Event Notification Report for June 6, 2000
U.S. Nuclear Regulatory Commission
Operations Center
Event Reports For
06/05/2000 - 06/06/2000
** EVENT NUMBERS **
37056 37057 37058 37059 37060
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|General Information or Other |Event Number: 37056 |
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| REP ORG: NC DIVISION OF RADIATION PROTECTION |NOTIFICATION DATE: 06/05/2000|
|LICENSEE: DURHAM VA HOSPITAL |NOTIFICATION TIME: 09:53[EDT]|
| CITY: DURHAM REGION: 2 |EVENT DATE: 06/04/2000|
| COUNTY: STATE: NC |EVENT TIME: 16:15[EDT]|
|LICENSE#: AGREEMENT: Y |LAST UPDATE DATE: 06/05/2000|
| DOCKET: |+----------------------------+
| |PERSON ORGANIZATION |
| |EDWARD MCALPINE R2 |
| |DON COOL NMSS |
+------------------------------------------------+ |
| NRC NOTIFIED BY: ALBRIGHT | |
| HQ OPS OFFICER: CHAUNCEY GOULD | |
+------------------------------------------------+ |
|EMERGENCY CLASS: N/A | |
|10 CFR SECTION: | |
|NAGR AGREEMENT STATE | |
| | |
| | |
| | |
| | |
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EVENT TEXT
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| THE DURHAM, N.C. VA HOSPITAL SENT SOME RADIOACTIVE WASTE TO THE DURHAM WASTE |
| TRANSFER STATION. |
| |
| A WASTE INDUSTRIES TRUCK SETOFF THE PORTAL MONITOR AT THE DURHAM WASTE |
| TRANSFER STATION. THE TRUCK HAD PICKED UP A LOAD OF WASTE FROM THE DURHAM |
| VA HOSPITAL. THE WASTE WAS RETURNED TO THE HOSPITAL. ONE BAG CONTAINED IN |
| THE WASTE WAS MEASURING 150,000 CPM AT ONE FOOT AND OFF SCALE AT THE BAG. |
| A DIAPER IN THE BAG WAS DETERMINED TO BE THE SOURCE. IT WAS DISCOVERED THE |
| PATIENT WHO HAD WORN THE DIAPER HAD RECEIVED 20 MILLICURIES OF TECHNETIUM-99 |
| ON THAT MORNING. |
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|Fuel Cycle Facility |Event Number: 37057 |
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| FACILITY: PORTSMOUTH GASEOUS DIFFUSION PLANT |NOTIFICATION DATE: 06/05/2000|
| RXTYPE: URANIUM ENRICHMENT FACILITY |NOTIFICATION TIME: 13:22[EDT]|
| COMMENTS: 2 DEMOCRACY CENTER |EVENT DATE: 06/05/2000|
| 6903 ROCKLEDGE DRIVE |EVENT TIME: 09:27[EDT]|
| BETHESDA, MD 20817 (301)564-3200 |LAST UPDATE DATE: 06/05/2000|
| CITY: PIKETON REGION: 3 +-----------------------------+
| COUNTY: PIKE STATE: OH |PERSON ORGANIZATION |
|LICENSE#: GDP-2 AGREEMENT: N |JOHN JACOBSON R3 |
| DOCKET: 0707002 |BRIAN SMITH NMSS |
+------------------------------------------------+CHARLES MILLER IRO |
| NRC NOTIFIED BY: KEITH VANDERPOOL | |
| HQ OPS OFFICER: JOHN MacKINNON | |
+------------------------------------------------+ |
|EMERGENCY CLASS: N/A | |
|10 CFR SECTION: | |
|NBNL RESPONSE-BULLETIN | |
| | |
| | |
| | |
| | |
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EVENT TEXT
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| 4 HOUR NRC BULLETIN 91-01 NOTIFICATION CONCERNING LOSS OF 2 CONTROLS OF |
| DOUBLE CONTINGENCY |
| |
| ON 6/5/00 AT 0927 HOURS PLANT PERSONNEL WERE REMOVING INSULATION FROM THE |
| X-705 PROCESS PIPING WHEN THEY DISCOVERED EVIDENCE OF A FAILURE OF THE |
| INTEGRITY OF SAID PIPING (material residue visible on the insulation). THIS |
| FAILURE VIOLATES NCSA-0705_076 WHICH TAKES CREDIT FOR THE INTEGRITY OF THE |
| PROCESS PIPING, THUS CONSTITUTING A LOSS OF ONE CONTROL. THE FACT THAT THE |
| ENCAPSULATING INSULATION PHYSICALLY CAPTURED THE LEAKING MATERIAL MEETS THE |
| DEFINITION FOR AN INADVERTENT CONTAINER THUS CONSTITUTING A LOSS OF ONE |
| CONTROL AS DESCRIBED BY NCSA-0705_076 WHICH TAKES CREDIT FOR COVERING, |
| MODIFICATION OR ELEVATION OF ABSORBENT MATERIALS TO PREVENT THE COLLECTION |
| OF URANIUM BEARING LIQUID IN AN INADVERTENT CONTAINER. |
| |
| IT SHOULD BE NOTED THAT IT IS NOT CLEAR WHETHER OR NOT THE TOTAL VOLUME OF |
| MATERIAL INVOLVED WAS GREATER THAN THE ALLOWED SAFE VOLUME (4.8 Liters ) |
| CREDITED IN THE EVALUATION FOR ENSURING DOUBLE CONTINGENCY. BASED ON VISUAL |
| INSPECTION OF THE MATERIAL PRESENT IN/ON THE INSULATION, IT IS ESTIMATED |
| THAT THE TOTAL AMOUNT OF URANIUM BEARING MATERIAL IS LESS THAN 350 GRAMS. |
| MORE RELIABLE ANALYSIS IS CURRENTLY BEING PERFORMED FOR MORE PRECISE |
| DETERMINATION OF THE AMOUNT OF MATERIAL. SINCE THE FAILURE TIME OF THE |
| PROCESS PIPING IS UNKNOWN, THE ENRICHMENT PERCENTAGE OF THE MATERIAL COULD |
| BE (worst case) 100% wt. U-235. THE MATERIAL PROCESSED IN THE X-705 RECOVERY |
| AREA PRIMARILY INVOLVES URANYL NITRATE, ALTHOUGH SOME URANYL FLUORIDE MAY BE |
| PRESENT. |
| |
| THE PSS HAS SUSPENDED ALL WORK/PROCESS EVOLUTIONS IN THE AFFECTED AREA |
| PENDING INVESTIGATION. CONTROLS WERE RE-ESTABLISHED UNDER THE DIRECTION OF |
| THE NUCLEAR CRITICALITY SAFETY STAFF AT 1156 HOURS THIS DATE. |
| |
| Safety Significance of Events: |
| |
| On June 5, 2000, it was discovered that the insulation around the A loop |
| density pot was contaminated by uranium-bearing material. This insulation |
| was approximately 1 to 3 inches in thickness and constructed out of an |
| absorbent material. The density pot is 4-inch schedule 40 piping located |
| below the A loop evaporator and is approximately |
| 24-inches in length. Clamp-on density transmitters are used for density |
| control in the uranium-bearing feed solution to the extractor/strippers. |
| After removal from the density pot, the insulation was observed to be coated |
| with a yellowish material, which, based on high count readings, appears to |
| be uranium-bearing. The material appeared dry in nature. It is not clear |
| when the material accumulated on/in the insulation or how much was present |
| during that accumulation. This insulation represents a violation of |
| NCSA-0705_076 in that the absorbent material (i.e., the insulation) was not |
| covered or modified properly. |
| |
| In addition, there is a potential loss of control in the failure of the |
| nearby system integrity. It is not clear when or exactly how the |
| uranium-bearing material was transported such that it accumulated on/in the |
| insulation. It should be noted that it is not clear whether or not the total |
| volume of material involved (i.e., which could /did accumulate on/in the |
| insulation) was greater than the allowed (i.e., safe) volume credited in the |
| evaluation for ensuring double contingency. Thus, while the anomalous |
| condition is being treated as a loss of both controls the most likely |
| scenario is that the material involved less than a safe amount of material |
| and so the safety significance of this event is low. |
| |
| 2. Potential Criticality Pathways Involved; |
| |
| If a sufficient amount of uranium-bearing material had accumulated on/in the |
| insulation, an unsafe geometry could have resulted and if the leaking |
| solution had contained a sufficient amount of uranium, the resulting |
| configuration could have been sufficient for a criticality to occur. It |
| should be noted that the allowed safe geometry and volume limits established |
| in NCSA-0705_076 are based on optimally moderated, UO2F2 and water solution |
| which contains uranium enriched to 100 wt%. |
| |
| 3. Controlled Parameters: |
| |
| The parameter which was violated during this upset was the geometry of |
| potential accumulation present on/in the insulation. In addition, the |
| physical integrity of nearby piping was violated at some point in the past. |
| As stated previously, the total amount of solution involved (i.e., the |
| volume of solution which leaked onto the insulation and resulted in the |
| uranium-bearing material being deposited on/in the insulation) is unknown, |
| so it is conservatively being evaluated as though the volume was greater |
| than the safe volume allowed. This represents the failure of both controls |
| relied upon for ensuring double contingency. |
| |
| 4 Estimated Amount, Enrichment, Form of Licensed Material: |
| |
| Based on visual inspection of the material present on/in the insulation, it |
| is estimated that the total amount of uranium-bearing material is less than |
| 350 grams. More reliable analysis is currently being performed for a more |
| precise determination of the amount of material. Since the failure time is |
| unknown, the enrichment of the material could be up to 100 wt% U-235. The |
| material processed in the X-705 recovery primarily involves uranyl nitrates |
| (U02(N03)2) , although some uranyl fluoride (UO2F2) may also be present. |
| |
| 5. Nuclear Criticality Safety Control(s) or control system(s) and |
| description of the failures or deficiencies: |
| |
| NCSA-0705_076.A00 takes credit for the physical integrity of systems which |
| contain uranium-bearing material and that unsafe volume/geometry containers |
| (including absorbent materials like the insulation) are either modified, |
| covered, or oriented to prevent an unsafe configuration from resulting in |
| the event of a leak. The absorbent material was not modified, covered, or |
| oriented to prevent an unsafe configuration. In addition, there is evidence |
| that at some time in the past a loss of nearby system integrity occurred |
| such that the insulation was exposed to an uranium-bearing solution. |
| |
| 6. Corrective Actions to Restore Safety System and when each was |
| Implemented: |
| |
| Under the direction of the nuclear criticality safety staff NCSA controls |
| were re-established at 1156 hours, with all maintenance work and process |
| evolutions suspended pending the ongoing investigation by facility |
| management and nuclear criticality safety staff personnel. |
| |
| The NRC Resident Inspector was notified of this event by the certificate |
| holder. |
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|Power Reactor |Event Number: 37058 |
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| FACILITY: VOGTLE REGION: 2 |NOTIFICATION DATE: 06/05/2000|
| UNIT: [1] [] [] STATE: GA |NOTIFICATION TIME: 13:52[EDT]|
| RXTYPE: [1] W-4-LP,[2] W-4-LP |EVENT DATE: 06/05/2000|
+------------------------------------------------+EVENT TIME: 11:40[EDT]|
| NRC NOTIFIED BY: CECIL H. WILLIAMS |LAST UPDATE DATE: 06/05/2000|
| HQ OPS OFFICER: JOHN MacKINNON +-----------------------------+
+------------------------------------------------+PERSON ORGANIZATION |
|EMERGENCY CLASS: N/A |EDWARD MCALPINE R2 |
|10 CFR SECTION: | |
|ARPS 50.72(b)(2)(ii) RPS ACTUATION | |
|AESF 50.72(b)(2)(ii) ESF ACTUATION | |
| | |
| | |
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|UNIT |SCRAM CODE|RX CRIT|INIT PWR| INIT RX MODE |CURR PWR| CURR RX MODE |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|1 M/R Y 100 Power Operation |0 Hot Standby |
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EVENT TEXT
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| MANUAL REACTOR TRIP DUE TO MAIN STEAM ISOLATION VALVE CLOSING. |
| |
| AT 1140 EDT the Unit One Control Room crew received a trouble alarm on Steam |
| Generator Loop 4 Inboard Main Steam Isolation Valve (MSIV). The operators |
| observed no light indication on the MSIV, a decreasing level in the Steam |
| Generator, a large decrease in indicated steam flow, and control rods began |
| inserting. The Shift Superintendent directed that the reactor be manually |
| tripped. The reactor was manually tripped and all systems functioned as |
| required with the exception of a non-1E 4160 V bus (loss steam dump bypass |
| control panel open/close indication) , which failed to auto transfer to |
| it's startup power source. Auxiliary Feedwater System (both motor and the |
| turbine driven pumps) actuated as expected on Steam Generator Lo-Lo levels. |
| |
| |
| The Control Room crew has exited the Emergency Operating Procedures and the |
| unit is stable in Mode 3 at normal operating temperature and pressure. |
| |
| The 4160 V breaker which failed to close was racked out of it's cubicle, |
| inspected and racked back into it's operating position, after which it was |
| successfully closed by the Control room crew. This reenergized the |
| non-1E 4160V bus and its associated loads. |
| |
| Investigation into the cause of the MSIV closure is ongoing. An Event Review |
| Team is being formed, and a restart date will be decided upon following |
| management review of the results of their investigation. |
| |
| Steam Generator Atmospheric valve controller was reduced to its lowest |
| setpoint and maintained the Reactor Coolant System at its Tave no load |
| condition (Steam Generator 1 & 4 Atmospheric valves opened/closed a few |
| times). The Steam Dump Bypass Control System was fully operable and |
| operated properly. Approximately one hour after the event non-1E 4160V bus |
| was re-energized. |
| |
| The NRC Resident Inspector was notified of this event by the licensee. |
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|Power Reactor |Event Number: 37059 |
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| FACILITY: CATAWBA REGION: 2 |NOTIFICATION DATE: 06/05/2000|
| UNIT: [] [2] [] STATE: SC |NOTIFICATION TIME: 15:40[EDT]|
| RXTYPE: [1] W-4-LP,[2] W-4-LP |EVENT DATE: 06/05/2000|
+------------------------------------------------+EVENT TIME: 12:37[EDT]|
| NRC NOTIFIED BY: K. PHILLIPS |LAST UPDATE DATE: 06/05/2000|
| HQ OPS OFFICER: JOHN MacKINNON +-----------------------------+
+------------------------------------------------+PERSON ORGANIZATION |
|EMERGENCY CLASS: N/A |EDWARD MCALPINE R2 |
|10 CFR SECTION: | |
|ARPS 50.72(b)(2)(ii) RPS ACTUATION | |
|AESF 50.72(b)(2)(ii) ESF ACTUATION | |
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| | |
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|UNIT |SCRAM CODE|RX CRIT|INIT PWR| INIT RX MODE |CURR PWR| CURR RX MODE |
+-----+----------+-------+--------+-----------------+--------+-----------------+
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|2 A/R Y 100 Power Operation |0 Hot Standby |
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EVENT TEXT
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| AUTOMATIC REACTOR TRIP ON HIGH STEAM GENERATOR WATER LEVEL |
| |
| |
| Automatic reactor trip from 100% power due to a feedwater transient caused |
| by a loss of control power to 2B main feedwater pump. The feedwater |
| transient resulted in a 2B steam generator high-high setpoint being reached |
| which tripped both main feedwater pumps, caused a feedwater isolation |
| signal, and tripped the main turbine which caused the reactor trip. All |
| rods fully inserted into the core. Steam generators levels are being |
| maintained at normal level with auxiliary feedwater at this time. The loss |
| of control power has been attributed to water intrusion into the 2B |
| feedwater pump control panel from extremely heavy rains and roof repairs |
| being in progress. |
| |
| All Emergency Core Cooling Systems and the Emergency Diesel Generators are |
| fully operable if needed. The electrical grid is stable an Unit 1 was not |
| affected by Unit 2's reactor trip. |
| |
| The NRC Resident Inspector was notified of this event by the licensee. |
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|Power Reactor |Event Number: 37060 |
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| FACILITY: DUANE ARNOLD REGION: 3 |NOTIFICATION DATE: 06/06/2000|
| UNIT: [1] [] [] STATE: IA |NOTIFICATION TIME: 06:02[EDT]|
| RXTYPE: [1] GE-4 |EVENT DATE: 06/06/2000|
+------------------------------------------------+EVENT TIME: 02:36[CDT]|
| NRC NOTIFIED BY: JOHN VAN SICKEL |LAST UPDATE DATE: 06/06/2000|
| HQ OPS OFFICER: STEVE SANDIN +-----------------------------+
+------------------------------------------------+PERSON ORGANIZATION |
|EMERGENCY CLASS: |JOHN JACOBSON R3 |
|10 CFR SECTION: | |
|AINC 50.72(b)(2)(iii)(C) POT UNCNTRL RAD REL | |
| | |
| | |
| | |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|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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| SECONDARY CONTAINMENT DECLARED INOPERABLE DUE TO LOSS OF WATER SEAL CAUSED |
| BY PIPE CORROSION |
| |
| "A 4 inch diameter floor drain outlet pipe inside the Standby Gas Treatment |
| Sump was identified by Operating personnel to be corroded through near the |
| wall of the sump. This piping is designed to act as a Secondary Containment |
| boundary which is used to form a loop seal between the Reactor Building and |
| the SBGT room. Normally, the piping would come out from the wall and make a |
| 90 degree turn to near the bottom of the sump, and open under water. |
| However, with the erosion occurring near the wall of the sump, a breech of |
| secondary containment exists. Due to the amount of corrosion, the opening |
| was estimated to be 12.57 square inches. Additionally, damaged seals on two |
| other doors (#225 and #128) located on airlocks associated with Secondary |
| Containment accounted for another 7 square inches, for a total of 19.57 |
| square inches. Openings in excess of 12.7 square inches in this |
| configuration have not been tested/evaluated. Therefore, Secondary |
| Containment was considered inoperable. Operations entered Technical |
| Specification LCO 3.6.4.1, condition A, for Secondary Containment inoperable |
| in Mode 1 at 0236[CDT]. Required action A.1 is to restore Secondary |
| Containment to operable status in 4 hours. |
| |
| "Operations took actions to prohibit access through the two seal damaged |
| doors/airlocks by posting them to prevent access. Once administrative |
| control of the doors was established, the known opening in secondary |
| containment was reduced to the corroded pipe in the SBGT sump, or 12.57 |
| square inches. This is less than the 12.7 square inches allowed. Technical |
| Specification LCO 3.6.4.1, condition A, was exited at 0258[CDT]." |
| |
| The licensee informed the NRC Resident Inspector. |
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