Event Notification Report for March 29, 2002
U.S. Nuclear Regulatory Commission
Operations Center
Event Reports For
03/28/2002 - 03/29/2002
** EVENT NUMBERS **
38809 38810 38811 38812 38813 38814 38815 38816
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|Power Reactor |Event Number: 38809 |
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+------------------------------------------------------------------------------+
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| FACILITY: DRESDEN REGION: 3 |NOTIFICATION DATE: 03/28/2002|
| UNIT: [] [2] [3] STATE: IL |NOTIFICATION TIME: 01:24[EST]|
| RXTYPE: [1] GE-1,[2] GE-3,[3] GE-3 |EVENT DATE: 03/27/2002|
+------------------------------------------------+EVENT TIME: 22:30[CST]|
| NRC NOTIFIED BY: BROCK |LAST UPDATE DATE: 03/28/2002|
| HQ OPS OFFICER: CHAUNCEY GOULD +-----------------------------+
+------------------------------------------------+PERSON ORGANIZATION |
|EMERGENCY CLASS: NON EMERGENCY |BRUCE BURGESS R3 |
|10 CFR SECTION: | |
|AUNA 50.72(b)(3)(ii)(B) UNANALYZED CONDITION | |
| | |
| | |
| | |
+-----+----------+-------+--------+-----------------+--------+-----------------+
|UNIT |SCRAM CODE|RX CRIT|INIT PWR| INIT RX MODE |CURR PWR| CURR RX MODE
|
+-----+----------+-------+--------+-----------------+--------+-----------------+
| | |
|2 N Y 95 Power Operation |95 Power Operation |
|3 N Y 100 Power Operation |100 Power Operation |
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EVENT TEXT
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| SPURIOUS OPERATION OF THE REACTOR HEAD VENT VALVES IN THE SAFE
SHUTDOWN |
| REPORT(SSR) IS NOT CONSISTENT WITH THE NRC SAFETY EVALUATION REPORT.
|
| |
| |
| Specifically the Section 3.4.3 of the SER states that spurious operation of |
| the Reactor Head Vent (RHV) valves {SO-2(3)-0220-46 ann SO-2(3)-0220-47} |
| which would result in Reactor Coolant inventory loss, will be prevented by a |
| pre-fire action to ensure closure by removing power from these valves. |
| However, the current SSR dispositions this postulated concern based upon the |
| assumption that spurious operation of greater than one normally closed valve |
| in a series combination is not considered a credible failure mode except for |
| high/low pressure systems. As a result, there is no pre-fire action to |
| ensure closure by removing power to RHV valves. The documentation (FPR |
| revision and 50.59) that supports the change in the licensing position of |
| these valves from that described in the SER to the current SSR has not been |
| located. |
| |
| A review was performed on the Fire Protection Report (FPR) which includes |
| the Fire Hazard Analysis & Safe Shutdown Analysis, to evaluate the options |
| for additional sources of water to address the loss of reactor inventory |
| from the spurious actions of the reactor head vent valves. This review |
| indicated that no specific circuit analysis was performed to determine what |
| other available sources of water could be used for makeup of reactor |
| inventory via the reactor head vent valves spurious operation. Therefore, |
| in the event of a fire in the various assumed Appendix R fire zones, a |
| qualified makeup source would not be available to mitigate the inventory |
| loss introduced by the spurious operation of both RHV valves. |
| |
| Fuses have been pulled to remove power to and close a RHV valve on both Unit |
| 2 and Unit 3 to comply with the SER. The action puts the plant in the |
| configuration required if the RHV valves are considered a high-low pressure |
| boundary. Completion of this action restores the plants compliance with the |
| referenced SER. |
| |
| Dresden Engineering will perform an evaluation that documents the RHV valves |
| as a high-low pressure boundary and that the actions taken above are |
| adequate to mitigate the multiple spurious failures which must be postulated |
| when these valves are considered a high/low pressure boundary. A revision |
| to the FPR will be made to document the results of this evaluation. |
| |
| The NRC Resident Inspector will be notified. |
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|Power Reactor |Event Number: 38810 |
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| FACILITY: HATCH REGION: 2 |NOTIFICATION DATE: 03/28/2002|
| UNIT: [] [2] [] STATE: GA |NOTIFICATION TIME: 09:54[EST]|
| RXTYPE: [1] GE-4,[2] GE-4 |EVENT DATE: 03/28/2002|
+------------------------------------------------+EVENT TIME: 03:00[EST]|
| NRC NOTIFIED BY: ED BURKETT |LAST UPDATE DATE: 03/28/2002|
| HQ OPS OFFICER: MIKE NORRIS +-----------------------------+
+------------------------------------------------+PERSON ORGANIZATION |
|EMERGENCY CLASS: NON EMERGENCY |CAROLYN EVANS R2 |
|10 CFR SECTION: | |
|AIND 50.72(b)(3)(v)(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 |
| | |
+------------------------------------------------------------------------------+
EVENT TEXT
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| SINGLE TRAIN HPCI DECLARED OOS |
| |
| "During valve surveillance testing, Motor Operated Valve 2E41F104 failed to |
| indicate OPEN. This is one of two in-line Primary Containment Isolation |
| Valves (PCIV) that provide vacuum breaker isolation capability for the High |
| Pressure Coolant Injection (HPCI) Steam Turbine Exhaust line. This failure |
| resulted in the PCIV being declared INOPERABLE at 0300 on 03-28-2002. To |
| comply with TS 3.6.1.3.B.1, the companion PCIV, 2E41F111, was CLOSED and |
| deactivated. This resulted in the HPCI system being declared INOPERABLE, |
| requiring a notification per 10CFR 50.72 for failure of a single train |
| system. The HPCI system was scheduled to be removed from service for |
| pre-planned maintenance, however, the failure of the 2E41F104 was not part |
| of the pre-planned maintenance activities. The HPCI system has been removed |
| from service, as scheduled, for performance of the pre-planned maintenance |
| work. |
| |
| "As of 0904, the 2E41F104 has been repaired, the equipment clearance |
| restored, and the valve has been satisfactorily functionally tested. |
| Complete functional testing and return to service of the HPCI system is in |
| progress, but has not been completed at this time. It is expected that the |
| HPCI system will be returned to service today (03-28-2002)." |
| |
| The NRC Resident has been notified. |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
|General Information or Other |Event Number: 38811 |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| REP ORG: LOUISIANA RADIATION PROTECTION DIV |NOTIFICATION DATE: 03/28/2002|
|LICENSEE: TERREBONNE GENERAL MEDICAL CENTER |NOTIFICATION TIME:
11:08[EST]|
| CITY: HOUMA REGION: 4 |EVENT DATE: 03/27/2002|
| COUNTY: STATE: LA |EVENT TIME: [CST]|
|LICENSE#: LA-2762-L01 AGREEMENT: Y |LAST UPDATE DATE: 03/28/2002|
| DOCKET: |+----------------------------+
| |PERSON ORGANIZATION |
| |CHUCK CAIN R4 |
| |JOHN HICKEY NMSS |
+------------------------------------------------+ |
| NRC NOTIFIED BY: SCOOT BLACKWELL | |
| HQ OPS OFFICER: MIKE NORRIS | |
+------------------------------------------------+ |
|EMERGENCY CLASS: NON EMERGENCY | |
|10 CFR SECTION: | |
|NAGR AGREEMENT STATE | |
| | |
| | |
| | |
| | |
+------------------------------------------------------------------------------+
EVENT TEXT
+------------------------------------------------------------------------------+
| MEDICAL MISADMINISTRATION |
| On March 21, 2002, the physician ordered a Resting Myoview scan on a |
| patient. This patient was assigned a different room and the Nuclear Medicine |
| department was not notified. When the technologist went to inject the |
| patient he verbally identified the patient and injected the wrong patient |
| with 20.6 mCi of Tc-99m Myoview. The technologist has suppose to identify |
| the patient by the ID bracelet but did not. The technologist was been |
| retrained in the procedure. This misadministration was discovered when the |
| correct patient was called in for the scan and the patient had not been |
| injected. The patient that received the misadministration was notified. |
| There was no apparent harm or injury to the patient. The patient that |
| received the misadministration was not suppose to be injected with |
| radiopharmaceuticals at all. The physician received enough information from |
| the stress test on the correct patient so that patient did not need to be |
| injected again. |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
|General Information or Other |Event Number: 38812 |
+------------------------------------------------------------------------------+
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| REP ORG: CALIFORNIA RADIATION CONTROL PRGM |NOTIFICATION DATE:
03/28/2002|
|LICENSEE: CALIFORNIA RADIAITION CONTROL |NOTIFICATION TIME: 12:52[EST]|
| CITY: LONG BEACH REGION: 4 |EVENT DATE: 03/28/2002|
| COUNTY: STATE: CA |EVENT TIME: [PST]|
|LICENSE#: CA4165 AGREEMENT: Y |LAST UPDATE DATE: 03/28/2002|
| DOCKET: |+----------------------------+
| |PERSON ORGANIZATION |
| |CHUCK CAIN R4 |
| |JOHN HICKEY NMSS |
+------------------------------------------------+ |
| NRC NOTIFIED BY: ROBERT GREGER | |
| HQ OPS OFFICER: RICH LAURA | |
+------------------------------------------------+ |
|EMERGENCY CLASS: NON EMERGENCY | |
|10 CFR SECTION: | |
|NAGR AGREEMENT STATE | |
| | |
| | |
| | |
| | |
+------------------------------------------------------------------------------+
EVENT TEXT
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| AGREEMENT STATE REPORT FOR STOLEN MOISTURE DENSITY GAGE |
| |
| "Just received word of a moisture density gauge that was stolen overnight. |
| Licensee is #4165-37 North County Compaction Engineering Inc., from |
| Escondido, CA. [ ]. The device is a CPN, model MC-1, S/N M14065450 stolen |
| from the cab of the operator's truck which he did take to his residence in |
| Long Beach, CA. Police report filed. The |
| gauge contains nominally 10 mCi of Cs-137 and 30 mCi of Am-241. The |
| licensee will place an announcement in the local paper describing [the] |
| device and offering a reward for the return of the gauge." |
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|General Information or Other |Event Number: 38813 |
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| REP ORG: ILLINOIS DEPT OF NUCLEAR SAFETY |NOTIFICATION DATE: 03/28/2002|
|LICENSEE: SHOLLE CORPORATION |NOTIFICATION TIME: 13:39[EST]|
| CITY: NORTHLAKE REGION: 3 |EVENT DATE: 03/27/2002|
| COUNTY: STATE: IL |EVENT TIME: [CST]|
|LICENSE#: 9201385 AGREEMENT: Y |LAST UPDATE DATE: 03/28/2002|
| DOCKET: |+----------------------------+
| |PERSON ORGANIZATION |
| |BRUCE BURGESS R3 |
| |JOHN HICKEY NMSS |
+------------------------------------------------+ |
| NRC NOTIFIED BY: JOE KLINGER | |
| HQ OPS OFFICER: MIKE NORRIS | |
+------------------------------------------------+ |
|EMERGENCY CLASS: NON EMERGENCY | |
|10 CFR SECTION: | |
|NAGR AGREEMENT STATE | |
| | |
| | |
| | |
| | |
+------------------------------------------------------------------------------+
EVENT TEXT
+------------------------------------------------------------------------------+
| AGREEMENT STATE REPORT FOR A LOST GAUGE |
| |
| "A general licensee reported the loss of an NDC Infrared Engineering Model |
| 103, serial no. 773, containing 100 mCi of Am-241. The gauging device was |
| initially installed in 1982. The general licensee is a manufacturer of |
| packaging products. The device was apparently installed at one time in a |
| plastic extruder line. In November 2000 it was reported to the Department as |
| being on the laminator in the plant. While performing the inventory for the |
| most recent Departmental self-inspection, the licensee was unable to account |
| for this device. Licensee states that it conducted an extensive |
| investigation of the circumstances surrounding the disappearance of the |
| device. Their investigation continues and they will file the required report |
| as soon as possible. The department's investigation is ongoing." |
+------------------------------------------------------------------------------+
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|General Information or Other |Event Number: 38814 |
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| REP ORG: ILLINOIS DEPT OF NUCLEAR SAFETY |NOTIFICATION DATE: 03/28/2002|
|LICENSEE: NASCOTE INDUSTRIES, INC |NOTIFICATION TIME: 13:39[EST]|
| CITY: NASHVILLE REGION: 3 |EVENT DATE: 03/27/2002|
| COUNTY: STATE: IL |EVENT TIME: [CST]|
|LICENSE#: GENERAL AGREEMENT: Y |LAST UPDATE DATE: 03/28/2002|
| DOCKET: |+----------------------------+
| |PERSON ORGANIZATION |
| |BRUCE BURGESS R3 |
| |JOHN HICKEY NMSS |
+------------------------------------------------+ |
| NRC NOTIFIED BY: JOE KLINGER | |
| HQ OPS OFFICER: MIKE NORRIS | |
+------------------------------------------------+ |
|EMERGENCY CLASS: NON EMERGENCY | |
|10 CFR SECTION: | |
|NAGR AGREEMENT STATE | |
| | |
| | |
| | |
| | |
+------------------------------------------------------------------------------+
EVENT TEXT
+------------------------------------------------------------------------------+
| AGREEMENT STATE REPORT FOR LOSS OF STATIC ELIMINATOR |
| |
| "General licensee reported the loss of a Po-210 static eliminator device. |
| The Licensee presumes that the device was recently lost during routine |
| manufacturing operations. The device is manufactured by NRD and is Model |
| P-2021, Serial no. A2BA986 containing approximately 2 mCi of Po-210. The |
| Licensee will continue to search and file the required written report." |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
|Power Reactor |Event Number: 38815 |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| FACILITY: RIVER BEND REGION: 4 |NOTIFICATION DATE: 03/28/2002|
| UNIT: [1] [] [] STATE: LA |NOTIFICATION TIME: 20:30[EST]|
| RXTYPE: [1] GE-6 |EVENT DATE: 03/28/2002|
+------------------------------------------------+EVENT TIME: 16:43[CST]|
| NRC NOTIFIED BY: KISHOR L. CHAPANERI |LAST UPDATE DATE: 03/28/2002|
| HQ OPS OFFICER: STEVE SANDIN +-----------------------------+
+------------------------------------------------+PERSON ORGANIZATION |
|EMERGENCY CLASS: NON EMERGENCY |CHUCK CAIN R4 |
|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 |
| | |
| | |
+------------------------------------------------------------------------------+
EVENT TEXT
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| OFFSITE NOTIFICATIONS DUE TO UNPLANNED EMERGENCY SIREN ACTUATION
|
| |
| "At 1643, it was discovered that a single River Bend Station Emergency |
| Siren located in East Baton Rouge Parish had intermittently sounded. A |
| notification was made to the Louisiana Office of Emergency Preparedness and |
| a subsequent message is to be broadcast on local radio stations informing |
| the public that this is an equipment related issue with this siren and no |
| emergency exists." |
| |
| The licensee informed state/local agencies and the NRC resident inspector. |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
|General Information or Other |Event Number: 38816 |
+------------------------------------------------------------------------------+
+------------------------------------------------------------------------------+
| REP ORG: NC DIV OF RADIATION PROTECTION |NOTIFICATION DATE: 03/28/2002|
|LICENSEE: THOMPSON-ARTHUR DIVISION APAC-CAROLIN|NOTIFICATION TIME:
23:00[EST]|
| CITY: GREENSBORO REGION: 2 |EVENT DATE: 03/28/2002|
| COUNTY: STATE: NC |EVENT TIME: [EST]|
|LICENSE#: 041-039 AGREEMENT: Y |LAST UPDATE DATE: 03/28/2002|
| DOCKET: |+----------------------------+
| |PERSON ORGANIZATION |
| |CAROLYN EVANS R2 |
| |PATRICIA HOLAHAN NMSS |
+------------------------------------------------+ |
| NRC NOTIFIED BY: LEE COX | |
| HQ OPS OFFICER: STEVE SANDIN | |
+------------------------------------------------+ |
|EMERGENCY CLASS: NON EMERGENCY | |
|10 CFR SECTION: | |
|NAGR AGREEMENT STATE | |
| | |
| | |
| | |
| | |
+------------------------------------------------------------------------------+
EVENT TEXT
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| AGREEMENT STATE REPORT INVOLVING A STOLEN TROXLER MOISTURE DENSITY
GAUGE |
| |
| The following is the text from a NC Department of Environment and Natural |
| Resources News Release: |
| |
| "A truck stolen about 4:30 this afternoon in Forsyth County was transporting |
| an instrument containing eight millicuries of Cesium-137, a radioactive |
| material that is a potential health and safety risk if handled improperly or |
| broken open. |
| |
| "The truck is a white Ford F150. The instrument is a Troxler brand portable |
| moisture density gauge model 4640B. It is yellow and has a stainless steel |
| handle with a radiation symbol protruding from a heavy base. It is about |
| 20-30 pounds and 24x12x14 inches. Its serial number is 1996. The gauge was |
| in a yellow box 24x12 inches and marked as containing radioactive material. |
| The box should be locked and chained to the truck. |
| |
| "The gauge uses radioactive materials to test conditions of soil and asphalt |
| during construction. Any health risk would occur only if a person were |
| directly exposed to the sealed radioactive source inside the instrument. |
| |
| "Employees of Thompson-Arthur Division APAC-Carolina, Inc., a paving company |
| in Greensboro, left the truck unattended. The company's license with the |
| state Division of Radiation Protection requires that the instrument not be |
| left unsecured. |
| |
| "Anyone who believes he or she has found the truck, box or gauge should stay |
| at least ten feet away and contact the local sheriffs office, police |
| department or state highway patrol immediately." |
| |
| NC Incident No. 02-12. |
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