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Event Notification Report for July 21, 1999

                    U.S. Nuclear Regulatory Commission
                              Operations Center

                              Event Reports For
                           07/20/1999 - 07/21/1999

                              ** EVENT NUMBERS **

35931  35936  35937  35938  35939  35940  

!!!!!!!!! THIS EVENT HAS BEEN RETRACTED. THIS EVENT HAS BEEN RETRACTED  !!!!!!!
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|Power Reactor                                    |Event Number:   35931       |
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| FACILITY: THREE MILE ISLAND        REGION:  1  |NOTIFICATION DATE: 07/18/1999|
|    UNIT:  [1] [] []                 STATE:  PA |NOTIFICATION TIME: 20:41[EDT]|
|   RXTYPE: [1] B&W-L-LP,[2] B&W-L-LP            |EVENT DATE:        07/18/1999|
+------------------------------------------------+EVENT TIME:        18:07[EDT]|
| NRC NOTIFIED BY:  BOB BOYER                    |LAST UPDATE DATE:  07/20/1999|
|  HQ OPS OFFICER:  STEVE SANDIN                 +-----------------------------+
+------------------------------------------------+PERSON          ORGANIZATION |
|EMERGENCY CLASS:          N/A                   |JOHN WHITE           R1      |
|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   |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|1     N          Y       100      Power Operation  |100      Power Operation  |
|                                                   |                          |
|                                                   |                          |
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                                   EVENT TEXT                                   
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| TWO OF THREE OPERATING REACTOR CONTAINMENT BUILDING (RCB) FANS UNEXPECTEDLY  |
| TRIPPED DURING TROUBLESHOOTING OF ENGINEERED SAFEGUARDS ACTUATION SIGNAL     |
| (ESAS) RELAYS BY A CONTROL ROOM OPERATOR (CRO).                              |
|                                                                              |
| "A CRO was checking the ESAS relays for noise, humming or signs of           |
| overheating after the relays had been exercised as a result of de-energizing |
| VBB for 1B Inverter restoration.  While trying to identify a humming relay   |
| the CRO touched what he thought was the frame of relay 1X1A RCB, but what he |
| touched actuated the relay contacts.  This caused AH-E-1B and AH-E-1C to     |
| trip.                                                                        |
|                                                                              |
| "The crew restarted AH-E-1B and AH-E-1C and followed Alarm response B-1-5    |
| '480V ES Motor Trip.'  Electrical prints (209-570 and 209-592) were referred |
| to and showed that the relay is a normally de-energized relay.  It sends a   |
| signal to the 1S and 1T 480V under voltage circuit, DH-V-4B to open and      |
| AH-E-1B/C to trip.  The UV relays were verified to have not actuated and     |
| they were manually reset as a precautionary measure.  DH-V-4B was verified   |
| still closed.                                                                |
|                                                                              |
| "It is believed since the CRO only slightly moved the relay and AH-E-1B/C    |
| contacts are normally closed when the relay is de-energized and the other    |
| three relays are normally open, that the movement was enough to break the    |
| closed contacts but not enough to make up the open contacts."                |
|                                                                              |
| The licensee will inform the NRC resident inspector.                         |
|                                                                              |
| *  *  * UPDATE AT 1337 ON 7/20/99  BY SCHORK RECEIVED BY WEAVER *  *  *      |
|                                                                              |
| The event that occurred on July 18, 1999, was an invalid actuation that only |
| involved the AH-E-1B and AH-E-1C fans that are part of the reactor building  |
| ventilation system.  Therefore, the requirement for reporting this as an ESF |
| actuation is exempted in accordance with 10CFR50.72(b)(2)(ii)(B)(3)(iii).    |
| Thus, GPU Nuclear is withdrawing the 4 hour report                           |
|                                                                              |
| A review of the reporting criteria of 10CFR50.73 found that the event is     |
| similarly not required to be reported and therefore GPU Nuclear will not be  |
| submitting a 30 day licensee event report regarding this issue.              |
|                                                                              |
| Nonetheless, the event has been entered into the GPU Nuclear 10CFR50,        |
| Appendix B Corrective Action Program and the cause and corrective action     |
| taken in response to this event will be documented in accordance with that   |
| program.                                                                     |
|                                                                              |
| The retraction of the 4 hour report has been discussed with W. Schmidt, the  |
| NRC Senior Resident Inspector.                                               |
|                                                                              |
| The NRC Operations Officer notified the R1DO Jim Noggle.                     |
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+------------------------------------------------------------------------------+
|General Information or Other                     |Event Number:   35936       |
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| REP ORG:  TN DIV OF RADIOLOGICAL HEALTH        |NOTIFICATION DATE: 07/20/1999|
|LICENSEE:  GE INSPECTION SERVICES               |NOTIFICATION TIME: 08:39[EDT]|
|    CITY:                           REGION:  2  |EVENT DATE:        07/15/1999|
|  COUNTY:                            STATE:  TN |EVENT TIME:        12:00[EDT]|
|LICENSE#:                        AGREEMENT:  Y  |LAST UPDATE DATE:  07/20/1999|
|  DOCKET:                                       |+----------------------------+
|                                                |PERSON          ORGANIZATION |
|                                                |ANN BOLAND           R2      |
|                                                |DON COOL             NMSS    |
+------------------------------------------------+                             |
| NRC NOTIFIED BY:  DEBRA SHULTS (fax)           |                             |
|  HQ OPS OFFICER:  BOB STRANSKY                 |                             |
+------------------------------------------------+                             |
|EMERGENCY CLASS:          N/A                   |                             |
|10 CFR SECTION:                                 |                             |
|NAGR                     AGREEMENT STATE        |                             |
|                                                |                             |
|                                                |                             |
|                                                |                             |
|                                                |                             |
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                                   EVENT TEXT                                   
+------------------------------------------------------------------------------+
| AGREEMENT STATE REPORT - PERSONNEL OVEREXPOSURE                              |
|                                                                              |
| On 07/19/99, the TN Division of Radiological Health (TN DRH) was notified by |
| the Corporate Radiation Safety Officer for GE Inspection Services of an      |
| overexposure to an Assistant Radiographer.  The overexposure occurred on     |
| 07/15/99 and was not reported to the TN DRH within the 24-hour requirement.  |
|                                                                              |
| A radiographer and an assistant were conducting radiography when they noted  |
| that the pocket dosimeter was off scale.  They ceased operations and sent    |
| the dosimeter badges to Landauer for analysis on 07/16/99. According to      |
| Landauer, the assistant radiographer received a 17-rem whole body dose.  It  |
| appears that the operator did not follow proper procedures for use of the    |
| device since the source was not returned fully into the camera.  TN DRH      |
| staff is on site on 07/20/99 conducting an investigation.                    |
|                                                                              |
| This is report #TN-99-095.                                                   |
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|Other Nuclear Material                           |Event Number:   35937       |
+------------------------------------------------------------------------------+
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| REP ORG:  PROFESSIONAL SERVICE INDUSTRIES      |NOTIFICATION DATE: 07/20/1999|
|LICENSEE:  PROFESSIONAL SERVICE INDUSTRIES      |NOTIFICATION TIME: 09:58[EDT]|
|    CITY:  LIMA                     REGION:  3  |EVENT DATE:        07/20/1999|
|  COUNTY:                            STATE:  OH |EVENT TIME:        01:00[EDT]|
|LICENSE#:                        AGREEMENT:  N  |LAST UPDATE DATE:  07/20/1999|
|  DOCKET:                                       |+----------------------------+
|                                                |PERSON          ORGANIZATION |
|                                                |PATRICK HILAND       R3      |
|                                                |DON COOL             NMSS    |
+------------------------------------------------+                             |
| NRC NOTIFIED BY:  CHRIS SMITH                  |                             |
|  HQ OPS OFFICER:  BOB STRANSKY                 |                             |
+------------------------------------------------+                             |
|EMERGENCY CLASS:          N/A                   |                             |
|10 CFR SECTION:                                 |                             |
|BAB1 20.2201(a)(1)(i)    LOST/STOLEN LNM>1000X  |                             |
|                                                |                             |
|                                                |                             |
|                                                |                             |
|                                                |                             |
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                                   EVENT TEXT                                   
+------------------------------------------------------------------------------+
| STOLEN TROXLER MOISTURE/DENSITY GAUGE                                        |
|                                                                              |
| A Troxler Model 3430 Moisture/Density Gauge (S/N 27891) was stolen from the  |
| back of a pickup truck in Lima, Ohio.  The licensee reported that both the   |
| gauge and its transport carrier were missing from the truck.  The local      |
| police were contacted and responded to the scene.                            |
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+------------------------------------------------------------------------------+
|General Information or Other                     |Event Number:   35938       |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| REP ORG:  OREGON RAD PROTECTION SERVICES       |NOTIFICATION DATE: 07/20/1999|
|LICENSEE:  MERLE WEST MEDICAL CENTER            |NOTIFICATION TIME: 13:06[EDT]|
|    CITY:  KLAMATH FALLS            REGION:  4  |EVENT DATE:        05/06/1999|
|  COUNTY:                            STATE:  OR |EVENT TIME:        12:00[PDT]|
|LICENSE#:  ORE-90442             AGREEMENT:  Y  |LAST UPDATE DATE:  07/20/1999|
|  DOCKET:                                       |+----------------------------+
|                                                |PERSON          ORGANIZATION |
|                                                |ELMO COLLINS         R4      |
|                                                |JOSIE PICCONE        NMSS    |
+------------------------------------------------+                             |
| NRC NOTIFIED BY:  TERRY LINDSEY                |                             |
|  HQ OPS OFFICER:  DOUG WEAVER                  |                             |
+------------------------------------------------+                             |
|EMERGENCY CLASS:          N/A                   |                             |
|10 CFR SECTION:                                 |                             |
|NAGR                     AGREEMENT STATE        |                             |
|                                                |                             |
|                                                |                             |
|                                                |                             |
|                                                |                             |
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                                   EVENT TEXT                                   
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| AGREEMENT STATE REPORT - MEDICAL MISADMINISTRATION                           |
|                                                                              |
| A patient received 97 mCi of Sm-153 instead of 62 mCi based on a dosage of 1 |
| mCi per Kg of body weight.                                                   |
| This event occurred at the Merle West Medical Center in Klamath Falls, OR.   |
| Sm-153 is used to alleviate bone pain in cancer patients.  The error was     |
| discovered by the chief technician.  No other information was immediately    |
| available.                                                                   |
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+------------------------------------------------------------------------------+
|Power Reactor                                    |Event Number:   35939       |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| FACILITY: POINT BEACH              REGION:  3  |NOTIFICATION DATE: 07/20/1999|
|    UNIT:  [1] [2] []                STATE:  WI |NOTIFICATION TIME: 14:44[EDT]|
|   RXTYPE: [1] W-2-LP,[2] W-2-LP                |EVENT DATE:        07/20/1999|
+------------------------------------------------+EVENT TIME:        13:09[CDT]|
| NRC NOTIFIED BY:  PHILLIP SHORT                |LAST UPDATE DATE:  07/20/1999|
|  HQ OPS OFFICER:  DOUG WEAVER                  +-----------------------------+
+------------------------------------------------+PERSON          ORGANIZATION |
|EMERGENCY CLASS:          N/A                   |PATRICK HILAND       R3      |
|10 CFR SECTION:                                 |                             |
|AOUT 50.72(b)(1)(ii)(B)  OUTSIDE DESIGN BASIS   |                             |
|                                                |                             |
|                                                |                             |
|                                                |                             |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|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                                   
+------------------------------------------------------------------------------+
| OUTSIDE DESIGN BASES - CONDITION OUTSIDE OF APPENDIX R REQUIREMENTS          |
|                                                                              |
| During an Appendix R baseline project review, a condition has been found     |
| that is considered to be outside the Appendix R Safe Shutdown design basis.  |
| During a postulated fire on the 26 foot level of the primary auxiliary       |
| building, fire related cable damage could lead to spurious opening of a      |
| single power operated relief valve (PORV) along with the inability to close  |
| its associated block valve.  Presently, plant procedures direct operators to |
| isolate air to the containment and vent the instrument air header locally in |
| order to shut the PORV.  The local valve operations that are required,       |
| however, are in the same area as the postulated fire.  Failure to get the    |
| PORVs closed in adequate time would place the plant outside of the           |
| performance goals of 10CFR50, Appendix R, Paragraph III.L.                   |
|                                                                              |
| The licensee notified the NRC resident inspector.                            |
+------------------------------------------------------------------------------+

+------------------------------------------------------------------------------+
|Power Reactor                                    |Event Number:   35940       |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| FACILITY: COMANCHE PEAK            REGION:  4  |NOTIFICATION DATE: 07/20/1999|
|    UNIT:  [1] [2] []                STATE:  TX |NOTIFICATION TIME: 16:50[EDT]|
|   RXTYPE: [1] W-4-LP,[2] W-4-LP                |EVENT DATE:        07/20/1999|
+------------------------------------------------+EVENT TIME:        15:05[CDT]|
| NRC NOTIFIED BY:  D.W. MCGAUGHEY               |LAST UPDATE DATE:  07/20/1999|
|  HQ OPS OFFICER:  DOUG WEAVER                  +-----------------------------+
+------------------------------------------------+PERSON          ORGANIZATION |
|EMERGENCY CLASS:          N/A                   |ELMO COLLINS         R4      |
|10 CFR SECTION:                                 |                             |
|AESS 50.72(b)(1)(v)      EMERGENCY SIREN INOP   |                             |
|                                                |                             |
|                                                |                             |
|                                                |                             |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|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                                   
+------------------------------------------------------------------------------+
| EMERGENCY SIRENS                                                             |
|                                                                              |
| All Comanche Peak Emergency Warning Sirens are inoperable.   The cause of    |
| the failure is unknown, but personnel are working to effect repairs.   Hood  |
| and Somervell counties have been notified.  The licensee notified the NRC    |
| Resident Inspector.                                                          |
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