Event Notification Report for September 24, 2001
U.S. Nuclear Regulatory Commission Operations Center Event Reports For 09/21/2001 - 09/24/2001 ** EVENT NUMBERS ** 38302 38303 38304 38305 38307 38308 +------------------------------------------------------------------------------+ |General Information or Other |Event Number: 38302 | +------------------------------------------------------------------------------+ +------------------------------------------------------------------------------+ | REP ORG: CALIFORNIA RADIATION CONTROL PRGM |NOTIFICATION DATE: 09/21/2001| |LICENSEE: MEDI-PHYSICS INC., dba NYCOMED AMERSH|NOTIFICATION TIME: 15:30[EDT]| | CITY: San Diego REGION: 4 |EVENT DATE: 09/21/2001| | COUNTY: STATE: CA |EVENT TIME: 11:00[PDT]| |LICENSE#: 5796-37 AGREEMENT: Y |LAST UPDATE DATE: 09/21/2001| | DOCKET: |+----------------------------+ | |PERSON ORGANIZATION | | |BILL JONES R4 | | |SUSAN FRANT NMSS | +------------------------------------------------+ | | NRC NOTIFIED BY: ROBERT GREGER | | | HQ OPS OFFICER: STEVE SANDIN | | +------------------------------------------------+ | |EMERGENCY CLASS: NON EMERGENCY | | |10 CFR SECTION: | | |NAGR AGREEMENT STATE | | | | | | | | | | | | | | +------------------------------------------------------------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | AGREEMENT STATE REPORT INVOLVING RAD CONTAMINATION DURING TRANSPORT | | | | "On August 24th at approximately 9:00 a.m. at the Medi-Physics facility | | located at 4877 Mercury Street. | | | | "A courier for Medi-Physics brought back some empty ammo containers from the | | morning deliveries. The containers were wiped upon receipt and it was | | discovered that one of the containers had removable contamination on the top | | of the container. From our phone conversation it appears that the level of | | removable contamination was approximately 300,000 DPM/ 100 cm2. The material | | was identified as Technetium-99. Medi-Physics will be submitting a letter | | with the details to my attention. The RSO at the hospital was contacted and | | he completed a survey to check for contamination at their facility. It is | | not known at this time the results of that survey. The courier's feet and | | the pedals of the vehicle also showed elevated levels of contamination." | | | | This information was reported to the San Diego Office on 9/21/01 at | | approximately 1100PDT. CA Event Report Identification XCA 85. | +------------------------------------------------------------------------------+ +------------------------------------------------------------------------------+ |General Information or Other |Event Number: 38303 | +------------------------------------------------------------------------------+ +------------------------------------------------------------------------------+ | REP ORG: NV DIV OF RAD HEALTH |NOTIFICATION DATE: 09/21/2001| |LICENSEE: SUNRISE DIAGNOSTIC CENTER |NOTIFICATION TIME: 17:25[EDT]| | CITY: LAS VEGAS REGION: 4 |EVENT DATE: 09/21/2001| | COUNTY: STATE: NV |EVENT TIME: [PDT]| |LICENSE#: 03-12-0395-02 AGREEMENT: Y |LAST UPDATE DATE: 09/21/2001| | DOCKET: |+----------------------------+ | |PERSON ORGANIZATION | | |JOHN PELLET R4 | | |ERIC LEEDS NMSS | +------------------------------------------------+ | | NRC NOTIFIED BY: STAN MARSHALL | | | HQ OPS OFFICER: STEVE SANDIN | | +------------------------------------------------+ | |EMERGENCY CLASS: NON EMERGENCY | | |10 CFR SECTION: | | |NAGR AGREEMENT STATE | | | | | | | | | | | | | | +------------------------------------------------------------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | AGREEMENT STATE REPORT INVOLVING POTENTIAL MEDICAL MISADMINISTRATION | | | | "Malfunction of Leksell Gamma Knife patient table. Possible | | misadministration to patient. Licensee is preparing a written report with | | more detail, corrective action, etc. | | | | "Patient being treated in a Gamma Knife unit rolled up against the table and | | table was unable to automatically retract from the Gamma Knife 'cave.' | | Licensee personnel were able to enter the room and manually remove the | | patient and table from the 'cave.' Personnel exposure estimated to be | | between 3 mr and 20 mr. Gamma Knife manufacturer (Leksell) has also been | | notified." | | | | Event Report ID No. NV-01-004. Event location Las Vegas, NV. | +------------------------------------------------------------------------------+ +------------------------------------------------------------------------------+ |Power Reactor |Event Number: 38304 | +------------------------------------------------------------------------------+ +------------------------------------------------------------------------------+ | FACILITY: MCGUIRE REGION: 2 |NOTIFICATION DATE: 09/22/2001| | UNIT: [1] [2] [] STATE: NC |NOTIFICATION TIME: 03:48[EDT]| | RXTYPE: [1] W-4-LP,[2] W-4-LP |EVENT DATE: 09/22/2001| +------------------------------------------------+EVENT TIME: 00:39[EDT]| | NRC NOTIFIED BY: ERIC WILKINSON |LAST UPDATE DATE: 09/22/2001| | HQ OPS OFFICER: FANGIE JONES +-----------------------------+ +------------------------------------------------+PERSON ORGANIZATION | |EMERGENCY CLASS: NON EMERGENCY |CHARLES CASTO R2 | |10 CFR SECTION: | | |APRE 50.72(b)(2)(xi) 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 | |2 N Y 100 Power Operation |100 Power Operation | | | | +------------------------------------------------------------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | OFFSITE NOTIFICATION TO THE LOCAL AUTHORITIES DUE TO AN INCIDENT IN FRONT OF | | THE PLANT | | | | The licensee's security department contacted the local police department | | about an incident just outside the plant at the highway entrance about a | | quarter mile from the protected area. | | | | The licensee notified the NRC Resident Inspector. | +------------------------------------------------------------------------------+ +------------------------------------------------------------------------------+ |Fuel Cycle Facility |Event Number: 38305 | +------------------------------------------------------------------------------+ +------------------------------------------------------------------------------+ | FACILITY: PORTSMOUTH GASEOUS DIFFUSION PLANT |NOTIFICATION DATE: 09/22/2001| | RXTYPE: URANIUM ENRICHMENT FACILITY |NOTIFICATION TIME: 06:21[EDT]| | COMMENTS: 2 DEMOCRACY CENTER |EVENT DATE: 09/22/2001| | 6903 ROCKLEDGE DRIVE |EVENT TIME: 02:25[EDT]| | BETHESDA, MD 20817 (301)564-3200 |LAST UPDATE DATE: 09/22/2001| | CITY: PIKETON REGION: 3 +-----------------------------+ | COUNTY: PIKE STATE: OH |PERSON ORGANIZATION | |LICENSE#: GDP-2 AGREEMENT: N |JOHN MADERA R3 | | DOCKET: 0707002 |ERIC LEEDS NMSS | +------------------------------------------------+RICHARD WESSMAN IRO | | NRC NOTIFIED BY: ERICK SPAETH | | | HQ OPS OFFICER: FANGIE JONES | | +------------------------------------------------+ | |EMERGENCY CLASS: NON EMERGENCY | | |10 CFR SECTION: | | |NBNL RESPONSE-BULLETIN | | | | | | | | | | | | | | +------------------------------------------------------------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | 4 HOUR REPORT - NRC BULLETIN 91-01 | | | | On 9/22/01 at 0225 hrs., operations personnel in the X-330 process building | | discovered that a UO2F2 deposit with "Greater Than Safe Mass" (GSM) was no | | longer being buffered with dry air or N2, to greater than or equal to 14 | | psia. The deposit was located at 31-5, cell 6/8 drop. The buffer pressure | | had been monitored from an adjacent cell 31-5-8. Block valves marked as open | | on a pin chart, were found to be closed, thus isolating the deposit from the | | monitoring cell. The GSM deposit pressure was verified to be 5.81 psia with | | Maintenance and Test Equipment (M&TE). | | | | NCSA-0330_004.A06 requirement #8a states in part, "If there is a deposit | | greater than a safe mass for systems conditions in the equipment, the | | pressure in the equipment shall monitored each shift and if the pressure is | | less than 14 psia it shall be adjusted with dry air or N2 to greater than 14 | | psia within 12 hours." | | | | Buffer pressure was increased to greater than 14 psia at 0425 hours. | | Remaining areas of the plant with similar conditions were checked and | | verified to be compliant with the 14 psia Buffer pressure requirement. | | | | SAFETY SIGNIFICANCE OF EVENTS: | | MODERATE, in this event the equipment was potentially without a buffer for 5 | | months which is insufficient time to allow enough water to enter the pipe | | and moderate the deposit to the level required to support a criticality. | | | | POTENTIAL CRITICALITY PATHWAYS INVOLVED (BRIEF SCENARIO[S] OF HOW | | CRITICALITY COULD OCCUR): Sufficient moderation must be added to a deposit | | at > safe mass to potentially create a critical configuration. This is | | highly dependent on geometry and reflection conditions. | | | | CONTROLLED PARAMETERS (MASS, MODERATION, GEOMETRY, CONCENTRATION, FTC.): | | In this event, moderation is the only available control, and it was not | | maintained. Other parameters, like geometry and reflection, are assumed to | | be optimum. | | | | ESTIMATED AMOUNT, ENRICHMENT, FORM OF LICENSED MATERIAL (INCLUDE PROCESS | | LIMIT AND % WORST CASE OF CRITICAL MASS): | | Worst case 1549 pounds U02F2 +/- 50% (max. 2323 pounds) at 2.26% based on | | available Non-Destructive analysis Measurements. This mass is above the | | minimum critical mass (690 pounds U02F2 at optimum conditions) for this | | enrichment level. | | | | NUCLEAR CRITICALITY SAFETY CONTROL(S) OR CONTROL SYSTEM(S) AND DESCRIPTION | | OF THE FAILURES OR DEFICIENCIES: | | Moderation Control was not maintained for up to 5 months, change in system | | configuration unknowingly isolated the deposit from pressure monitoring | | point. | | | | CORRECTIVE ACTIONS TO RESTORE SAFETY SYSTEM AND WHEN EACH WAS IMPLEMENTED: | | 0425 hours required buffer re-established, the valves involved were opened | | and tagged to remain open, verified remaining 4 like conditions were | | buffered as required. Investigation in progress. | | | | The licensee notified the NRC Resident Inspector and the on-site DOE | | representative. | +------------------------------------------------------------------------------+ +------------------------------------------------------------------------------+ |Power Reactor |Event Number: 38307 | +------------------------------------------------------------------------------+ +------------------------------------------------------------------------------+ | FACILITY: WATTS BAR REGION: 2 |NOTIFICATION DATE: 09/23/2001| | UNIT: [1] [] [] STATE: TN |NOTIFICATION TIME: 18:45[EDT]| | RXTYPE: [1] W-4-LP,[2] W-4-LP |EVENT DATE: 09/23/2001| +------------------------------------------------+EVENT TIME: 18:34[EDT]| | NRC NOTIFIED BY: BEN HUNT |LAST UPDATE DATE: 09/23/2001| | HQ OPS OFFICER: JOHN MacKINNON +-----------------------------+ +------------------------------------------------+PERSON ORGANIZATION | |EMERGENCY CLASS: NON EMERGENCY |BRIAN BONSER R2 | |10 CFR SECTION: |JOHN ZWOLINSKI NRR | |NINF INFORMATION ONLY | | | | | | | | | | | +-----+----------+-------+--------+-----------------+--------+-----------------+ |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 +------------------------------------------------------------------------------+ | CONDITION FOR AN UNUSUAL EVENT REPORTED BUT NOT DECLARED. | | | | | | At 1755ET the sensing line to the "B" Centrifugal Charging Pump (CCP) local | | discharge pressure gage broke. The operator noticed that the Volume Control | | Tank level was decreasing, Reactor Coolant System Pressurizer level did not | | change, but the VCT low level alarm was never reached. The leak was from | | the sensing line for "B" CCP local discharge pressure gage which is located | | in the Auxiliary Building. The leak rate was determined to be approximately | | 25 gpm by using the plant computer monitor to determine the rate of change | | of the Volume Control Tank level. All the water issuing from the sensing | | line drained into the Auxiliary Building drain system which drained into the | | radwaste system. No release offsite. | | | | The licensee is not in any Limiting Condition of Operation at this time. | | "B" CCP is fully operable because it's discharge pressure can be read from | | several locations, "A" CCP is fully operable. All other emergency core | | cooling systems, emergency diesel generators are fully operable if needed. | | State and Local officials were notified of this event. | | | | The time between 1801 hours and 1834 hours were used to determine the size | | of the leak from the Volume Control Tank. | | | | The NRC Resident Inspector will be notified of this event by the licensee. | +------------------------------------------------------------------------------+ +------------------------------------------------------------------------------+ |Power Reactor |Event Number: 38308 | +------------------------------------------------------------------------------+ +------------------------------------------------------------------------------+ | FACILITY: NINE MILE POINT REGION: 1 |NOTIFICATION DATE: 09/24/2001| | UNIT: [1] [] [] STATE: NY |NOTIFICATION TIME: 05:55[EDT]| | RXTYPE: [1] GE-2,[2] GE-5 |EVENT DATE: 09/24/2001| +------------------------------------------------+EVENT TIME: 04:55[EDT]| | NRC NOTIFIED BY: LAURIE RAYLE |LAST UPDATE DATE: 09/24/2001| | HQ OPS OFFICER: FANGIE JONES +-----------------------------+ +------------------------------------------------+PERSON ORGANIZATION | |EMERGENCY CLASS: NON EMERGENCY |JAMES LINVILLE R1 | |10 CFR SECTION: | | |ACOM 50.72(b)(3)(xiii) LOSS COMM/ASMT/RESPONSE| | | | | | | | | | | +-----+----------+-------+--------+-----------------+--------+-----------------+ |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 +------------------------------------------------------------------------------+ | LOSS OF PROMPT NOTIFICATION TONE ALERT RADIO FOR GREATER THAN 1 HOUR | | | | The licensee received a call at 0504 EDT from the Oswego County Warning | | Point that the Oswego County Prompt Notification Tone Alert Radio had been | | out-of-service for greater than 1 hour as of 0455 EDT. The cause of the | | outage is unknown and is being investigated. | | | | The licensee notified the NRC Resident Inspector. | +------------------------------------------------------------------------------+
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