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Event Notification Report for March 19, 2007

U.S. Nuclear Regulatory Commission
Operations Center

Event Reports For
03/16/2007 - 03/19/2007

** EVENT NUMBERS **


43207 43229 43230 43237 43243 43245 43246 43247

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!!!!! THIS EVENT HAS BEEN RETRACTED. THIS EVENT HAS BEEN RETRACTED !!!!!
Power Reactor Event Number: 43207
Facility: SAN ONOFRE
Region: 4 State: CA
Unit: [ ] [2] [3]
RX Type: [1] W-3-LP,[2] CE,[3] CE
NRC Notified By: SUSAN GARDNER
HQ OPS Officer: JOE O'HARA
Notification Date: 03/02/2007
Notification Time: 17:03 [ET]
Event Date: 03/02/2007
Event Time: 10:14 [PST]
Last Update Date: 03/16/2007
Emergency Class: NON EMERGENCY
10 CFR Section:
26.73 - FITNESS FOR DUTY
Person (Organization):
DALE POWERS (R4)
THEODORE QUAY (NRR)

Unit SCRAM Code RX CRIT Initial PWR Initial RX Mode Current PWR Current RX Mode
2 N Y 99 Power Operation 99 Power Operation
3 N Y 98 Power Operation 98 Power Operation

Event Text

FITNESS FOR DUTY - LICENSED EMPLOYEE

A licensed employee had a confirmed positive for alcohol during a random fitness-for-duty test. The employee's access to the plant has been revoked. Contact the Headquarters Operations Officer for additional details.

The licensee notified the NRC Resident Inspector.

* * * RETRACTION PROVIDED BY S.GARDNER TO KOZAL ON 3/16/07 1728 EDT * * *

The licensee provided a retraction regarding the above positive alcohol fitness-for-duty test. Contact the Headquarters Operations Officer for additional details.

The licensee notified the NRC Resident Inspector. R4DO (Shannon) notified.

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!!!!! THIS EVENT HAS BEEN RETRACTED. THIS EVENT HAS BEEN RETRACTED !!!!!
Hospital Event Number: 43229
Rep Org: SIBLEY MEMORIAL HOSPITAL
Licensee: SIBLEY MEMORIAL HOSPITAL
Region: 1
City: WASHINGTON State: DC
County:
License #: 08-07398-03
Agreement: N
Docket:
NRC Notified By: JORDIE KECK
HQ OPS Officer: JASON KOZAL
Notification Date: 03/12/2007
Notification Time: 13:57 [ET]
Event Date: 03/12/2007
Event Time: 12:00 [EDT]
Last Update Date: 03/13/2007
Emergency Class: NON EMERGENCY
10 CFR Section:
35.3045(a)(1) - DOSE <> PRESCRIBED DOSAGE
Person (Organization):
CHRIS HOTT (R1)
SANDRA WASTLER (FSME)

Event Text

INCORRECT RADIONUCLIDE ADMINISTERED TO PATIENT

The licensee was performing a gall bladder study that required a dose of 5 millicuries of Tc-99 to be administered. A participant in the study was given the wrong radionuclide Gallium Citrate (Ga-67), accelerator produced, in error. Both syringes containing the doses were located in the same case, which was delivered to Sibley Hospital by Mallinckrodt. The licensee informed the patient of the error and that there is minimal risk of adverse effects to the patients health.

The actual dose versus the prescribed dose is still under investigation. Additional corrective actions will be determined at a later date.

* * * UPDATE 0900 EDT ON 3/13/07 FROM JORDIE KECK TO S. SANDIN * * *

The licensee is retracting this report after conducting a review that concluded no reporting criteria was met. Notified R1DO (Hott) and FSME (Morell).

A "Medical Event" may indicate potential problems in a medical facility's use of radioactive materials. It does not necessarily result in harm to the patient.

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General Information or Other Event Number: 43230
Rep Org: LOUISIANA RADIATION PROTECTION DIV
Licensee: BAYOU INSPECTION SERVICES
Region: 4
City: AMELIA State: LA
County:
License #: LA-7112-L01
Agreement: Y
Docket:
NRC Notified By: RICHARD PENROD
HQ OPS Officer: JOHN MacKINNON
Notification Date: 03/12/2007
Notification Time: 15:17 [ET]
Event Date: 12/31/2006
Event Time: 12:00 [CDT]
Last Update Date: 03/12/2007
Emergency Class: NON EMERGENCY
10 CFR Section:
AGREEMENT STATE
Person (Organization):
MICHAEL SHANNON (R4)
SANDRA WASTLER (FSME)

Event Text

AGREEMENT STATE REPORT -TWO OVEREXPOSURES

This Agreement State report was received from the State of Louisiana via facsimile.

"Bayou Inspection Services reported an overexposure [of] two employees. (Deleted) received an annual dose of 5055 mR. (Deleted) received an annual dose of 5330 mR. Radiation Safety Officer stated he talked to both employees and told them they must do a better job of protecting themselves from exposure to radiation."

Event Report ID No.: LA070004

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General Information or Other Event Number: 43237
Rep Org: OHIO BUREAU OF RADIATION PROTECTION
Licensee: UNKNOWN
Region: 3
City: STRONGSVILLE State: OH
County:
License #: UNKNOWN
Agreement: Y
Docket:
NRC Notified By: STEVEN JAMES
HQ OPS Officer: JASON KOZAL
Notification Date: 03/14/2007
Notification Time: 19:34 [ET]
Event Date: 03/12/2007
Event Time: 15:00 [EDT]
Last Update Date: 03/14/2007
Emergency Class: NON EMERGENCY
10 CFR Section:
AGREEMENT STATE
Person (Organization):
RICHARD SKOKOWSKI (R3)
JOSEPH GIITTER (FSME)
ILTAB VIA E-MAIL ()

This material event contains a "Less than Cat 3" level of radioactive material.

Event Text

AGREEMENT STATE REPORT - LOST/STOLEN EXIT SIGNS

The State provided the following information via email:

"On 3/14/07 the Strongsville Ohio Police Department was notified that ten (10) tritium exit signs were missing and presumed stolen from a storage area at a local shopping center construction site. The apparent theft occurred between 3 PM on 3/12/07 and 1 PM on 3/13/07. The contractor reporting the incident stated that the signs could have been taken by anyone that had access to the construction site, because many different contractors were using the same storage area. The ten signs were all packaged in one box. The signs are manufactured by SRB Technologies as the Betalux-E Life Safety Sign, Model 171. They are distributed by Cooper Lighting under the name Sure Lites, TRX1 series. The signs are rated for a 20-year life cycle."

Ohio event # - OH70003

THIS MATERIAL EVENT CONTAINS A "LESS THAN CAT 3" LEVEL OF RADIOACTIVE MATERIAL

Sources that are "Less than IAEA Category 3 sources," are either sources that are very unlikely to cause permanent injury to individuals or contain a very small amount of radioactive material that would not cause any permanent injury. Some of these sources, such as moisture density gauges or thickness gauges that are Category 4, the amount of unshielded radioactive material, if not safely managed or securely protected, could possibly - although it is unlikely - temporarily injure someone who handled it or were otherwise in contact with it, or who were close to it for a period of many weeks.

This source is not amongst those sources or devices identified by the IAEA Code of Conduct for the Safety & Security of Radioactive Sources to be of concern from a radiological standpoint. Therefore is it being categorized as a less than Category 3 source

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Power Reactor Event Number: 43243
Facility: GINNA
Region: 1 State: NY
Unit: [1] [ ] [ ]
RX Type: [1] W-2-LP
NRC Notified By: KYLE GARNISH
HQ OPS Officer: PETE SNYDER
Notification Date: 03/17/2007
Notification Time: 02:13 [ET]
Event Date: 03/16/2007
Event Time: 22:09 [EDT]
Last Update Date: 03/17/2007
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):
CHRIS HOTT (R1)

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

Event Text

AUTOMATIC REACTOR TRIP CAUSED BY SAFETY INJECTION SIGNAL

At 2209 on 3/16/07, the plant tripped on a Safety Injection (SI) signal initiated because of low main steam line pressure in the 'A' main steam loop. The licensee is currently conducting a post trip review but believes that the low main steam line pressure in 'A' loop was caused by a spurious isolation of the 'B' Main Steam Line Isolation Valve (MSIV). The isolation in the 'B' main steam loop lead to high main steam flow and low main steam line pressure in the 'A' main steam loop. The 'A' MSIV then also auto-closed on the SI signal.

The plant is currently stable in Mode 3 at about 2235 psig pressure and 547 degrees average Reactor Coolant System (RCS) temperature. All control rods fully inserted on the trip. Decay heat is currently being removed by auxiliary feedwater feeding the steam generators and steaming out the plant atmospheric steam valves. Since plant pressure did not decrease below 1500 psig, SI did not actually inject into the RCS. The licensee secured SI. No primary PORV's or safety valves lifted. No main steam safeties lifted according to plant closure indicators. There are no primary to secondary steam generator tube leaks.

All electrical safeguards buses are powered by offsite power. The Emergency Diesel Generators (EDG) started but did not load and were shut down. The EDGs are operable and available if needed.

The licensee notified the NRC Resident Inspector.

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Power Reactor Event Number: 43245
Facility: PILGRIM
Region: 1 State: MA
Unit: [1] [ ] [ ]
RX Type: [1] GE-3
NRC Notified By: DAVID NOYES
HQ OPS Officer: JOHN MacKINNON
Notification Date: 03/17/2007
Notification Time: 21:11 [ET]
Event Date: 03/17/2007
Event Time: 16:58 [EDT]
Last Update Date: 03/17/2007
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(3)(iv)(A) - VALID SPECIF SYS ACTUATION
Person (Organization):
CHRIS HOTT (R1)

Unit SCRAM Code RX CRIT Initial PWR Initial RX Mode Current PWR Current RX Mode
1 N N 0 Hot Shutdown 0 Hot Shutdown

Event Text

GROUP ISOLATIONS FOLLOWING MANUAL REACTOR SCRAM

"On March 17 2007, at approximately 1658 EDT, Group 2 (Reactor Building Ventilation Isolation) and Group 6 (RWCU Isolation) automatic containment isolation signals were received due to low reactor water level following the insertion of a manual scram signal. The manual scram signal was inserted following the reaching of internal administrative limits on changes in unidentified drywell leakage. The receipt of these isolation signals is not unusual following the insertion of a scram signal.

"The reactor was manually shutdown due to reaching internal administrative limits on changes in unidentified drywell leakage. Prior to the manual shutdown, the leakage had not reached the applicable Technical Specification limits. Drywell leakage as of 1800 EDT was 1.3 GPM identified and 2.59 GPM unidentified with the unit in Hot Shutdown Mode.

"All safety systems responded as expected. The plant is in a stable condition. Investigation is continuing."

The licensee notified the NRC Resident Inspector.

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Power Reactor Event Number: 43246
Facility: MONTICELLO
Region: 3 State: MN
Unit: [1] [ ] [ ]
RX Type: [1] GE-3
NRC Notified By: RANDY SAND
HQ OPS Officer: JEFF ROTTON
Notification Date: 03/18/2007
Notification Time: 04:41 [ET]
Event Date: 03/17/2007
Event Time: 23:46 [CDT]
Last Update Date: 03/18/2007
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(3)(iv)(A) - VALID SPECIF SYS ACTUATION
Person (Organization):
RICHARD SKOKOWSKI (R3)

Unit SCRAM Code RX CRIT Initial PWR Initial RX Mode Current PWR Current RX Mode
1 N N 0 Refueling 0 Refueling

Event Text

RPS TRIP SIGNAL AND CONTAINMENT ISOLATIONS RECEIVED DURING MAINTENANCE

"With the plant in refueling outage with all rods in and in Mode 5, a RPS trip and a containment isolation was received at 2347, 03/17/07. This event occurred when Div #2 Bus 16 Bus Pot Drawer was opened during isolation of 1AR Transformer Metering under C/O-17605. The opening of this Pot Drawer caused Div #2 4KV Bus 16, Div #2 480V LC-104 and Div #2 480V MCC-141, 142, 143, and 144 to open. 'B' RPS tripped causing full RPS trip due to SRM shorting removed. The loss of power caused RBV [Reactor Building Ventilation] and Spent Fuel Pool Radiation Monitors to trip and cause containment isolation to occur. Investigation into C/O-17605, restoration of power, resetting of RPS and containment isolation in progress."

The containment valves that received an isolation signal were: Primary Containment Atmosphere Control, Post Accident H2/O2 Control system, Post Accident Sampling system, O2 analyzing and SCTMT isolation (H&V).

The licensee notified the NRC Resident Inspector.

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Power Reactor Event Number: 43247
Facility: DUANE ARNOLD
Region: 3 State: IA
Unit: [1] [ ] [ ]
RX Type: [1] GE-4
NRC Notified By: HANS OLSON
HQ OPS Officer: BILL HUFFMAN
Notification Date: 03/18/2007
Notification Time: 22:07 [ET]
Event Date: 03/18/2007
Event Time: 19:40 [CDT]
Last Update Date: 03/18/2007
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):
RICHARD SKOKOWSKI (R3)

Unit SCRAM Code RX CRIT Initial PWR Initial RX Mode Current PWR Current RX Mode
1 M/R Y 28 Power Operation 0 Hot Shutdown

Event Text

MANUAL REACTOR SCRAM DUE TO COOLANT CHEMISTRY CONCERNS

"This report Is being made under 50.72(b)(2)(iv)(B) for inserting a manual reactor scram due to high levels of reactor coolant chlorides, sulfates, and conductivity. These elevated chemistry parameters may be due to a possible resin intrusion following the placement of a Condensate Demineralizer in service.

"In addition, this report is being made under 50.72(b)(3)(iv)(A), 'Any event or condition that results in valid actuation of any systems listed in paragraph (b)(3)(iv)(B) of this section' due to PCIS groups 2, 3, and 4 being received when reactor water level dropped below 170 inches. All isolations went to completion. The reactor water level drop is normal following a scram from 28% power due to void collapse in the reactor vessel. Reactor water level was restored to normal and the PCIS group isolations were reset.

"The current plan is to cooldown the plant and enter Mode 4."

The scram was characterized as uncomplicated. All rods fully inserted. No safety relief valves lifted. Reactor water low level was approximately 165 inches and was restored with normal reactor feedwater. Decay heat is currently being removed via steam line drains. There were no electrical alignment or grid issues as a result of the transient. No significant Technical Specification LCOs were in effect at the time of the scram.

The licensee notified the NRC Resident Inspector.

Page Last Reviewed/Updated Thursday, March 29, 2012
Thursday, March 29, 2012