Event Notification Report for February 25, 2000

DAMAGED INDUSTRIAL THICKNESS GAUGE

An NDS Model 200 thickness gauge containing 2.001 Ci of Am-241 was damaged when it was struck and dislodged by a break in the continuous strip passing through the thickness gauge measuring area. The location of the gauge is located on the #6 line in the east galvanizing line of the sheet products division. The area was immediately isolated. Their outside consultant was called in to survey and wipe test the gauge. The shutter was in the closed position, there were no indications of a leak or higher than normal radiation readings, and the wipes came back negative for source leakage. There were no personnel injuries due to this event. US Steel has contacted the manufacturer, who will send someone out to retrieve the source and determine if it can be reused or needs to be replaced.

US Steel intends to submit a written report to the NRC within thirty days.

OFFSITE NOTIFICATION TO THE STATE OF FLORIDA REGARDING A SEA TURTLE RESCUE FROM THE PLANT INTAKE AREA

"RESCUED STRANDED KEMPS-RIDLEY TURTLE AT CRYSTAL RIVER UNIT 3 INTAKE AREA. FLORIDA POWER CORPORATION ENVIRONMENTAL REPRESENTATIVE WILL NOTIFY STATE OF FLORIDA."

THE LICENSEE WILL INFORM THE NRC RESIDENT INSPECTOR.

CONTAMINATION LEVELS FOLLOWING URANYL NITRATE SPILL (LOW LEVEL ENRICHED URANIUM) EXCEED ALLOWABLE LIMITS

"Westinghouse is making this notification in accordance with 10CFR70.50(b)(1), 'Domestic Licensing of Special Nuclear Material'.

"On February 8, 2000, contamination was discovered on a small portion (less than approximately 10%) of a 20 feet x 50 feet outside concrete pad, located adjacent to the Columbia Plant Manufacturing Building (between the building and the Uranyl Nitrate Tank Storage Pad). The contamination resulted from leakage of aqueous material through the wall of the Manufacturing Building from a spill of uranyl nitrate material in the UF6 Bay, near the HF Spiking Station, which occurred on 2/7/00. The leakage of aqueous material outside the building was identified after the inside spill was decontaminated.

"The concrete pad was roped off, and decontamination efforts were begun. Based upon initial contamination survey results, the event was not deemed notifiable because contamination levels did not exceed the limit in 10CFR70.50(b)(1)(ii). Decontamination efforts were hampered by the presence of soil on the concrete pad, which had accumulated over the years. As these materials were removed, on February 25, 2000, additional radioactive materials were discovered, making this event reportable under 10CFR70.50(b)(1). Contamination levels measured on 2/25/00 averaged approximately 133 dpm/100 cm2 alpha removable and approximately 6,000 dpm/100 cm2 non-removable alpha.

" The area remains roped off, and a decontamination plan is being formulated. As indicated above, the contamination surveys on 2/25/00 reveal that the majority of the contamination is fixed in the concrete.

" The decontamination plan will address removal of any loose material on the surface of the concrete, decontamination of the concrete, evaluation of the potential for further movement of material through the walls of the Plant, and an assessment of any movement of radioactive material into the soil."

The licensee discussed the above report with NRC staff in Region II.

24-HOUR NRC BULLETIN 91-01 REPORT INVOLVING THE LOSS OF ONE CRITICALITY CONTROL DURING MAINTENANCE ACTIVITIES

"At 0835 hours on 02/25/00, a Nuclear Criticality Safety (NCS) anomalous condition was identified by X-333 Operations personnel, when it was discovered that a process piping opening was not completely covered nor was it being manned by maintenance personnel as required by NCSA-PLANT062.A02. Maintenance Activity at this location had been terminated at approximately 0600 hours, 02/25/00.

"This violated requirement #4 of NCSA-PLANT062.A02 which states; 'Openings/Penetrations made during, or as a result of, maintenance activities will 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 1055 hours by covering the openings under the direction of the Nuclear Safety Engineer.

"This is reportable under NRC Bulletin 91-01; 24-hour criticality control.

"There was no loss of hazardous/radioactive material or radioactive/radiological exposure as a result of this event.

"SAFETY SIGNIFICANCE OF EVENTS:

"The safety significance of this event is extremely low. The limited amount of time the flanges were uncovered and unattended did not allow any more moisture to enter than if work had continued and the equipment had been attended for the entire period. Lack of attending personnel during the 'see & flee' simply removed the ability to mitigate an unlikely event involving the entrance of liquid water (or other moderator) into the equipment.

"POTENTIAL CRITICALITY PATHWAYS INVOLVED (BRIEF SCENARIO[S] OF HOW CRITICALITY COULD OCCUR):

"If the equipment had been mis-categorized and actually contained greater than the minimum Critical mass of uranium (more than 3400 pounds U02F2 at 1.44 wt% enrichment) and liquid water entered the exposed openings, a critical configuration might have formed inside the cascade equipment.

"CONTROLLED PARAMETERS (MASS, MODERATION, GEOMETRY, CONCENTRATION, ETC.):

"Controlled parameters include mass and moderation.

"ESTIMATED AMOUNT, ENRICHMENT, FORM OF LICENSED MATERIAL (INCLUDE PROCESS LIMIT AND % WORST CASE OF CRITICAL MASS):

"The exact amount is unknown, however, the cell was categorized as 'uncomplicated handling' which means the cell has less than the safe mass (approximately 1500 pounds U02F2 at 1.44 wt% enrichment). The form would be U02F2.

"NUCLEAR CRITICALITY SAFETY CONTROL(S) OR CONTROL SYSTEM(S) AND DESCRIPTION OF THE FAILURES OR DEFICIENCIES

"By leaving the exposed flanges unattended, control #4 of NCSA-PLANT062.A02 which requires 'Opening/penetration made during maintenance activities shall be covered to minimize the potential for moderator collection and moist air exposure when unattended.'

"CORRECTIVE ACTIONS TO RESTORE SAFETY SYSTEM AND WHEN EACH WAS IMPLEMENTED:

"Moderation control was reestablished at 1055 hours, 02/25/00, under the direction of the Nuclear Safety Engineer, by covering the opening."

Operations personnel informed both the DOE Site Representative and the NRC Resident Inspector.

AGREEMENT STATE REPORT INVOLVING A RADIOLOGIST (OCCUPATIONAL WORKER) WHO RECEIVED > 5 REM DURING CALDENDER YEAR 1999

ON 2/25/00 THE KANSAS DEPARTMENT OF HEALTH & ENVIRONMENT WAS NOTIFIED THAT A RADIOLOGIST PERFORMING INTERVENTIONIST RADIOLOGY AT THE UNIVERSITY OF KANSAS MEDICAL CENTER IN KANSAS CITY, KS, HAD RECEIVED 5.29 REM WHOLE BODY IN 1999 (CUMMULATIVE). THIS WAS DISCOVERED IN A REVIEW OF RECORDS PERFORMED BY THE UNIVERSITY.

MEDICAL MISADMINISTRATION

On 2/25/2000, an individual was implanted with 58 I-125 seeds for prostate treatment. However, the activity of the seeds implanted (0.354 mCi/seed) was higher than prescribed (0.27 mCi/seed). The licensee reported that, although the actual dose to the prostate was similar to the planned treatment dose, since the activity of the implanted seeds exceeded the prescribed activity by more than 20%, this occurrence was being treated as a misadministration.

The misadministration was discovered during a review performed on 4/17/2000. The licensee reported that an error occurred when the seeds were being ordered, and that additional steps would be added to the procedure to prevent recurrence. The radiation oncologist has been notified, and he will inform the patient of the incident.