The U.S. Nuclear Regulatory Commission is in the process of rescinding or revising guidance and policies posted on this webpage in accordance with Executive Order 14151 Ending Radical and Wasteful Government DEI Programs and Preferencing, and Executive Order 14168 Defending Women From Gender Ideology Extremism and Restoring Biological Truth to the Federal Government. In the interim, any previously issued diversity, equity, inclusion, or gender-related guidance on this webpage should be considered rescinded that is inconsistent with these Executive Orders.

Event Notification Report for February 18, 1999

                    U.S. Nuclear Regulatory Commission
                              Operations Center

                              Event Reports For
                           02/17/1999 - 02/18/1999

                              ** EVENT NUMBERS **

35361  35373  35374  35375  35376  35377  35378  35379  35380  35381  

+------------------------------------------------------------------------------+
|Fuel Cycle Facility                              |Event Number:   35361       |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| FACILITY: PORTSMOUTH GASEOUS DIFFUSION PLANT   |NOTIFICATION DATE: 02/10/1999|
|   RXTYPE: URANIUM ENRICHMENT FACILITY          |NOTIFICATION TIME: 11:19[EST]|
| COMMENTS: 2 DEMOCRACY CENTER                   |EVENT DATE:        02/10/1999|
|           6903 ROCKLEDGE DRIVE                 |EVENT TIME:        07:00[EST]|
|           BETHESDA, MD 20817    (301)564-3200  |LAST UPDATE DATE:  02/17/1999|
|    CITY:  PIKETON                  REGION:  3  +-----------------------------+
|  COUNTY:  PIKE                      STATE:  OH |PERSON          ORGANIZATION |
|LICENSE#:  GDP-2                 AGREEMENT:  N  |GARY SHEAR           R3      |
|  DOCKET:  0707002                              |SCOTT MOORE          NMSS    |
+------------------------------------------------+FRANK CONGEL         IRO     |
| NRC NOTIFIED BY:  ERIC SPAETH                  |BOB PIERSON          NMSS    |
|  HQ OPS OFFICER:  JOHN MacKINNON               |                             |
+------------------------------------------------+                             |
|EMERGENCY CLASS:          N/A                   |                             |
|10 CFR SECTION:                                 |                             |
|NBNL                     RESPONSE-BULLETIN      |                             |
|                                                |                             |
|                                                |                             |
|                                                |                             |
|                                                |                             |
+------------------------------------------------------------------------------+

                                   EVENT TEXT                                   
+------------------------------------------------------------------------------+
| NRC BULLETIN 91-01, 4-HOUR NOTIFICATION INVOLVING INCORRECT RAFFINATE MASS   |
| AND CONCENTRATION CALCULATION                                                |
|                                                                              |
| On 02/10/99, X-705 building personnel discovered that a Nuclear Criticality  |
| Safety Approval (NCSA) requirement had not been maintained in the X-705      |
| Decontamination Facility.  Uranium recovery waste stream solutions are       |
| sampled to determine the U-235 concentration, mass, and enrichment as        |
| spelled out in NCSA-0705_027, Heavy Metals Precipitation.  These sample      |
| results are used to calculate U-235 concentration and U-235 mass prior to    |
| transferring and processing the waste solutions as identified in the         |
| administrative requirements of the NCSA.                                     |
|                                                                              |
| Sample results for raffinate solutions (recovery waste streams) were         |
| recorded incorrectly on the raffinate transfer sheet and the heavy metals    |
| batch sheets. The double contingency principle was violated as result of:    |
| 1) failure of the operator to correctly determine the U-235 concentration    |
| prior to transfer (control "A") and 2) failure of supervision to find the    |
| error while verifying the data and calculations (control "B"). This error    |
| resulted in solution being transferred and processed to a geometrically      |
| unfavorable sludge collection tub without the correct U-235 concentration    |
| and U-235 mass being recorded.                                               |
|                                                                              |
| There was no loss of hazardous/radioactive material or radioactive           |
| radiological contamination exposure as a result of this event.               |
|                                                                              |
| SAFETY SIGNIFICANCE OF EVENTS:  The safety significance of this event is     |
| low.  This is because when this material was sampled for enrichment, the     |
| enrichment was found to be 3.95% U-235.  Also, due to the reduction of HEU   |
| material on site, material now being processed through the heavy metals      |
| systems routinely has an enrichment less than 10% U-235.                     |
|                                                                              |
| POTENTIAL CRITICALITY PATHWAYS INVOLVED (BRIEF SCENARIO[S] OF HOW            |
| CRITICALITY COULD OCCUR):  For a criticality to occur, both calculations of  |
| how much material is in the system must be wrong and the total mass of       |
| material must exceed 760 grams U-235.  The minimum critical mass for 100%    |
| enriched material is approximately 760 grams U-235.  Even if the enrichment  |
| had been 100%, the total mass in the system as a result of this event would  |
| have been 245 grams.                                                         |
|                                                                              |
| Also, a second path would be the processing material and collecting material |
| with greater than the minimum critical mass in the heavy metals collection   |
| drums.                                                                       |
|                                                                              |
| CONTROLLED PARAMETERS (MASS, MODERATION, GEOMETRY. CONCENTRATION, ETC.):     |
| The controlled parameter in this case was mass.  (Both of the mass controls  |
| were lost because the calculations were in error.)                           |
|                                                                              |
| ESTIMATED AMOUNT, ENRICHMENT, FORM OF LICENSED MATERIAL (INCLUDE PROCESS     |
| LIMIT AND % WORST CASE OF CRITICAL MASS):  The total amount of material in   |
| the system was 245 grams U-235 assuming an enrichment of 100%.  The          |
| enrichment was measured after the event and found to be 3.95% U-235.  The    |
| material was uranium solution.  The minimum critical mass at 100% enrichment |
| is approximately 760 grams U-235, and using the 100% enriched values, the    |
| percent worst case critical mass is 32.2%.                                   |
|                                                                              |
| NUCLEAR CRITICALITY SAFETY CONTROL(S) OR CONTROL SYSTEM(S) AND DESCRIPTION   |
| OF THE FAILURES OR DEFICIENCIES:  NCSA-0705_027 requires that material to be |
| processed through the heavy metals recovery system is sampled and the total  |
| amount of uranium in the material calculated and recorded by an operator on  |
| a transfer sheet and verified by another operator or supervisor on the same  |
| sheet.  If the enrichment of the sample is not known, an enrichment of 100%  |
| is assumed for the calculation.  The total amount of U-235 allowed to be     |
| processed at any time is limited to 200 grams.  The calculations done by     |
| both the operator and the verifier used a concentration value ten times less |
| than the actual enrichment, which was only 3.95%.                            |
|                                                                              |
| CORRECTIVE ACTIONS TO RESTORE SAFETY SYSTEM AND WHEN EACH WAS IMPLEMENTED:   |
| The heavy metals precipitation was shutdown and isolated.  Similar           |
| operations (microfiltration filter press and oil and grease removal unit )   |
| were also shut down and isolated.  An investigation has been initiated to    |
| determine if similar anomalous conditions exists in those operations.        |
|                                                                              |
| The NRC resident inspector has been informed of this event by the Portsmouth |
| personnel.                                                                   |
|                                                                              |
| *************** UPDATE AT 1825 ON 02/17/99 FROM JOE HALCOMB RECEIVED BY      |
| TROCINE ***************                                                      |
|                                                                              |
| On 02/10/99, the error in the mass values for the sludge collection drum was |
| corrected.   This changed the total  U-235 mass in the drum from 43.02 grams |
| to 139.78 grams.  This value is below the NCSA limit of 200 grams.           |
|                                                                              |
| Portsmouth personnel notified the NRC resident inspector.  The NRC           |
| operations officer notified the R3DO (Jordan), NMSS EO (Haughney), and IRO   |
| (Hogan).                                                                     |
+------------------------------------------------------------------------------+

+------------------------------------------------------------------------------+
|Power Reactor                                    |Event Number:   35373       |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| FACILITY: SALEM                    REGION:  1  |NOTIFICATION DATE: 02/17/1999|
|    UNIT:  [] [2] []                 STATE:  NJ |NOTIFICATION TIME: 02:16[EST]|
|   RXTYPE: [1] W-4-LP,[2] W-4-LP                |EVENT DATE:        02/17/1999|
+------------------------------------------------+EVENT TIME:        02:02[EST]|
| NRC NOTIFIED BY:  STEVE SAUER                  |LAST UPDATE DATE:  02/17/1999|
|  HQ OPS OFFICER:  DICK JOLLIFFE                +-----------------------------+
+------------------------------------------------+PERSON          ORGANIZATION |
|EMERGENCY CLASS:          N/A                   |JIM TRAPP            R1      |
|10 CFR SECTION:                                 |                             |
|ASHU 50.72(b)(1)(i)(A)   PLANT S/D REQD BY TS   |                             |
|NLCO                     TECH SPEC LCO A/S      |                             |
|                                                |                             |
|                                                |                             |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|UNIT |SCRAM CODE|RX CRIT|INIT PWR|   INIT RX MODE  |CURR PWR|  CURR RX MODE   |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|                                                   |                          |
|2     N          Y       100      Power Operation  |98       Power Operation  |
|                                                   |                          |
+------------------------------------------------------------------------------+
                                   EVENT TEXT                                   
+------------------------------------------------------------------------------+
| - TECH SPEC REQUIRED PLANT SHUTDOWN DUE TO A 28 VOLT DC BATTERY CELL TESTING |
| LOW -                                                                        |
|                                                                              |
| AT 0202 ON 02/17/99, DURING THE PERFORMANCE OF A QUARTERLY SURVEILLANCE      |
| TEST, THE VOLTAGE OF ONE OF THE 28 VOLT DC BATTERY CELLS TESTED AT 2.11 VDC. |
| THE TECH SPEC MINIMUM LIMIT IS 2.13 VDC.  TECH SPEC LCO A/S 3.8.2.5 REQUIRES |
| THE LICENSEE TO REPLACE THE AFFECTED CELL IN TWO HOURS OR PLACE UNIT 2 IN    |
| THE HOT STANDBY MODE WITHIN SIX HOURS.  THE LICENSEE PLANS TO REPLACE THE    |
| AFFECTED CELL WITHIN TWO HOURS.                                              |
|                                                                              |
| THE LICENSEE INFORMED THE NRC RESIDENT INSPECTOR.                            |
|                                                                              |
| * * * UPDATE AT 0354 ON 02/17/99 FROM STEVE SAUER TO JOLLIFFE * * *          |
|                                                                              |
| AT 0351 ON 02/17/99, THE LICENSEE REPLACED THE AFFECTED BATTERY CELL AND     |
| EXITED TECH SPEC LCO A/S 3.8.2.5.                                            |
|                                                                              |
| THE LICENSEE PLANS TO  INFORM THE NRC RESIDENT INSPECTOR.  THE NRC           |
| OPERATIONS OFFICER NOTIFIED THE R1DO JIM TRAPP.                              |
+------------------------------------------------------------------------------+

+------------------------------------------------------------------------------+
|Power Reactor                                    |Event Number:   35374       |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| FACILITY: LIMERICK                 REGION:  1  |NOTIFICATION DATE: 02/17/1999|
|    UNIT:  [1] [2] []                STATE:  PA |NOTIFICATION TIME: 03:50[EST]|
|   RXTYPE: [1] GE-4,[2] GE-4                    |EVENT DATE:        02/17/1999|
+------------------------------------------------+EVENT TIME:        02:50[EST]|
| NRC NOTIFIED BY:  CARL RICH                    |LAST UPDATE DATE:  02/17/1999|
|  HQ OPS OFFICER:  DICK JOLLIFFE                +-----------------------------+
+------------------------------------------------+PERSON          ORGANIZATION |
|EMERGENCY CLASS:          N/A                   |JIM TRAPP            R1      |
|10 CFR SECTION:                                 |                             |
|DDDD 73.71               UNSPECIFIED PARAGRAPH  |                             |
|                                                |                             |
|                                                |                             |
|                                                |                             |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|UNIT |SCRAM CODE|RX CRIT|INIT PWR|   INIT RX MODE  |CURR PWR|  CURR RX MODE   |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|1     N          Y       100      Power Operation  |100      Power Operation  |
|2     N          Y       100      Power Operation  |100      Power Operation  |
|                                                   |                          |
+------------------------------------------------------------------------------+
                                   EVENT TEXT                                   
+------------------------------------------------------------------------------+
| - PLANT SECURITY REPORT -                                                    |
|                                                                              |
| A COMPROMISE OF PLANT SECURITY DOCUMENT WAS DISCOVERED.  COMPENSATORY        |
| MEASURES WERE IMMEDIATELY TAKEN UPON DISCOVERY.  CONTACT THE NRC OPERATIONS  |
| OFFICER FOR ADDITIONAL DETAILS.                                              |
|                                                                              |
| THE LICENSEE PLANS TO INFORM THE NRC RESIDENT INSPECTOR.                     |
+------------------------------------------------------------------------------+

+------------------------------------------------------------------------------+
|Power Reactor                                    |Event Number:   35375       |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| FACILITY: QUAD CITIES              REGION:  3  |NOTIFICATION DATE: 02/17/1999|
|    UNIT:  [] [2] []                 STATE:  IL |NOTIFICATION TIME: 05:16[EST]|
|   RXTYPE: [1] GE-3,[2] GE-3                    |EVENT DATE:        02/17/1999|
+------------------------------------------------+EVENT TIME:        00:20[CST]|
| NRC NOTIFIED BY:  DARYL NOHR                   |LAST UPDATE DATE:  02/17/1999|
|  HQ OPS OFFICER:  DICK JOLLIFFE                +-----------------------------+
+------------------------------------------------+PERSON          ORGANIZATION |
|EMERGENCY CLASS:          N/A                   |MIKE JORDAN          R3      |
|10 CFR SECTION:                                 |                             |
|AESF 50.72(b)(2)(ii)     ESF ACTUATION          |                             |
|                                                |                             |
|                                                |                             |
|                                                |                             |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|UNIT |SCRAM CODE|RX CRIT|INIT PWR|   INIT RX MODE  |CURR PWR|  CURR RX MODE   |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|                                                   |                          |
|2     N          Y       100      Power Operation  |100      Power Operation  |
|                                                   |                          |
+------------------------------------------------------------------------------+
                                   EVENT TEXT                                   
+------------------------------------------------------------------------------+
| - UNIT 2 RECEIVED ESF ACTUATIONS DUE TO A FAILED VOLTAGE REGULATOR. -        |
|                                                                              |
| AT 0020 CST ON 02/17/99, UNIT 2 (100% POWER) UNEXPECTEDLY RECEIVED THE       |
| FOLLOWING ENGINEERED SAFETY FEATURE (ESF) ACTUATIONS:  HALF SCRAM SIGNAL,    |
| HALF PRIMARY CONTAINMENT ISOLATION SYSTEM (PCIS) GROUP 1 ISOLATION SIGNAL    |
| (MAIN STEAM LINE VALVES), HALF PCIS GROUP 2 ISOLATION SIGNAL (VENT AND       |
| SAMPLE VALVES INSIDE THE DRYWELL), AND REACTOR WATER CLEANUP ISOLATION       |
| SIGNAL.  AS PART OF THE PARTIAL PCIS GROUP 2 ESF ACTUATION, SEVERAL PRIMARY  |
| CONTAINMENT ISOLATION VALVES CLOSED.                                         |
|                                                                              |
| AT THE TIME OF THE ESF ACTUATION, THE #2A REACTOR PROTECTION SYSTEM (RPS)    |
| WAS BEING SUPPLIED FROM ITS RESERVE FEED, AND THE LICENSEE DETERMINED IT TO  |
| BE TRIPPED DUE TO A FAILED VOLTAGE REGULATOR.  THE LICENSEE REENERGIZED THE  |
| #2A RPS FROM ITS NORMAL FEED AND RESTORED THE PLANT LINEUP TO NORMAL EXCEPT  |
| THE #2A MAIN STEAM LINE RADIATION MONITOR DOWNSCALE WOULD NOT RESET.  THE    |
| LICENSEE INSERTED A HALF SCRAM SIGNAL AND A HALF PCIS GROUP 1 ISOLATION      |
| SIGNAL IN ACCORDANCE WITH TECH SPEC REQUIREMENTS WHILE REPAIRS ARE IN        |
| PROGRESS.                                                                    |
|                                                                              |
| THE LICENSEE PLANS TO INFORM THE NRC RESIDENT INSPECTOR.                     |
+------------------------------------------------------------------------------+

+------------------------------------------------------------------------------+
|Power Reactor                                    |Event Number:   35376       |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| FACILITY: COOK                     REGION:  3  |NOTIFICATION DATE: 02/17/1999|
|    UNIT:  [1] [2] []                STATE:  MI |NOTIFICATION TIME: 08:23[EST]|
|   RXTYPE: [1] W-4-LP,[2] W-4-LP                |EVENT DATE:        02/16/1999|
+------------------------------------------------+EVENT TIME:        13:56[EST]|
| NRC NOTIFIED BY:  MARY B. GREENDONNER          |LAST UPDATE DATE:  02/17/1999|
|  HQ OPS OFFICER:  DICK JOLLIFFE                +-----------------------------+
+------------------------------------------------+PERSON          ORGANIZATION |
|EMERGENCY CLASS:          N/A                   |MIKE JORDAN          R3      |
|10 CFR SECTION:                                 |                             |
|HFIT 26.73               FITNESS FOR DUTY       |                             |
|                                                |                             |
|                                                |                             |
|                                                |                             |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|UNIT |SCRAM CODE|RX CRIT|INIT PWR|   INIT RX MODE  |CURR PWR|  CURR RX MODE   |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|1     N          N       0        Cold Shutdown    |0        Cold Shutdown    |
|2     N          N       0        Cold Shutdown    |0        Cold Shutdown    |
|                                                   |                          |
+------------------------------------------------------------------------------+
                                   EVENT TEXT                                   
+------------------------------------------------------------------------------+
| - FITNESS-FOR-DUTY REPORT -                                                  |
|                                                                              |
| AT 1356 ON 02/16/99, A  LICENSEE SUPERVISOR WAS DETERMINED TO BE UNDER THE   |
| INFLUENCE OF ALCOHOL DURING A FOR-CAUSE FITNESS-FOR-DUTY TEST.  THE          |
| INDIVIDUAL'S PLANT ACCESS AUTHORIZATION WAS TERMINATED.  THE INDIVIDUAL HAS  |
| BEEN REFERRED TO THE LICENSEE FITNESS-FOR-DUTY PROGRAM.  CONTACT THE NRC     |
| OPERATIONS OFFICER FOR ADDITIONAL DETAILS.                                   |
|                                                                              |
| THE LICENSEE INFORMED THE NRC RESIDENT INSPECTOR.                            |
+------------------------------------------------------------------------------+

+------------------------------------------------------------------------------+
|Fuel Cycle Facility                              |Event Number:   35377       |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| FACILITY: PADUCAH GASEOUS DIFFUSION PLANT      |NOTIFICATION DATE: 02/17/1999|
|   RXTYPE: URANIUM ENRICHMENT FACILITY          |NOTIFICATION TIME: 11:22[EST]|
| COMMENTS: 2 DEMOCRACY CENTER                   |EVENT DATE:        02/17/1999|
|           6903 ROCKLEDGE DRIVE                 |EVENT TIME:        09:52[CST]|
|           BETHESDA, MD 20817    (301)564-3200  |LAST UPDATE DATE:  02/17/1999|
|    CITY:  PADUCAH                  REGION:  3  +-----------------------------+
|  COUNTY:  McCRACKEN                 STATE:  KY |PERSON          ORGANIZATION |
|LICENSE#:  GDP-1                 AGREEMENT:  Y  |MIKE JORDAN          R3      |
|  DOCKET:  0707001                              |SCOTT MOORE, NMSS    EO      |
+------------------------------------------------+                             |
| NRC NOTIFIED BY:  BILL HALICKS                 |                             |
|  HQ OPS OFFICER:  DICK JOLLIFFE                |                             |
+------------------------------------------------+                             |
|EMERGENCY CLASS:          N/A                   |                             |
|10 CFR SECTION:                                 |                             |
|BAAA 20.1906(d)          SURFACE CONTAMINATION E|                             |
|                                                |                             |
|                                                |                             |
|                                                |                             |
|                                                |                             |
+------------------------------------------------------------------------------+

                                   EVENT TEXT                                   
+------------------------------------------------------------------------------+
| - UF6 CYLINDER RECEIVED WITH REMOVABLE RADIOACTIVE SURFACE CONTAMINATION -   |
|                                                                              |
| AT 0952 CST ON 02/17/99, PADUCAH RECEIVED AN EMPTY UF6 CYLINDER ON THE BACK  |
| OF A FLAT BED TRUCK FROM STARMET CMI, BARNWELL, SC.  THE CARRIER WAS RSB     |
| LOGISTICS, ST LOUIS, MO.  THE SURFACE OF THE CYLINDER WAS SURVEYED UPON      |
| RECEIPT AND CONTAMINATION LEVELS WERE 2,379 DPM PER 100 SQUARE CM BETA/GAMMA |
| REMOVABLE RADIOACTIVE SURFACE CONTAMINATION.  (THE MAXIMUM ACCEPTABLE LIMIT  |
| OF 10CFR71.87(i) IS 2,200.)  THE SURVEY RESULTS OF THE TRUCK WERE LESS THAN  |
| THE MINIMUM DETECTABLE ACTIVITY.  THE LICENSEE PLACED THE CYLINDER IN A      |
| RADIOLOGICALLY CONTROLLED AREA AND PLANS TO DECONTAMINATE IT.                |
|                                                                              |
| PADUCAH PERSONNEL NOTIFIED THE NRC REGION 3 IN ACCORDANCE WITH THE           |
| REQUIREMENTS OF 10CFR20.1906(d)(1) AS A 1-HOUR EVENT NOTIFICATION REPORT.    |
| PADUCAH PERSONNEL ALSO NOTIFIED THE NRC RESIDENT INSPECTOR..                 |
+------------------------------------------------------------------------------+

+------------------------------------------------------------------------------+
|Power Reactor                                    |Event Number:   35378       |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| FACILITY: HARRIS                   REGION:  2  |NOTIFICATION DATE: 02/17/1999|
|    UNIT:  [1] [] []                 STATE:  NC |NOTIFICATION TIME: 13:05[EST]|
|   RXTYPE: [1] W-3-LP                           |EVENT DATE:        02/17/1999|
+------------------------------------------------+EVENT TIME:        12:19[EST]|
| NRC NOTIFIED BY:  MARK PALMER                  |LAST UPDATE DATE:  02/17/1999|
|  HQ OPS OFFICER:  LEIGH TROCINE                +-----------------------------+
+------------------------------------------------+PERSON          ORGANIZATION |
|EMERGENCY CLASS:          N/A                   |ANN BOLAND           R2      |
|10 CFR SECTION:                                 |                             |
|ASHU 50.72(b)(1)(i)(A)   PLANT S/D REQD BY TS   |                             |
|NLCO                     TECH SPEC LCO A/S      |                             |
|                                                |                             |
|                                                |                             |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|UNIT |SCRAM CODE|RX CRIT|INIT PWR|   INIT RX MODE  |CURR PWR|  CURR RX MODE   |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|1     N          Y       100      Power Operation  |70       Power Operation  |
|                                                   |                          |
|                                                   |                          |
+------------------------------------------------------------------------------+
                                   EVENT TEXT                                   
+------------------------------------------------------------------------------+
| TECHNICAL SPECIFICATION REQUIRED PLANT SHUTDOWN DUE TO FAILURE OF THE 'A'    |
| REACTOR TRIP BREAKER TO CLOSE RELIABLY DURING TESTING                        |
|                                                                              |
| The following text is a portion of a facsimile received from the licensee:   |
|                                                                              |
| "During [technical specification] surveillance testing [with the unit] at    |
| 100% power, a testing failure occurred on the train 'A' reactor trip         |
| breaker.  The test in progress was MST-I001, Train 'A' Solid State           |
| Protection System Actuation Logic and Master Relay Test.  During this test,  |
| the 'A' reactor trip breaker failed to close with the test pushbutton.  The  |
| following timeline occurred:"                                                |
|                                                                              |
| "0821- [The] train 'A' reactor trip bypass breaker [was racked in and        |
| closed].  This began a 2-hour time                                           |
| limit allowed for surveillance testing.                                      |
| 0916 - Reactor trip breaker 'A' failed to close with the test pushbutton.    |
| At this point, the 2-hour limit for                                          |
| surveillance testing ended, and [Technical Specification] 3.3.1, action 8,   |
| was entered.  This action                                                    |
| required the plant to be in Mode 3 within 6 hours.  The time to enter Mode 3 |
| is 1516.                                                                     |
| 1026 - NRC Region II representative, George MacDonald, [was] notified of     |
| [limiting condition for operation]                                           |
| and necessity to be in Mode 3 by 1516.  Mr. MacDonald was notified because   |
| [the] Harris resident                                                        |
| inspectors are out of town.                                                  |
| 1219 - [A generator] load reduction for plant shutdown [was commenced].      |
| Maintenance and engineering                                                  |
| personnel are investigating the problem."                                    |
|                                                                              |
| The licensee emphasized that the train 'A' reactor trip breaker did not fail |
| to open, which is its safety function.  The breaker only failed to re-close. |
| It has since been opened and re-closed several times during ongoing          |
| troubleshooting activities.  The licensee currently believes that the        |
| failure of the breaker to re-close reliably may be the result of a possible  |
| problem with the test circuitry allowing the test signal to stay in.         |
|                                                                              |
| Although all of the emergency diesel generators and emergency core cooling   |
| systems are operable and available if needed, the licensee stated that the   |
| emergency response date system is not available due to a Y2K problem.  (The  |
| Y2K problem is not related to the breaker problem.)                          |
+------------------------------------------------------------------------------+

+------------------------------------------------------------------------------+
|Power Reactor                                    |Event Number:   35379       |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| FACILITY: CALVERT CLIFFS           REGION:  1  |NOTIFICATION DATE: 02/17/1999|
|    UNIT:  [1] [] []                 STATE:  MD |NOTIFICATION TIME: 15:55[EST]|
|   RXTYPE: [1] CE,[2] CE                        |EVENT DATE:        02/17/1999|
+------------------------------------------------+EVENT TIME:        14:30[EST]|
| NRC NOTIFIED BY:  ERIC MEERBACH                |LAST UPDATE DATE:  02/17/1999|
|  HQ OPS OFFICER:  LEIGH TROCINE                +-----------------------------+
+------------------------------------------------+PERSON          ORGANIZATION |
|EMERGENCY CLASS:          N/A                   |JIM TRAPP            R1      |
|10 CFR SECTION:                                 |                             |
|APRE 50.72(b)(2)(vi)     OFFSITE NOTIFICATION   |                             |
|                                                |                             |
|                                                |                             |
|                                                |                             |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|UNIT |SCRAM CODE|RX CRIT|INIT PWR|   INIT RX MODE  |CURR PWR|  CURR RX MODE   |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|1     N          Y       100      Power Operation  |100      Power Operation  |
|                                                   |                          |
|                                                   |                          |
+------------------------------------------------------------------------------+
                                   EVENT TEXT                                   
+------------------------------------------------------------------------------+
| OFFSITE NOTIFICATION OF HIGH COLIFORM IN THE DRINKING WATER AT THE VISITOR'S |
| CENTER                                                                       |
|                                                                              |
| A positive coliform result was received for the drinking water at the site's |
| visitor's center.  Accordingly, Chemistry personnel were notified, and an    |
| Issue Report was generated.  The licensee also notified the Maryland         |
| Department of the Environment and the NRC resident inspector.                |
+------------------------------------------------------------------------------+

+------------------------------------------------------------------------------+
|Hospital                                         |Event Number:   35380       |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| REP ORG:  LOWER BUCKS HOSPITAL                 |NOTIFICATION DATE: 02/17/1999|
|LICENSEE:  LOWER BUCKS HOSPITAL                 |NOTIFICATION TIME: 16:24[EST]|
|    CITY:  BRISTOL                  REGION:  1  |EVENT DATE:        02/17/1999|
|  COUNTY:  BUCKS                     STATE:  PA |EVENT TIME:        12:00[EST]|
|LICENSE#:  SNM-1800              AGREEMENT:  N  |LAST UPDATE DATE:  02/17/1999|
|  DOCKET:                                       |+----------------------------+
|                                                |PERSON          ORGANIZATION |
|                                                |JIM TRAPP            R1      |
|                                                |CHARLEY HAUGHNEY     NMSS    |
+------------------------------------------------+                             |
| NRC NOTIFIED BY:  DR. MARK ANSLEY              |                             |
|  HQ OPS OFFICER:  LEIGH TROCINE                |                             |
+------------------------------------------------+                             |
|EMERGENCY CLASS:          N/A                   |                             |
|10 CFR SECTION:                                 |                             |
|NCAR                     CARDIAC PACEMAKER      |                             |
|                                                |                             |
|                                                |                             |
|                                                |                             |
|                                                |                             |
+------------------------------------------------------------------------------+

                                   EVENT TEXT                                   
+------------------------------------------------------------------------------+
| DEATH OF A PATIENT WITH AN IMPLANTED NUCLEAR-POWERED CARDIAC PACEMAKER       |
| (24-hour report)                                                             |
|                                                                              |
| A representative from Lower Bucks Hospital located in Bristol, PA, reported  |
| the death of a patient with an implanted nuclear-powered cardiac pacemaker.  |
| The patient expired today (02/17/99) at Einstein Hospital located in         |
| Philadelphia, PA.  The pacemaker was manufactured by Coratomic (model        |
| #C-101, serial #1054), and it contained 4 grams of Plutonium-238.            |
|                                                                              |
| The pacemaker is currently implanted in the patient, and the licensee plans  |
| to have Einstein Hospital remove it.  Once the pacemaker is retrieved, it    |
| will be shipped to the manufacturer for proper disposal.  When notification  |
| of receipt is received by the licensee, the licensee plans to submit a       |
| written report to the NRC.  The licensee also plans to notify the NRC Region |
| I Office.                                                                    |
|                                                                              |
| (Contact the NRC operations officer for a site contact telephone number.)    |
+------------------------------------------------------------------------------+

+------------------------------------------------------------------------------+
|Power Reactor                                    |Event Number:   35381       |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| FACILITY: NINE MILE POINT          REGION:  1  |NOTIFICATION DATE: 02/17/1999|
|    UNIT:  [1] [] []                 STATE:  NY |NOTIFICATION TIME: 18:47[EST]|
|   RXTYPE: [1] GE-2,[2] GE-5                    |EVENT DATE:        02/17/1999|
+------------------------------------------------+EVENT TIME:        18:40[EST]|
| NRC NOTIFIED BY:  JIM KRONENBITTER             |LAST UPDATE DATE:  02/17/1999|
|  HQ OPS OFFICER:  LEIGH TROCINE                +-----------------------------+
+------------------------------------------------+PERSON          ORGANIZATION |
|EMERGENCY CLASS:          N/A                   |JIM TRAPP            R1      |
|10 CFR SECTION:                                 |                             |
|ASHU 50.72(b)(1)(i)(A)   PLANT S/D REQD BY TS   |                             |
|NLCO                     TECH SPEC LCO A/S      |                             |
|                                                |                             |
|                                                |                             |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|UNIT |SCRAM CODE|RX CRIT|INIT PWR|   INIT RX MODE  |CURR PWR|  CURR RX MODE   |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|1     N          Y       100      Power Operation  |98       Power Operation  |
|                                                   |                          |
|                                                   |                          |
+------------------------------------------------------------------------------+
                                   EVENT TEXT                                   
+------------------------------------------------------------------------------+
| TECHNICAL SPECIFICATION REQUIRED PLANT SHUTDOWN DUE TO FAILURE TO PERFORM    |
| SURVEILLANCE TESTING IN ACCORDANCE WITH ASME SECTION XI REQUIREMENTS         |
| FOLLOWING REPLACEMENT OF EMERGENCY (ISO) CONDENSER TUBE BUNDLES LAST FALL    |
|                                                                              |
| The following text is a portion of a facsimile received from the licensee:   |
|                                                                              |
| "In accordance with Technical Specification 3.2.6(a)1, Quality Group A, B,   |
| and C components shall satisfy the requirements contained in Section XI of   |
| the ASME Boiler and Pressure Vessel Code and applicable addenda for          |
| continued service of ASME Code Class 1, 2, and 3 components to be considered |
| operable.  The pre-service inspection (radiographs) for emergency condensers |
| 111, 112, 121, and 122 was performed prior to the construction hydrostatic   |
| test for emergency condensers 111, 112, 121, and 122.  This sequence of      |
| testing is contrary to the requirements of the ASME code.  Emergency         |
| condensers 111, 112, 121, and 122 are inoperable.  Technical Specification   |
| 3.1.3(e) requires [that] a normal orderly shutdown shall be initiated within |
| [1-]hour and [that] the reactor shall be in the Cold Shutdown condition      |
| within [10] hours with no emergency cooling system operable."                |
|                                                                              |
| The licensee stated that all of the Unit 1 emergency condensers were         |
| declared inoperable at approximately 1750, and a unit shutdown was commenced |
| at 1840.                                                                     |
|                                                                              |
| The licensee notified the NRC resident inspector.                            |
|                                                                              |
| HOO NOTE:  At approximately 1900 on 02/17/99, the licensee requested a       |
| Notice of Enforcement Discretion to                                          |
| allow 48 hours to perform the required testing.  A Notice of Enforcement     |
| Discretion was granted by                                                    |
| the NRC Region 1 Office at 2026.                                             |
+------------------------------------------------------------------------------+


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