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Event Notification Report for February 25, 2005

U.S. Nuclear Regulatory Commission
Operations Center

Event Reports For
02/24/2005 - 02/25/2005

** EVENT NUMBERS **


41398 41429 41431 41437 41439 41440 41441 41442

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Power Reactor Event Number: 41398
Facility: KEWAUNEE
Region: 3 State: WI
Unit: [1] [ ] [ ]
RX Type: [1] W-2-LP
NRC Notified By: ETHAN TREPTOW
HQ OPS Officer: STEVE SANDIN
Notification Date: 02/10/2005
Notification Time: 15:14 [ET]
Event Date: 01/23/2005
Event Time: [CST]
Last Update Date: 02/24/2005
Emergency Class: NON EMERGENCY
10 CFR Section:
OTHER UNSPEC REQMNT
Person (Organization):
ERIC DUNCAN (R3)
TERRY REIS (NRR)
JACK CRLENJAK (IRD)

Unit SCRAM Code RX CRIT Initial PWR Initial RX Mode Current PWR Current RX Mode
1 N Y 100 Power Operation 100 Power Operation

Event Text

DISCOVERY OF AFTER-THE-FACT EMERGENCY CONDITION (UNUSUAL EVENT)

"On 2/10/05 at 13:35, the Shift Manager became aware of a condition that previously existed which met the Emergency Plan criteria for declaration of an Unusual Event. On 1/23/05, a Radiation Protection Technician released nitrogen into the RAF Countroom as part of an experiment. During the experiment, the atmospheric monitors in the room detected life-threatening levels of nitrogen (oxygen deficient atmosphere). This has been determined to meet the criteria for an Unusual Event per Emergency Classification Level Chart P for a release of toxic or flammable gas on site and portable monitors indicate concentrations at life threatening levels."

Management became aware of the unauthorized experiment conducted by the Technician during a management review. There were no personnel injuries as a result of this incident.

The licensee will inform both state/local agencies and the NRC Resident Inspector.

* * * UPDATE FROM LICENSEE (ROBB) TO NRC (HUFFMAN) AT 1907 EST ON 2/24/05 * * *

"On 2/24/05 at approximately 1720 hours, it was discovered that a second incident had occurred prior to the previously reported occurrence (EN#41398) that met the Emergency Plan criteria for an Unusual Event declaration. Based on the investigation of the 1/23/05 incident, the same Radiation Protection Technician had released liquid nitrogen in the Auxiliary Building elevator, as part of the same data collection activity. The release may have been at the levels of 'Immediate Danger to Life and Health' in this separate case. This previous incident occurred on 1/22/05 at approximately 1200 hours."

The licensee will inform both state/local agencies and the NRC Resident Inspector.

R3DO(Lanksbury), NRR EO (Carpenter), and IRD (Kennedy) notified.

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General Information or Other Event Number: 41429
Rep Org: TEXAS DEPARTMENT OF HEALTH
Licensee: PSI, INC.
Region: 4
City: HARLINGEN State: TX
County:
License #: L04944
Agreement: Y
Docket:
NRC Notified By: D. RAY JISHA
HQ OPS Officer: MARK ABRAMOVITZ
Notification Date: 02/22/2005
Notification Time: 16:00 [ET]
Event Date: 02/19/2005
Event Time: 17:35 [CST]
Last Update Date: 02/22/2005
Emergency Class: NON EMERGENCY
10 CFR Section:
AGREEMENT STATE
Person (Organization):
DALE POWERS (R4)
SCOTT MOORE (NMSS)
CNSNS MEXICO (FAX)

Event Text

AGREEMENT STATE - LOST TROXLER THIN LAYER DENSITY GAGE

The following was received from the state via e-mail:

"On Saturday, 02/19/2005, 1430 CST, the licensee's representative received notification that a technician had lost a Troxler Model 4640-B, Thin layer Density Gauge, S/N 1880. The device contains a double encapsulated source of 10mCi of Cs-137 that was last leak tested on 12/09/04. The source rod handle was padlocked and key was removed according to the technician. The shipping/transport case was lost in the Brownsville, TX area where it was being used at a temporary jobsite.

"Per company protocol and as discussed during loss notification to TX DSHS, a $500.00 'no-questions-asked' reward for the recovery of the device to be issued to area media outlets."

Texas Incident No: I-8213

* * * UPDATE FROM R. JISHA TO J. KNOKE AT 12:41 EST ON 2/23/05 * * *

"The gauge was apparently lost off the back of a pick-up truck at a job site in the vicinity of FR511 and EXPWY. 77 an incorporated area northwest of Brownsville proper. Since the gauge was not secured in the case which was secured to the vehicle, it was not lost but presumably the device had bounced off the truck on a rough section of road. Multiple attempts were made to retrace the route but none were successful in recovering the device. The manufacture (Troxler) has been notified."

Notified R4DO (D. Powers) and NMSS (S. Moore) and CNSNS Mexico via fax.

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General Information or Other Event Number: 41431
Rep Org: ARIZONA RADIATION REGULATORY AGENCY
Licensee: WALMART
Region: 4
City: TUCSON State: AZ
County:
License #:
Agreement: Y
Docket:
NRC Notified By: AUBREY GODWIN
HQ OPS Officer: JEFF ROTTON
Notification Date: 02/22/2005
Notification Time: 16:22 [ET]
Event Date: 02/21/2005
Event Time: 08:50 [MST]
Last Update Date: 02/22/2005
Emergency Class: NON EMERGENCY
10 CFR Section:
AGREEMENT STATE
Person (Organization):
DALE POWERS (R4)
SCOTT MOORE (NMSS)

Event Text

AGREEMENT STATE - GENERAL LICENSE - LOST AND DAMAGED TRITIUM SIGNS

The following information was provided by the State of Arizona via facsimile:

"At approximately 8:50 AM, February 21, 2005, the Agency received notice from AZ DPS advising that 9 Tritium Exit signs were missing. In addition, three signs were located in the store (under construction). A forth sign was damaged in the store. The [damaged] sign was not glowing as the other three. This information was supplied by the Tucson Police Department to AZ DPS who advised the Agency. The Tucson Fire Department was also at the site and they indicated they thought the sources were removed between Friday night and Monday morning. The building does not have doors or windows, but is otherwise closed.

"Since the facility is under construction, who is the responsible party is a portion of the investigation. The signs have not been reported as transferred into the State. The devices were made by Isolite and contain 11.5 Curies of Tritium each. As much as 103.5 Curies of tritium may be missing in addition to the 11.5 [Curies] in the broken exit sign. Tucson Police report # 0502210205 applies to this event.

"Due to the potential contamination of persons a press release may be made.

"The Agency continues to investigate this event. The US FBI will be notified of this event."

Arizona Report #: 05-02

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Power Reactor Event Number: 41437
Facility: SEQUOYAH
Region: 2 State: TN
Unit: [ ] [2] [ ]
RX Type: [1] W-4-LP,[2] W-4-LP
NRC Notified By: GARY GARNER
HQ OPS Officer: HOWIE CROUCH
Notification Date: 02/24/2005
Notification Time: 00:35 [ET]
Event Date: 02/23/2005
Event Time: 21:06 [EST]
Last Update Date: 02/24/2005
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(2)(iv)(B) - RPS ACTUATION - CRITICAL
50.72(b)(3)(iv)(A) - VALID SPECIF SYS ACTUATION
Person (Organization):
JOEL MUNDAY (R2)

Unit SCRAM Code RX CRIT Initial PWR Initial RX Mode Current PWR Current RX Mode
2 A/R Y 100 Power Operation 0 Hot Standby

Event Text

AUTOMATIC REACTOR TRIP ON LOW-LOW STEAM GENERATOR LEVEL

The following information, in addition to the phone report, was obtained from the licensee via facsimile:

"While performing maintenance, [Maintenance] inadvertently opened a 125 VDC battery board [four] breaker which resulted in a reactor trip from steam generator low-low level.

"The plant is being maintained in Mode 3 at NOP/NOT [Normal Operating Pressure/Normal Operating Temperature], 547 [degrees] and 2235 psig, with auxiliary feedwater supplying the steam generators and steam dumps removing the decay heat."

All rods inserted on the trip. No relief valves lifted during the transient. The electric plant is stable with 125 VDC restored to a normal configuration. Steam generator level has been restored to normal levels. Unit 1 was not affected by the transient.

The licensee has notified the NRC Resident Inspector.

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Other Nuclear Material Event Number: 41439
Rep Org: DEPARTMENT OF VETERANS AFFAIRS
Licensee: DEPARTMENT OF VETERANS AFFAIRS
Region: 4
City: LAS VEGAS State: NV
County:
License #: 03-23853-01VA
Agreement: Y
Docket:
NRC Notified By: EDWIN LEIDHOLDT
HQ OPS Officer: BILL HUFFMAN
Notification Date: 02/24/2005
Notification Time: 15:10 [ET]
Event Date: 02/24/2005
Event Time: 10:35 [PST]
Last Update Date: 02/24/2005
Emergency Class: NON EMERGENCY
10 CFR Section:
20.1906(d)(1) - SURFACE CONTAM LEVELS > LIMITS
Person (Organization):
DALE POWERS (R4)
ROGER LANKSBURY (R3)
SCOTT MOORE (NMSS)

Event Text

REMOVABLE RADIOACTIVE SURFACE CONTAMINATION ON A PACKAGE

The Department of Veterans Affairs, National Health Physics Program reported that a package received at one of its facilities had removable radioactive surface contamination that exceeded limits. The package was received on 2/24/05 at the VA Southern Nevada Health Care System in Las Vegas, NV. The package had a contamination level of 85,000 DPM over a 300 square cm wipe. The contamination was identified as Technetium-99M via spectral analysis.

The package was received from Bio Tech, a commercial pharmacy in Las Vegas. Southern Nevada Health Care notified Bio Tech and the pharmacy has sent a representative to the facility to assist in the investigation. The package was delivered by a pharmacy delivery vehicle and the status of any contamination in the vehicle is unknown. There was no apparent damage to the package.

Appropriate steps have been taken to prevent the spread of contamination.

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Power Reactor Event Number: 41440
Facility: CRYSTAL RIVER
Region: 2 State: FL
Unit: [3] [ ] [ ]
RX Type: [3] B&W-L-LP
NRC Notified By: RICHARD SWEENEY
HQ OPS Officer: BILL HUFFMAN
Notification Date: 02/24/2005
Notification Time: 17:56 [ET]
Event Date: 02/24/2005
Event Time: 15:30 [EST]
Last Update Date: 02/24/2005
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(2)(xi) - OFFSITE NOTIFICATION
Person (Organization):
JOEL MUNDAY (R2)
CYNTHIA CARPENTER (NRR)
KRISS KENNEDY (IRD)

Unit SCRAM Code RX CRIT Initial PWR Initial RX Mode Current PWR Current RX Mode
3 N Y 100 Power Operation 100 Power Operation

Event Text

OFFSITE NOTIFICATION RELATED TO HEART ATTACK FATALITY

"At 1423 the control room received an emergency phone call of an employee who was experiencing intermittent unconsciousness and in cardiac arrest. The individual was transported to a local hospital where he was declared deceased at 1530. 29CFR1904.39(b)(5) requires to report a fatality to OSHA caused by a heart attack at work. This ENS report is being made in accordance with 50.72(b)(2)(xi) contact of off site agency."

There was no radioactive contamination involved in this event. The licensee does not plan any media or press release and has not notified any other government agencies besides OSHA. The NRC Resident Inspector will be notified.

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Power Reactor Event Number: 41441
Facility: MONTICELLO
Region: 3 State: MN
Unit: [1] [ ] [ ]
RX Type: [1] GE-3
NRC Notified By: KURT ARNDT
HQ OPS Officer: BILL HUFFMAN
Notification Date: 02/24/2005
Notification Time: 22:39 [ET]
Event Date: 02/24/2005
Event Time: 21:11 [CST]
Last Update Date: 02/24/2005
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(3)(iv)(A) - VALID SPECIF SYS ACTUATION
Person (Organization):
ROGER LANKSBURY (R3)

Unit SCRAM Code RX CRIT Initial PWR Initial RX Mode Current PWR Current RX Mode
1 N Y 90 Power Operation 90 Power Operation

Event Text

ESF ACTUATION FOLLOWING TRIP OF REACTOR PROTECTION MOTOR-GENERATOR SET

A trip of the "A" RPS M-G set resulted in an "A" Group 2 isolation and startup of the standby gas treatment system. There was a preliminary report of a possible fire/smoke smell in the vicinity of the M-G set. However, when an operator reported to the location there was no observed fire. The fire brigade was also dispatched but found no fire or smoke in the M-G set area.

The licensee is preparing to place the RPS on its alternate power supply. This will allow the Group 2 isolations and standby gas treatment system actions to be reset. The cause of the M-G set trip is still under investigation.

The licensee will be notifying the NRC Resident Inspector as well as state and local authorities.

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Power Reactor Event Number: 41442
Facility: COLUMBIA GENERATING STATION
Region: 4 State: WA
Unit: [2] [ ] [ ]
RX Type: [2] GE-5
NRC Notified By: RICHARD MEYERS
HQ OPS Officer: JOHN KNOKE
Notification Date: 02/25/2005
Notification Time: 04:42 [ET]
Event Date: 02/24/2005
Event Time: 18:00 [PST]
Last Update Date: 02/25/2005
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(3)(v)(D) - ACCIDENT MITIGATION
Person (Organization):
DALE POWERS (R4)

Unit SCRAM Code RX CRIT Initial PWR Initial RX Mode Current PWR Current RX Mode
2 N Y 100 Power Operation 100 Power Operation

Event Text

POTENTIAL BREACH OF SECONDARY CONTAINMENT DURING SEISMIC EVENT.

The licensee provided the following information:

"This event notification is being made to report an event that could have prevented fulfillment of the safety function to mitigate the consequences of an accident IAW 10CFR50.72(b)(3)(v)(D).

"The potential for creation of an actual hole through Secondary Containment (SC) via the Plant Service Water (TSW) system high point reactor building auto vents (TSW-AV-1A and TSW-AV-1 B) exists if a seismic event occurs and the Seismic Category 2 TSW loop-seal piping outside of Secondary Containment is breached (e.g., because of a pipe break) and has drained.

"Neither of the above conditions presently exists. However, a Secondary Containment breach could occur as a result of a single passive failure (i.e., pipe break in the TSW loop-seal piping described above). TSW-AV-1A and TSW-AV-1B are designed to open automatically when neither TSW system pump is operating to break the vacuum condition that would otherwise exist in the piping. When TSW-AV-1A and TSW-AV-1B are open in vacuum breaker mode, the resultant hole size into the TSW system piping would exceed the allowable Secondary Containment cumulative hole size [ of 32 square inches total], if the loop seal were also breached as described above. Due to this condition Secondary Containment was declared INOPERABLE at 1800 PST 2/24/05. As a compensatory measure to prevent exceeding the allowable Secondary Containment cumulative hole size, one of the two TSW reactor building auto vents (TSW-AV-1B) was isolated by closure of a manual valve (TSW-V-55B). This action was completed at 1828 PST 2/24/05 and the Secondary Containment was declared OPERABLE. One TSW auto vent is sufficient to perform the vacuum breaker function."

This condition was found by the licensee's System Engineer. The extent of condition and long term corrective action is under review by licensee.

Licensee will inform the NRC Resident Inspector.

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Friday, March 30, 2012