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Event Notification Report for December 6, 1999

                    U.S. Nuclear Regulatory Commission
                              Operations Center

                              Event Reports For
                           12/03/1999 - 12/06/1999

                              ** EVENT NUMBERS **

36471  36483  36484  36485  36486  36487  36488  

!!!!!!!!! THIS EVENT HAS BEEN RETRACTED. THIS EVENT HAS BEEN RETRACTED  !!!!!!!
+------------------------------------------------------------------------------+
|Power Reactor                                    |Event Number:   36471       |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| FACILITY: PALISADES                REGION:  3  |NOTIFICATION DATE: 11/28/1999|
|    UNIT:  [1] [] []                 STATE:  MI |NOTIFICATION TIME: 19:50[EST]|
|   RXTYPE: [1] CE                               |EVENT DATE:        11/28/1999|
+------------------------------------------------+EVENT TIME:        15:45[EST]|
| NRC NOTIFIED BY:  DALE ENGLE                   |LAST UPDATE DATE:  12/05/1999|
|  HQ OPS OFFICER:  STEVE SANDIN                 +-----------------------------+
+------------------------------------------------+PERSON          ORGANIZATION |
|EMERGENCY CLASS:          N/A                   |RONALD GARDNER       R3      |
|10 CFR SECTION:                                 |                             |
|ADAS 50.72(b)(2)(i)      DEG/UNANALYZED COND    |                             |
|                                                |                             |
|                                                |                             |
|                                                |                             |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|UNIT |SCRAM CODE|RX CRIT|INIT PWR|   INIT RX MODE  |CURR PWR|  CURR RX MODE   |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|1     N          N       0        Cold Shutdown    |0        Cold Shutdown    |
|                                                   |                          |
|                                                   |                          |
+------------------------------------------------------------------------------+
                                   EVENT TEXT                                   
+------------------------------------------------------------------------------+
| "B" TRAIN LOW PRESSURE SAFETY INJECTION (LPSI) FLOW RATES FOUND DEGRADED     |
| DURING SURVEILLANCE TESTING.                                                 |
|                                                                              |
| "WHILE PERFORMING QO-8B (LOW PRESSURE SAFETY INJECTION FLOW TESTING), IT WAS |
| DETERMINED THAT FLOW TO TWO (2) OF FOUR (4) LOOPS (VALVES-MO-3012 & MO-3014  |
| [RIGHT CHANNEL]) WAS INADEQUATE.  THE FLOW RATES WERE BELOW THE DESIGN BASIS |
| FOR ACCIDENT CONDITIONS.  [THIS] CONDITION WAS DISCOVERED DURING             |
| SURVEILLANCE TESTING WHILE THE PLANT WAS IN COLD SHUTDOWN.  THIS IS          |
| REPORTABLE PER 50.72(b)(2)(I)."                                              |
|                                                                              |
| THE DESIGN FLOW RATE IS 1720 GPM.  THE AS-FOUND FLOW RATES THROUGH VALVES    |
| 3012 & 3014 WERE 1650 AND 1500 GPM, RESPECTIVELY.  THE "B" TRAIN LPSI HAS    |
| BEEN DECLARED INOPERABLE PENDING CORRECTIVE ACTION WHICH IS TO BE            |
| DETERMINED.  THE UNIT IS NOT IN A TECH SPEC ACTION STATEMENT IN THAT LPSI IS |
| NOT REQUIRED FOR CURRENT PLANT CONDITIONS.  THE SURVEILLANCE TEST WHICH      |
| IDENTIFIED THIS CONDITION IS PERFORMED EACH REFUELING OUTAGE (APPROXIMATELY  |
| EVERY 18 MONTHS).  THE LICENSEE INFORMED THE NRC RESIDENT INSPECTOR.         |
|                                                                              |
| * * * RETRACTED AT 1813 EST ON 12/5/99 BY ROBERT VINCENT TO FANGIE JONES * * |
| *                                                                            |
|                                                                              |
| The licensee conducted extensive testing and analysis to better model        |
| accidents and the performance of the LPSI system.  They have determined that |
| the LPSI system flow rates are capable of meeting the requirements of        |
| accident mitigation and are retracting this event notification.              |
|                                                                              |
| The licensee notified the NRC Resident Inspector and the NRC Headquarters    |
| Operations Officer notified the R3DO (Geoffrey Wright).                      |
+------------------------------------------------------------------------------+

+------------------------------------------------------------------------------+
|Power Reactor                                    |Event Number:   36483       |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| FACILITY: PEACH BOTTOM             REGION:  1  |NOTIFICATION DATE: 12/03/1999|
|    UNIT:  [2] [3] []                STATE:  PA |NOTIFICATION TIME: 00:09[EST]|
|   RXTYPE: [2] GE-4,[3] GE-4                    |EVENT DATE:        12/02/1999|
+------------------------------------------------+EVENT TIME:        22:25[EST]|
| NRC NOTIFIED BY:  BREIDENBAUGH                 |LAST UPDATE DATE:  12/03/1999|
|  HQ OPS OFFICER:  JOHN MacKINNON               +-----------------------------+
+------------------------------------------------+PERSON          ORGANIZATION |
|EMERGENCY CLASS:          N/A                   |STEVEN DENNIS        R1      |
|10 CFR SECTION:                                 |                             |
|AIND 50.72(b)(2)(iii)(D) ACCIDENT MITIGATION    |                             |
|                                                |                             |
|                                                |                             |
|                                                |                             |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|UNIT |SCRAM CODE|RX CRIT|INIT PWR|   INIT RX MODE  |CURR PWR|  CURR RX MODE   |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|2     N          Y       100      Power Operation  |100      Power Operation  |
|3     N          Y       100      Power Operation  |100      Power Operation  |
|                                                   |                          |
+------------------------------------------------------------------------------+
                                   EVENT TEXT                                   
+------------------------------------------------------------------------------+
| PERFORMANCE OF RHR LOGIC FUNCTIONAL TEST DEFEATS THE AUTOMATIC START OF ALL  |
| FOUR RHR PUMPS.                                                              |
|                                                                              |
| A review of the Residual Heat Removal (RHR) logic system functional test     |
| identified that during part of the performance of the test, the automatic    |
| start of all four RHR pumps was defeated.  Manual initiation remained        |
| available.  This test was last performed on both Unit 2 and Unit 3 in 1997.  |
| This report is being made due to the loss of the automatic initiation of the |
| Low Pressure Coolant Injection (LPCI) mode of RHR.  This alone could have    |
| prevented the fulfillment of a safety function.                              |
|                                                                              |
| The NRC resident inspector will be notified of this event by the licensee.   |
+------------------------------------------------------------------------------+

+------------------------------------------------------------------------------+
|Power Reactor                                    |Event Number:   36484       |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| FACILITY: CALLAWAY                 REGION:  4  |NOTIFICATION DATE: 12/03/1999|
|    UNIT:  [1] [] []                 STATE:  MO |NOTIFICATION TIME: 13:47[EST]|
|   RXTYPE: [1] W-4-LP                           |EVENT DATE:        12/03/1999|
+------------------------------------------------+EVENT TIME:             [CST]|
| NRC NOTIFIED BY:  BRUCE SCHOENBACH             |LAST UPDATE DATE:  12/03/1999|
|  HQ OPS OFFICER:  FANGIE JONES                 +-----------------------------+
+------------------------------------------------+PERSON          ORGANIZATION |
|EMERGENCY CLASS:          N/A                   |DALE POWERS          R4      |
|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  |
|                                                   |                          |
|                                                   |                          |
+------------------------------------------------------------------------------+
                                   EVENT TEXT                                   
+------------------------------------------------------------------------------+
| PART OF THE RCS LEAK RATE DETECTION SYSTEM MAY BE OUTSIDE DESIGN BASES.      |
|                                                                              |
| "Callaway was contacted by Wolf Creek [see Event #36481] with a concern      |
| regarding the Containment Normal Sump Level Measurement System and           |
| Containment Air Cooler Condensate Flow Rate System not [being] capable of    |
| performing their design function in all cases.  Further review by Callaway   |
| determined this concern was also applicable to Callaway Plant.  These        |
| systems are required per Tech Spec 3.4.6.1b&c for the RCS Leakage Detection  |
| Systems.  The FSAR states [that] this system meets the requirements of Reg.  |
| Guide 1.45, which requires the leakage detection system to be able to detect |
| a 1 gpm leak within 1 hour.  The methodology used will not always provide    |
| adequate leak detection to ensure a 1 gpm RCS leak will be detected in 1     |
| hour.                                                                        |
|                                                                              |
| "Therefore, Callaway may be operating outside its design bases since the     |
| Containment Normal Sump Level Measurement System and Containment Air Cooler  |
| Condensate Flow Rate System do not meet this design bases at this time.  The |
| licensee is pursuing a software change to bring the systems into compliance  |
| with the design bases well within the 30-day action statement requirement of |
| Tech Spec 3.4.6.1.  The licensee has notified the NRC Resident Inspector."   |
+------------------------------------------------------------------------------+

+------------------------------------------------------------------------------+
|General Information or Other                     |Event Number:   36485       |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| REP ORG:  TENNESSEE DIV. OF RAD. HEALTH        |NOTIFICATION DATE: 12/03/1999|
|LICENSEE:  JOHNSON CITY MEDICAL CENTER          |NOTIFICATION TIME: 16:45[EST]|
|    CITY:  JOHNSON CITY             REGION:  2  |EVENT DATE:        12/03/1999|
|  COUNTY:                            STATE:  TN |EVENT TIME:        16:00[EST]|
|LICENSE#:  R-90005-L97           AGREEMENT:  Y  |LAST UPDATE DATE:  12/03/1999|
|  DOCKET:                                       |+----------------------------+
|                                                |PERSON          ORGANIZATION |
|                                                |KENNETH BARR         R2      |
|                                                |JOSIE PICCONE        NMSS    |
+------------------------------------------------+                             |
| NRC NOTIFIED BY:  CHARLES ARNOTT               |                             |
|  HQ OPS OFFICER:  FANGIE JONES                 |                             |
+------------------------------------------------+                             |
|EMERGENCY CLASS:                                |                             |
|10 CFR SECTION:                                 |                             |
|NAGR                     AGREEMENT STATE        |                             |
|NINF                     INFORMATION ONLY       |                             |
|                                                |                             |
|                                                |                             |
|                                                |                             |
+------------------------------------------------------------------------------+

                                   EVENT TEXT                                   
+------------------------------------------------------------------------------+
| NEW SOURCES FOR BRACHYTHERAPY DEVICE TOO LONG                                |
|                                                                              |
| The State of Tennessee, Division of Radiological Health, received a call     |
| from Mountain States Alliance DBA Johnson City Medical Center concerning     |
| receipt of three new sources for brachytherapy treatment that did not fit.   |
| The three sources, model number CDC.T1 Product Code CDCS.J4, which contain   |
| cesium-137, were the same model number, but were 1 millimeter longer than    |
| the original sources.  The extra length would not allow the shielded storage |
| drawer to close.  The medical center called Tennessee to inform them of the  |
| problem and called the manufacturer, Amersham, in Illinois.  The Division of |
| Radiological Health called the State of Illinois for their information.      |
+------------------------------------------------------------------------------+

+------------------------------------------------------------------------------+
|Fuel Cycle Facility                              |Event Number:   36486       |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| FACILITY: PADUCAH GASEOUS DIFFUSION PLANT      |NOTIFICATION DATE: 12/03/1999|
|   RXTYPE: URANIUM ENRICHMENT FACILITY          |NOTIFICATION TIME: 22:05[EST]|
| COMMENTS: 2 DEMOCRACY CENTER                   |EVENT DATE:        12/03/1999|
|           6903 ROCKLEDGE DRIVE                 |EVENT TIME:        13:00[CST]|
|           BETHESDA, MD 20817    (301)564-3200  |LAST UPDATE DATE:  12/03/1999|
|    CITY:  PADUCAH                  REGION:  3  +-----------------------------+
|  COUNTY:  McCRACKEN                 STATE:  KY |PERSON          ORGANIZATION |
|LICENSE#:  GDP-1                 AGREEMENT:  Y  |GEOFFREY WRIGHT      R3      |
|  DOCKET:  0707001                              |SUSAN SHANKMAN       NMSS    |
+------------------------------------------------+CHARLES MILLER       IRO     |
| NRC NOTIFIED BY:  E. G. WALKER                 |                             |
|  HQ OPS OFFICER:  FANGIE JONES                 |                             |
+------------------------------------------------+                             |
|EMERGENCY CLASS:          N/A                   |                             |
|10 CFR SECTION:                                 |                             |
|NBNL                     RESPONSE-BULLETIN      |                             |
|                                                |                             |
|                                                |                             |
|                                                |                             |
|                                                |                             |
+------------------------------------------------------------------------------+

                                   EVENT TEXT                                   
+------------------------------------------------------------------------------+
| NRC BULLETIN 91-01 RESPONSE (24-HOUR REPORT) - LOSS OF A DOUBLE CONTINGENCY  |
| CONTROL                                                                      |
|                                                                              |
| "On 12-3-99, at 1300 CST, the C-333 Seal Exhaust and Wet Air Station pumps   |
| were discovered to be hard-piped to the building lube oil supply in          |
| violation of NCSE.014. The NCSE (Nuclear Criticality Safety Evaluation)      |
| credits an air gap as a design feature of the lube oil piping to prevent the |
| potential for backflow of uranium contaminated oil into the unit lube oil    |
| system.                                                                      |
|                                                                              |
| "In order for a criticality to be possible, significant quantities of oil    |
| contaminated with uranium enriched to greater than 1.0 wt. % 235U assay      |
| would have to backflow into the unit lube oil system and collect in the Seal |
| Exhaust and Wet Air pumps with the oil reservoir filled above 4.75 inches.   |
| In order for oil to backflow, the pump reservoir would need to be filled to  |
| absolute capacity, operator level checks would need to fail to detect and    |
| correct the overfilled condition, and the oil would need to backflow through |
| multiple closed valves and overcome the elevation head of the oil lines.     |
| Therefore, it is not considered credible that contaminated oil intrusion     |
| into the unit lube oil system has ever occurred.                             |
|                                                                              |
| "The Nuclear Criticality Safety Evaluation (NCSE) relies upon an air gap     |
| being installed in the oil fill line to the Seal Exhaust and Wet Air pumps   |
| to prevent backflow of uranium contaminated oil into the unit lube oil       |
| supply system. There are no double contingency arguments for this scenario   |
| because the scenario is considered incredible with the installed air gap.    |
|                                                                              |
| "NCSA (Nuclear Criticality Safety Approval) GEN-01 was immediately initiated |
| on discovery of the problem to ensure nuclear criticality safety             |
| implementation.  Initiation of a modification package to correct the         |
| deficiency was implemented in accordance with NCS engineering approval."     |
|                                                                              |
| Paducah personnel notified the NRC Resident Inspector.                       |
+------------------------------------------------------------------------------+

+------------------------------------------------------------------------------+
|Power Reactor                                    |Event Number:   36487       |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| FACILITY: PRAIRIE ISLAND           REGION:  3  |NOTIFICATION DATE: 12/04/1999|
|    UNIT:  [] [2] []                 STATE:  MN |NOTIFICATION TIME: 01:17[EST]|
|   RXTYPE: [1] W-2-LP,[2] W-2-LP                |EVENT DATE:        12/03/1999|
+------------------------------------------------+EVENT TIME:        22:30[CST]|
| NRC NOTIFIED BY:  MICHAEL T. MURPHY            |LAST UPDATE DATE:  12/04/1999|
|  HQ OPS OFFICER:  LEIGH TROCINE                +-----------------------------+
+------------------------------------------------+PERSON          ORGANIZATION |
|EMERGENCY CLASS:          N/A                   |GEOFFREY WRIGHT      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                                   
+------------------------------------------------------------------------------+
| ACTUATION OF TWO UNIT 2 AUXILIARY BUILDING NORMAL RADIATION MONITORS DURING  |
| PERFORMANCE OF VENTILATION SYSTEM SURVEILLANCE TESTING                       |
|                                                                              |
| The following text is a portion of a facsimile received from the licensee:   |
|                                                                              |
| "At 2230 [CST] during normal Unit 1 [and] 2 [reactor coolant system]         |
| sampling, a [high] radiation and [emergency safety feature (ESF)] actuation  |
| signal was received on [radiation monitors] 2R-30 and 2R-37 ([auxiliary      |
| building] normal exhaust monitors).  Normal exhaust was off, and [the        |
| auxiliary] building special ventilation system was in operation while        |
| performing [surveillance procedure] SP-1172, Monthly Ventilation System      |
| Operation.  Alarm response procedures were completed for high radiation on   |
| 2R-30 [and 2R-]37.  [The] duty chemist was informed, the sample was secured, |
| and 2R-30 [and 2R-]37 levels [then] returned normal.  At 2255 [CST,] the     |
| actuating signals were reset, and all equipment returned to normal."         |
|                                                                              |
| The licensee stated that all systems functioned as required in response to   |
| the high radiation and ESF actuation signal.  The cause of the ESF signal is |
| under investigation.  At the time of this event notification, both units     |
| were operating at 100% power.                                                |
|                                                                              |
| The licensee notified the NRC resident inspector.                            |
+------------------------------------------------------------------------------+

+------------------------------------------------------------------------------+
|Fuel Cycle Facility                              |Event Number:   36488       |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| FACILITY: PORTSMOUTH GASEOUS DIFFUSION PLANT   |NOTIFICATION DATE: 12/04/1999|
|   RXTYPE: URANIUM ENRICHMENT FACILITY          |NOTIFICATION TIME: 11:04[EST]|
| COMMENTS: 2 DEMOCRACY CENTER                   |EVENT DATE:        12/03/1999|
|           6903 ROCKLEDGE DRIVE                 |EVENT TIME:        16:10[EST]|
|           BETHESDA, MD 20817    (301)564-3200  |LAST UPDATE DATE:  12/04/1999|
|    CITY:  PIKETON                  REGION:  3  +-----------------------------+
|  COUNTY:  PIKE                      STATE:  OH |PERSON          ORGANIZATION |
|LICENSE#:  GDP-2                 AGREEMENT:  N  |GEOFFREY WRIGHT      R3      |
|  DOCKET:  0707002                              |SUSAN SHANKMAN       NMSS    |
+------------------------------------------------+CHARLES MILLER       IRO     |
| NRC NOTIFIED BY:  JEFF CASTLE                  |                             |
|  HQ OPS OFFICER:  LEIGH TROCINE                |                             |
+------------------------------------------------+                             |
|EMERGENCY CLASS:          N/A                   |                             |
|10 CFR SECTION:                                 |                             |
|NBNL                     RESPONSE-BULLETIN      |                             |
|                                                |                             |
|                                                |                             |
|                                                |                             |
|                                                |                             |
+------------------------------------------------------------------------------+

                                   EVENT TEXT                                   
+------------------------------------------------------------------------------+
| NRC BULLETIN 91-01 RESPONSE (24-HOUR REPORT) - LOSS OF MODERATION CONTROL    |
|                                                                              |
| The following text is a portion of a facsimile received from Portsmouth:     |
|                                                                              |
| "At 1610 hours on 12/03/99, operations personnel in the X-333 Process        |
| Building identified a piece of unattended cascade equipment (33-8-6 stage-1  |
| converter) which had an uncovered 'A'-line flange. This violated requirement |
| #4 of NCSA-PLANT062.A02 which states; 'Openings/penetrations made during     |
| maintenance activities shall be covered to minimize the potential for        |
| moderator collection and moist air exposure when unattended.'  This          |
| constitutes the loss of one NCS control (moderation) with mass and           |
| interaction controls maintained throughout this event.  Moderation control   |
| was reestablished at 1800 hours under the direction of Nuclear Criticality   |
| Safety (NCS) personnel by covering the opening."                             |
|                                                                              |
| "This is reportable under NRC Bulletin 91-01:  24-hour criticality           |
| control."                                                                    |
|                                                                              |
| "There was no lose of hazardous/radioactive material or                      |
| radioactive/radiological exposure as a result of this event."                |
|                                                                              |
| "SAFETY SIGNIFICANCE OF EVENTS:  This event has a low safety significance.   |
| Although the control credited toward making moderation intrusion unlikely    |
| was lost, no actual intrusion of liquid moderation occurred.  Interaction    |
| and mass controls remained in place."                                        |
|                                                                              |
| "POTENTIAL CRITICALITY PATHWAYS INVOLVED (BRIEF SCENARIO(S) OF HOW           |
| CRITICALITY COULD OCCUR):  For a criticality to occur, additional U-235      |
| would have to be added to the system."                                       |
|                                                                              |
| "CONTROLLED PARAMETERS (MASS, MODERATION, GEOMETRY, CONCENTRATION, ETC.):    |
| Mass, moderation, and interaction are controlled.  The mass and interaction  |
| controls were maintained, but moderation control was lost."                  |
|                                                                              |
| "ESTIMATED AMOUNT, ENRICHMENT, FORM OF LICENSED MATERIAL (INCLUDE PROCESS    |
| LIMIT AND % WORST CASE OF CRITICAL MASS):  UO2F2 [was] equal to or less than |
| 3% enriched U-235."                                                          |
|                                                                              |
| "NUCLEAR CRITICALITY SAFETY CONTROL(S) OR CONTROL SYSTEM(S) AND DESCRIPTION  |
| OF THE FAILURES OR DEFICIENCIES:  Mass, moderation, and interaction are      |
| controlled.  The mass and interaction controls ware maintained, but          |
| moderation control was lost."                                                |
|                                                                              |
| "CORRECTIVE ACTIONS TO RESTORE SAFETY SYSTEM AND WHEN EACH WAS IMPLEMENTED:  |
| Moderation control was reestablished at 1800 hours [on] 12/03/99 under the   |
| direction of NCS personnel by covering the opening."                         |
|                                                                              |
| Portsmouth personnel notified the NRC resident inspector and the Department  |
| of Energy site representative.                                               |
+------------------------------------------------------------------------------+