 until March 2004, the licensee failed to communicate the bounding assumption that uranium concentration was limited to the minimum infinite critical concentration for mass in the incinerator system to the engineering staff in the Uranium Recovery and Recycle Systems organization.
	7.	License Application Section 3.4.1 states in part that operations to assure safe compliant activities involving nuclear material will be conducted in accordance with approved procedures. Licensee Procedure RA 310, Section 6.3.1B, requires in part that NCS independent technical reviewers confirm CSE conclusions including supplements and revisions. The CSE for incinerator ash handling contained in ISA Section 5.3.5.9 states in part that ash in the low-level radioactive waste (LLWR) incineration process does not exceed 15 wt% uranium. Contrary to the above, during initial preparation in 1996 or subsequent revisions between 1996 and 2004, licensee NCS independent technical reviewers failed to confirm the conclusion in the incinerator ash handling CSE that ash in the low-level radioactive waste (LLWR) incineration process does not exceed 15 wt% uranium.
	8.	License Application Section 3.4.1 states in part that operations to assure safe compliant activities involving nuclear material will be conducted in accordance with approved procedures. Licensee Procedure RA 107, Section 8.5, requires in part that a 24-hour notification to the NRC be made for any NCS event, in an analyzed system, for which less than previously documented double contingency protection remains. Contrary to the above, licensee personnel failed to identify that less than previously documented double contingency protection remained and failed to notify the NRC during an NCS review of a 1998 event involving excess mass accumulation in the incinerator cross-over pipe.
	This is a Severity Level II problem (Supplement VI). Civil Penalty - $24,000

Pursuant to the provisions of 10 CFR 2.201, Westinghouse Electric Company is hereby required to submit a written statement or explanation to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, within 30 days of the date of this Notice of Violation and Proposed Imposition of Civil Penalty (Notice). This reply should be clearly marked as a "Reply to a Notice of Violation; EA-04-096" and should include: (1) admission or denial of the alleged violation, (2) the reasons for the violation if admitted, and if denied, the reasons why, (3) the corrective steps that have been taken and the results achieved, (4) the corrective steps that will be taken to avoid further violations, and (5) the date when full compliance will be achieved. Your response may reference or include previously docketed correspondence if the correspondence adequately addresses the required response. If an adequate reply is not received within the time specified in this Notice, an order or a Demand for Information may be issued as to why the license should not be modified, suspended, or revoked or why such other action as may be proper should not be taken. Consideration may be given to extending the response time for good cause shown.

Within the same time as provided for the response required above under 10 CFR 2.201, the Licensee may pay the civil penalty proposed above in accordance with NUREG/BR-0254 and by submitting to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, a statement indicating when and by what method payment was made, or may protest imposition of the civil penalty in whole or in part by a written answer addressed to the Director, Office of Enforcement, U.S. Nuclear Regulatory Commission. Should the Licensee fail to answer within 30 days of the date of this Notice, an order imposing the civil penalty will be issued. Should the licensee elect to file an answer in accordance with 10 CFR 2.205 protesting the civil penalty, in whole or in part, such answer should be clearly marked as an "Answer to a Notice of Violation" and may: (1) deny the violation listed in this Notice, in whole or in part, (2) demonstrate extenuating circumstances, (3) show error in this Notice, or (4) show other reasons why the penalty should not be imposed. In addition to protesting the civil penalty in whole or in part, such answer may request remission or mitigation of the penalty.

In requesting mitigation of the proposed penalty, the factors addressed in Section VI.C.2 of the Enforcement Policy should be addressed. Any written answer in accordance with 10 CFR 2.205 should be set forth separately from the statement or explanation in reply pursuant to 10 CFR 2.201, but may incorporate parts of the 10 CFR 2.201 reply by specific reference (e.g., citing page and paragraph numbers) to avoid repetition. The attention of the licensee is directed to the other provisions of 10 CFR 2.205 regarding the procedure for imposing a civil penalty.

Upon failure to pay any civil penalty due which subsequently has been determined in accordance with the applicable provisions of 10 CFR 2.205, this matter may be referred to the Attorney General, and the penalty, unless compromised, remitted, or mitigated, may be collected by civil action pursuant to Section 234c of the Act, 42 U.S.C. 2282c.

The response noted above (Reply to Notice of Violation, statement as to payment of civil penalty, and Answer to a Notice of Violation) should be addressed to: Frank Congel, Director, Office of Enforcement, U.S. Nuclear Regulatory Commission, One White Flint North, 11555 Rockville Pike, Rockville, MD 20852-2738, with a copy to the Regional Administrator, U.S. Nuclear Regulatory Commission, Region II, and a copy to the NRC Resident Inspector at the facility that is the subject of this Notice.

Because your response will be made available electronically for public inspection in the NRC Public Document Room or from the NRC's document system (ADAMS), to the extent possible, it should not include any personal privacy, proprietary, or safeguards information so that it can be made available to the public without redaction. ADAMS is accessible from the NRC Web site at the Public NRC Library. If personal privacy or proprietary information is necessary to provide an acceptable response, then please provide a bracketed copy of your response that identifies the information that should be protected and a redacted copy of your response that deletes such information. If you request withholding of such material, you must specifically identify the portions of your response that you seek to have withheld and provide in detail the bases for your claim of withholding (e.g., explain why the disclosure of information will create an unwarranted invasion of personal privacy or provide the information required by 10 CFR 2.390(b) to support a request for withholding confidential commercial or financial information). If safeguards information is necessary to provide an acceptable response, please provide the level of protection described in 10 CFR 73.21.

In accordance with 10 CFR 19.11, you may be required to post this Notice within two working days.

Dated this 28^th day of July 2004