Event Notification Report for March 14, 2003
U.S. Nuclear Regulatory Commission Operations Center Event Reports For 03/13/2003 - 03/14/2003 ** EVENT NUMBERS ** 39554 39655 39660 39664 39665 39667 39668 39669 !!!!!!!!! THIS EVENT HAS BEEN RETRACTED. THIS EVENT HAS BEEN RETRACTED !!!!!!! +------------------------------------------------------------------------------+ |Power Reactor |Event Number: 39554 | +------------------------------------------------------------------------------+ +------------------------------------------------------------------------------+ | FACILITY: FERMI REGION: 3 |NOTIFICATION DATE: 02/01/2003| | UNIT: [2] [] [] STATE: MI |NOTIFICATION TIME: 09:41[EST]| | RXTYPE: [2] GE-4 |EVENT DATE: 02/01/2003| +------------------------------------------------+EVENT TIME: 01:45[EST]| | NRC NOTIFIED BY: JEFF GROFF |LAST UPDATE DATE: 03/13/2003| | HQ OPS OFFICER: HOWIE CROUCH +-----------------------------+ +------------------------------------------------+PERSON ORGANIZATION | |EMERGENCY CLASS: NON EMERGENCY |MARK RING R3 | |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 +------------------------------------------------------------------------------+ | LOSS OF A SAFETY FUNCTION DUE TO ALL FOUR EMERGENCY DIESEL GENERATORS BEING | | DECLARED INOPERABLE | | | | The following information was received from the Licensee via facsimile: | | | | "At 0145 hours [EST] on 2/1/2003, all four Emergency Diesel Generators | | (EDGs) were declared inoperable following discovery of a Fuel Oil leakage | | drain path change that was installed to prevent Fuel Oil leakage from | | reaching the ground water. | | | | "This change involved the installation of plastic sleeves on the fuel oil | | drains for all four EDGs to reroute the fuel oil drains to a catch basin. | | The normal drain path is through the RHR [Residual Heat Removal] Complex | | (which houses the EDGs) drain system to the chemical pond. This change was | | installed after a crack was discovered in a 21 inch concrete line in the | | drain path from the RHR Complex Drain Sump to the Chemical Pond. This change | | was installed on 01/17/03. | | | | "While running EDG 11 for post maintenance testing following a scheduled | | maintenance outage, fuel oil in a drain sleeve backed up and spilled out of | | a vent on the fuel oil drain header. This spillage resulted in a small | | lagging fire. EDG 11 was immediately shutdown and the fire was extinguished | | within a few minutes. No significant damage to EDG 11 was caused by the | | fire. Since all four EDGs had a similar fuel oil drain configuration, they | | were declared inoperable at 0145 hours and Technical Specification 3.8.1, | | Condition B was entered, which requires restoration of one division of the | | EDGs within 2 hours. | | | | "At 0329 hours, the normal fuel oil drain configuration was restored for EDG | | 13 and EDG 14 (Division 2) and Technical Specification 3.8.1, Condition B | | was exited. At 0345 hours, the normal fuel oil drain configuration was | | restored for EDG 12 (Division 1). EDG 11 remains inoperable until the | | completion of post maintenance testing. | | | | "This notification is being made in accordance with 10CFR50.72(b)(3)(v)[(D)] | | due to all four EDGs being inoperable causing the loss of a safety | | function." | | | | The fire was extinguished without offsite assistance and there were no | | injuries due to the fire. | | | | The Licensee has notified the NRC Resident Inspector. | | | | *** RETRACTION AT 1118 EST ON 3/13/03 FROM PATRICK FALLON TO ERIC THOMAS | | *** | | | | "While running EDG (Emergency Diesel Generator) 11 for post maintenance | | testing following a scheduled maintenance outage on February 1, 2003, fuel | | oil in a drain sleeve backed up and spilled out of a vent on the fuel oil | | drain header. This spillage resulted in a small fire. The fire caused no | | damage to EDG 11. Since all four EDGs had a similar temporary fuel oil drain | | configuration, they were declared inoperable. The normal fuel oil drain | | configuration was restored within the Completion Time of Technical | | Specification 3.8.1, Condition B. Notification was made in accordance with | | 10 CFR 50.72(b)(3)(v) due to all four EDGs being declared inoperable causing | | the loss of a safety function. | | | | "The cause of the fire is believed to be excessive fuel oil leaking from the | | EDG 11 fuel injector compartment onto the exhaust manifold. (The cause was | | initially reported as normal fuel injector leakage backing up into the fuel | | oil drain header due to the temporary drain configuration). The injectors | | allowed an abnormally high rate of fuel oil leakage into the fuel oil drain | | header for EDG 11 only. The fuel oil drain rates for EDGs 12, 13, and 14 | | were observed to be normal during subsequent surveillance testing, and | | within the capability of the temporary fuel oil drain configuration. | | | | "Therefore, EDGs 12, 13, and 14 were capable of performing their safety | | function and there was no common mode failure, as a result of the temporary | | drain configuration. This condition is therefore not reportable under 10 CFR | | 50.72(b)(3)(v). The original notification, Event Number 39554, is | | retracted." | | | | The Licensee has notified the NRC Resident Inspector. | +------------------------------------------------------------------------------+ +------------------------------------------------------------------------------+ |General Information or Other |Event Number: 39655 | +------------------------------------------------------------------------------+ +------------------------------------------------------------------------------+ | REP ORG: TEXAS DEPARTMENT OF HEALTH |NOTIFICATION DATE: 03/10/2003| |LICENSEE: PROFESSIONAL SERVICES INDUSTRIES, PSI|NOTIFICATION TIME: 14:54[EST]| | CITY: HOUSTON REGION: 4 |EVENT DATE: 03/08/2003| | COUNTY: STATE: TX |EVENT TIME: 12:45[CST]| |LICENSE#: AGREEMENT: Y |LAST UPDATE DATE: 03/10/2003| | DOCKET: |+----------------------------+ | |PERSON ORGANIZATION | | |MARK SHAFFER R4 | | |KEVIN HSUEH NMSS | +------------------------------------------------+ | | NRC NOTIFIED BY: GLENN CORBIN | | | HQ OPS OFFICER: JOHN MacKINNON | | +------------------------------------------------+ | |EMERGENCY CLASS: NON EMERGENCY | | |10 CFR SECTION: | | |NAGR AGREEMENT STATE | | | | | | | | | | | | | | +------------------------------------------------------------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | AGREEMENT STATE REPORT: STOLEN TROXLER MOISTURE DENSITY GAUGE | | | | | | "A Troxler model #3430 (serial number 27095), portable moisture/density | | gauge was reported stolen from the Texas Medical Center construction project | | site located at 2450 Holcomb, Houston, Texas between 12:45 p.m. and 1:30 | | p.m. CT on Saturday, March 8, 2003. This device is bright yellow, | | approximately 11" long x 8" wide x 5" tall with two metal posts | | approximately 18" tall protruding from the top of the device and a locked | | handle at the top. The device contains two sealed sources (isotopes) | | double-encapsulated in stainless steel, and is licensed by the Texas | | Department of Health. When not in use, the device emits low-level energy | | equivalent to a single chest x-ray, which poses no threat unless the device | | is tampered with. | | | | "A police report has been filed with the Houston Police Department. | | | | "The company is offering a $500.00 reward for the return of the device on | | the 'no-questions-asked' bases. If found, please do not move the device and | | contact the Houston Police Department and refer to police report no. | | 032141303E. If anyone has any information regarding the theft of the device | | please [call PSI]." | | | | The State of Texas believes the Troxler moisture density gauge contains 10 | | millicuries of Cesium-137 and 40 millicuries of Am/Be-241. | +------------------------------------------------------------------------------+ +------------------------------------------------------------------------------+ |General Information or Other |Event Number: 39660 | +------------------------------------------------------------------------------+ +------------------------------------------------------------------------------+ | REP ORG: OR DEPT OF HEALTH RAD PROTECTION |NOTIFICATION DATE: 03/11/2003| |LICENSEE: ROGUE VALLEY MEDICAL CENTER |NOTIFICATION TIME: 11:59[EST]| | CITY: MEDFORD REGION: 4 |EVENT DATE: 03/11/2003| | COUNTY: JACKSON STATE: OR |EVENT TIME: [PST]| |LICENSE#: ORE-90064 AGREEMENT: Y |LAST UPDATE DATE: 03/11/2003| | DOCKET: |+----------------------------+ | |PERSON ORGANIZATION | | |MARK SHAFFER R4 | | |KEVIN HSUEH NMSS | +------------------------------------------------+ | | NRC NOTIFIED BY: EDWIN WRIGHT | | | HQ OPS OFFICER: JOHN MacKINNON | | +------------------------------------------------+ | |EMERGENCY CLASS: NON EMERGENCY | | |10 CFR SECTION: | | |NAGR AGREEMENT STATE | | | | | | | | | | | | | | +------------------------------------------------------------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | AGREEMENT STATE REPORT: MISSING BRACHEYTHERAPY IRIDIUM-192 SEED. | | | | Dr. Sinnott called to report the loss of an Ir-192 bracheytherapy seed with | | a current activity of 6 millicuries. The source was last visually | | inventoried in December 2002. The loss was noted yesterday, March 9, 2002, | | while the physicist was packaging sources for return to the manufacturer. | +------------------------------------------------------------------------------+ +------------------------------------------------------------------------------+ |Power Reactor |Event Number: 39664 | +------------------------------------------------------------------------------+ +------------------------------------------------------------------------------+ | FACILITY: PALO VERDE REGION: 4 |NOTIFICATION DATE: 03/13/2003| | UNIT: [] [2] [] STATE: AZ |NOTIFICATION TIME: 11:14[EST]| | RXTYPE: [1] CE,[2] CE,[3] CE |EVENT DATE: 02/27/2003| +------------------------------------------------+EVENT TIME: 09:28[MST]| | NRC NOTIFIED BY: DUANE KANITZ |LAST UPDATE DATE: 03/13/2003| | HQ OPS OFFICER: YAMIR DIAZ +-----------------------------+ +------------------------------------------------+PERSON ORGANIZATION | |EMERGENCY CLASS: NON EMERGENCY |MARK SHAFFER R4 | |10 CFR SECTION: | | |AINV 50.73(a)(1) INVALID SPECIF SYSTEM A| | | | | | | | | | | +-----+----------+-------+--------+-----------------+--------+-----------------+ |UNIT |SCRAM CODE|RX CRIT|INIT PWR| INIT RX MODE |CURR PWR| CURR RX MODE | +-----+----------+-------+--------+-----------------+--------+-----------------+ | | | |2 N Y 98 Power Operation |98 Power Operation | | | | +------------------------------------------------------------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | INVALID SPECIFIED SYSTEM ACTUATION 60 DAY REPORT | | | | "The following event description is based on information currently | | available. If through subsequent reviews of this event, additional | | information is identified that is pertinent to this event or alters the | | information being provided at this time, a follow-up notification will be | | made via the ENS or under the reporting requirements of 10CFR50.73. | | | | "On February 17, 2003, at approximately 0928 Mountain Standard Time, Palo | | Verde Nuclear Generating Station Unit 2 experienced an invalid actuation | | (start) of the 'A' Emergency Diesel Generator (EDG). EDG 'A' inadvertently | | started when an Instrument and Control technician, performing the ESFAS | | train 'A' subgroup relay functional and response time surveillance test, | | completed a step in the test procedure out of sequence. The technician | | verified the status of [actuated] an ESFAS relay contact, which generates an | | EDG start signal, before the 'A' EDG control mode switch was placed in the | | OFF position. | | | | "This report is not considered an LER. | | | | "EDG 'A' was the specific System and train that actuated. | | | | "EDG 'A' started in the Emergency Mode. The train actuation was complete. | | | | "EDG 'A' started and came up to rated speed and voltage as designed. | | | | "This report is being made under 10 CFR 50.73 (a) (2) (iv) (A)." | | | | The licensee has notified the NRC Resident Inspector. | +------------------------------------------------------------------------------+ +------------------------------------------------------------------------------+ |Power Reactor |Event Number: 39665 | +------------------------------------------------------------------------------+ +------------------------------------------------------------------------------+ | FACILITY: OYSTER CREEK REGION: 1 |NOTIFICATION DATE: 03/13/2003| | UNIT: [1] [] [] STATE: NJ |NOTIFICATION TIME: 13:38[EST]| | RXTYPE: [1] GE-2 |EVENT DATE: 03/13/2003| +------------------------------------------------+EVENT TIME: 06:15[EST]| | NRC NOTIFIED BY: CIGANIK |LAST UPDATE DATE: 03/13/2003| | HQ OPS OFFICER: CHAUNCEY GOULD +-----------------------------+ +------------------------------------------------+PERSON ORGANIZATION | |EMERGENCY CLASS: NON EMERGENCY |MOHAMED SHANBAKY 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 +------------------------------------------------------------------------------+ | MAJOR LOSS OF EMERGENCY PREPAREDNESS CAPABILITIES | | | | The licensee was notified by Ocean County that their alarm panel indicated | | the radio power to the prompt notification sirens had failed with unknown | | affect on the sirens operation. The Licensee Technicians were dispatched | | and had to reboot a computer to clear the alarm. Sirens would not operate | | until the computer was rebooted. Sirens tested satisfactory @ 0930 hours. | | | | This notification was made because it can not be determined if the Ocean | | County siren activation technicians possess the knowledge and skills to | | reboot this computer if siren activation would have been required. If it is | | later determined that the technicians did possess the required knowledge | | and skills, this notification may be retracted. | | | | The NRC Resident Inspector was notified along with local agencies. | +------------------------------------------------------------------------------+ +------------------------------------------------------------------------------+ |Power Reactor |Event Number: 39667 | +------------------------------------------------------------------------------+ +------------------------------------------------------------------------------+ | FACILITY: CALLAWAY REGION: 4 |NOTIFICATION DATE: 03/13/2003| | UNIT: [1] [] [] STATE: MO |NOTIFICATION TIME: 16:32[EST]| | RXTYPE: [1] W-4-LP |EVENT DATE: 03/13/2003| +------------------------------------------------+EVENT TIME: 08:00[CST]| | NRC NOTIFIED BY: BREDEMAN |LAST UPDATE DATE: 03/13/2003| | HQ OPS OFFICER: CHAUNCEY GOULD +-----------------------------+ +------------------------------------------------+PERSON ORGANIZATION | |EMERGENCY CLASS: NON EMERGENCY |MARK SHAFFER R4 | |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 | +-----+----------+-------+--------+-----------------+--------+-----------------+ |1 N Y 100 Power Operation |100 Power Operation | | | | | | | +------------------------------------------------------------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | ERROR IN THE CURRENT SAFETY ANALYSIS FOR A STEAM GENERATOR TUBE RUPTURE | | | | "On March 13, 2003 while operating at 100% power, Callaway Plant determined | | a problem existed in the current safety analysis for a steam generator tube | | rupture accident accompanied by an overfill condition of the ruptured steam | | generator. This problem was discovered while reviewing a future plant | | modification package. The current FSAR analysis concluded that an overfill | | condition would not occur during a tube rupture accident. | | | | "Through investigations instigated during the modification review process, | | it was determined that for current plant conditions, an overfill condition | | could result if an auxiliary feedwater control valve supplying the ruptured | | steam generator were to fail open. In this case, it was concluded that the | | ruptured steam generator would overfill and water would be released through | | the steam generator safety valves, resulting in a radioactive release to the | | environment greater than allowed by regulatory guidance. Since this | | accident was not adequately incorporated in the FSAR, specific procedural | | time limits for operator actions had not been developed. This lack of | | credited operator time limits coupled with past plant modifications result | | in a potential to exist for the ruptured steam generator overfill scenario. | | | | "Current Technical Specifications allow a reactor coolant system Dose | | Equivalent Iodine (DEI) value of 1.0 microcurie per gram. To assure | | compliance with existing regulatory guidance, plant procedures have been | | changed to administratively reduce the steady state DEI limit to 0.3 | | microcurie per gram, a value that has not been exceeded in the last three | | years. Current steady state DEI concentration in the reactor coolant system | | is 0.001769 microcurie per gram. The new lower DEI limit will ensure that | | if an overfill condition were to occur during a steam generator tube | | rupture, post accident radiological consequences would not exceed the limits | | imposed by the FSAR and the Standard Review Plan." | | | | The NRC Resident Inspector was notified. | +------------------------------------------------------------------------------+ +------------------------------------------------------------------------------+ |Hospital |Event Number: 39668 | +------------------------------------------------------------------------------+ +------------------------------------------------------------------------------+ | REP ORG: REGIONS HOSPITAL |NOTIFICATION DATE: 03/13/2003| |LICENSEE: REGIONS HOSPITAL |NOTIFICATION TIME: 17:27[EST]| | CITY: ST PAUL REGION: 3 |EVENT DATE: 03/07/2003| | COUNTY: STATE: MN |EVENT TIME: 09:00[CST]| |LICENSE#: 22-02003-04 AGREEMENT: N |LAST UPDATE DATE: 03/13/2003| | DOCKET: |+----------------------------+ | |PERSON ORGANIZATION | | |KENNETH O'BRIEN R3 | | | | +------------------------------------------------+ | | NRC NOTIFIED BY: SOGARD | | | HQ OPS OFFICER: CHAUNCEY GOULD | | +------------------------------------------------+ | |EMERGENCY CLASS: NON EMERGENCY | | |10 CFR SECTION: | | |BSUR 20.1906(d)(1) SURFACE CONTAM LEVELS >| | | | | | | | | | | | | | +------------------------------------------------------------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | SURFACE CONTAMINATION ON AMMO BOX GREATER THAN ACCEPTABLE LIMITS | | | | On March 7 @ 0900 an ammo box was received from Syncor that measured | | 0.3mr/hr at the surface and had a wipe of approximately 9707 DPM (2200 DPM | | is acceptable). Syncor was notified of the contamination on the box. The | | box was put into the hospital's storage area until March 11 when the | | measurements taken were at background. The box was than returned to Syncor. | +------------------------------------------------------------------------------+ +------------------------------------------------------------------------------+ |Power Reactor |Event Number: 39669 | +------------------------------------------------------------------------------+ +------------------------------------------------------------------------------+ | FACILITY: MONTICELLO REGION: 3 |NOTIFICATION DATE: 03/13/2003| | UNIT: [1] [] [] STATE: MN |NOTIFICATION TIME: 18:35[EST]| | RXTYPE: [1] GE-3 |EVENT DATE: 03/13/2003| +------------------------------------------------+EVENT TIME: 14:30[CST]| | NRC NOTIFIED BY: JACK EARCLEY |LAST UPDATE DATE: 03/13/2003| | HQ OPS OFFICER: RICH LAURA +-----------------------------+ +------------------------------------------------+PERSON ORGANIZATION | |EMERGENCY CLASS: NON EMERGENCY |KENNETH O'BRIEN 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 | +-----+----------+-------+--------+-----------------+--------+-----------------+ |1 N Y 100 Power Operation |100 Power Operation | | | | | | | +------------------------------------------------------------------------------+ EVENT TEXT +------------------------------------------------------------------------------+ | DEGRADED APPENDIX "R" BARRIER AT MONTICELLO | | | | "During inspection of penetration FZ-4900 in the upper 4KV room it was | | discovered there was a portion of the penetration seal that was degraded | | which caused the upper and lower 4KV rooms to communicate with each other. | | Penetration seal FZ-4900 is a gypsum wall board assembly approximately 18 | | inches wide 4 foot high and 24 foot long. The degraded part of the | | penetration is approximately 1 inch by 4 inch hole. The upper and lower 4 KV | | areas are required to be separated in accordance with 10CFR50 Appendix R | | requirements." | | | | The licensee indicated they established a fire watch as a compensatory | | measure. | | | | The NRC Resident Inspector was notified. | +------------------------------------------------------------------------------+
Page Last Reviewed/Updated Wednesday, March 24, 2021
Page Last Reviewed/Updated Wednesday, March 24, 2021