United States Nuclear Regulatory Commission - Protecting People and the Environment
Home > NRC Library > Document Collections > Reports Associated with Events > Event Notification Reports > 2009 > April 16

Event Notification Report for April 16, 2009

U.S. Nuclear Regulatory Commission
Operations Center

Event Reports For
04/15/2009 - 04/16/2009

** EVENT NUMBERS **


44979 44981 44986 44988 44992 44993

To top of page
General Information or Other Event Number: 44979
Rep Org: NC DIV OF RADIATION PROTECTION
Licensee: UNIVERSITY OF NORTH CAROLINA HOSPITALS
Region: 1
City: CHAPEL HILL State: NC
County:
License #: 068-0565-1
Agreement: Y
Docket:
NRC Notified By: HENRY BARNES
HQ OPS Officer: DONALD NORWOOD
Notification Date: 04/09/2009
Notification Time: 13:48 [ET]
Event Date: 04/08/2009
Event Time: 11:45 [EDT]
Last Update Date: 04/09/2009
Emergency Class: NON EMERGENCY
10 CFR Section:
AGREEMENT STATE
Person (Organization):
LAWRENCE DOERFLEIN (R1)
ANGELA MCINTOSH (FSME)

Event Text

AGREEMENT STATE REPORT - MISADMINISTRATION INVOLVING Y-90 MICROSPHERES

The following was received via facsimile:

"N.C. Radiation Protection Section was notified of a misadministration involving Y-90 microspheres. The licensee reports that the administered dosage was 24 percent less than the prescribed dosage.

"Licensee reports no equipment malfunction and no leakage of radioactive material from the delivery device. Licensee has notified patient and there are no plans to perform a second administration.

"Licensee is contacting vendor to assist in investigation.

"N.C. Radiation Protection has not received any media attention as of this report. No press release has been issued."

The North Carolina Event Report ID Number for this event is NC-09-22.

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.

To top of page
General Information or Other Event Number: 44981
Rep Org: TEXAS DEPARTMENT OF HEALTH
Licensee: FLINT HILLS RESOURCES LP
Region: 4
City: ODESSA State: TX
County:
License #: 00547
Agreement: Y
Docket:
NRC Notified By: ART TUCKER
HQ OPS Officer: DAN LIVERMORE
Notification Date: 04/10/2009
Notification Time: 08:30 [ET]
Event Date: 04/09/2009
Event Time: 19:21 [CDT]
Last Update Date: 04/10/2009
Emergency Class: NON EMERGENCY
10 CFR Section:
AGREEMENT STATE
Person (Organization):
BLAIR SPITZBERG (R4)
MARK DELLIGATTI (FSME)

Event Text

AGREEMENT STATE REPORT - LEVEL GAUGE CESIUM-137 SOURCE WOULD NOT RETRACT

The following information was provided via email:

"On April 9, 2009, at 19:21 the Agency [state] received a phone call from the Radiation Safety Officer (RSO) at Flint Hills Resources in Odessa Texas. The RSO reported that a 300 millicurie (120 mCi calculated) Cesium (Cs) -137 source used in an Ohmart\VEGA model # SHLM level gauge would not fully retract into the source holder. The gauge is installed on the side of a [chemical] reactor vessel. The source will retract to the sleeve between the vessel and the gauge housing, but will not go into the gauge. The source is currently fully inserted into the vessel. Dose rates in the area are normal. No additional exposure was received by individuals at the facility. Management will meet on April 10, 2009, to determine how to address the source retrieval. The gauge was to be removed from the vessel for disposal by the manufacturer. The licensee will provide additional information next week. A similar event occurred at this facility in October, 2008 (EN44543)."

To top of page
General Information or Other Event Number: 44986
Rep Org: WA DIVISION OF RADIATION PROTECTION
Licensee: PERMA-FIX NORTHWEST
Region: 4
City: RICHLAND State: WA
County:
License #: WN-I0508-1
Agreement: Y
Docket:
NRC Notified By: SEAN MURPHY
HQ OPS Officer: MARK ABRAMOVITZ
Notification Date: 04/13/2009
Notification Time: 12:21 [ET]
Event Date: 02/03/2009
Event Time: [PDT]
Last Update Date: 04/13/2009
Emergency Class: NON EMERGENCY
10 CFR Section:
AGREEMENT STATE
Person (Organization):
JACK WHITTEN (R4)
ANGELA McINTOSH (FSME)
CYNDI JONES (NSIR)

Event Text

AGREEMENT STATE REPORT - POTENTIAL OVEREXPOSURE TO THE LUNGS

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

"On February 9 2009, a worker was sent for a lung count at the Battelle (Pacific Northwest National Laboratory) lung counter for a bioassay measurement. The lung count was ordered due to the worker working in an area where airborne contamination levels could cause more then 2.5 DAC-hrs (with respiratory protection factors applied), and greater then 520 DAC-hrs assuming no respiratory protection was worn in one day. The reason for requiring this count was to ensure that measures used to protect the workers were functioning properly. The workers first lung count detected approximately 0.2 nCi of Am-241. Assuming the exposure was from 10 days prior, the intake was approximately 1.9 nCi Am-241. The annual limit of intake for Am-241 is 6 nCi (1micron AMAD particle size). The estimated dose was about 1/3 of the annual limit, or 16 REM CDE (Annual limit 50 REM). The worker had previous whole body exposure, but this added amount did not cause a limit to be exceeded.

"On March 25, 2009 the licensee informed the Washington State Department of Health that further testing by Battelle caused a revision to the original calculated dose and the new calculated dose would exceed the 50 REM CDE limit. The date of exposure (February 3, 2009) was assumed by the licensee, based on air sample data and the use of respiratory protection that may not have provided adequate coverage (use of filtering respirator instead of supplied air). On February 3, the worker was in a containment in which air sample results were about 1e-8 microCi/ml gross alpha activity concentration for several hours and was wearing a Powered Air Purifying Respirator (PAPR, protection factor of 1000). Bioassay results (fecal) from one other worker who was also in the containment showed a small amount of activity, and a dose was assigned to this second worker that did not exceed the legal limit. The second workers lung count was less than detection limits.

"The cause is still unknown.

"Contributing factors: High airborne activity, loss of respiratory protection.

"DOH is conducting an investigation of this incident.

"Corrective action : Curtailment of work in containment, training on removal of anti contamination clothing and respirator, investigation of respiratory protection failure.

"There was no media coverage of this incident.

"Activity and isotope(s) involved: Am-241, Pu-240/241

Overexposures: (number of workers/members of public; dose estimate; body part receiving dose; consequence): There was one potential overexposed worker, no members of the public were exposed, estimated dose to the worker is about 100 REM CDE and 5 REM CEDE. This value will change following further measurements, investigation and calculations.

"Worker was removed from the restricted area, work in the area where the intake was assumed to occur was stopped, pending the outcome of further investigation."

Washington State Incident Number: WA-09-013

To top of page
Fuel Cycle Facility Event Number: 44988
Facility: PORTSMOUTH AMERICAN CENTRIFUGE
RX Type: URANIUM ENRICHMENT FACILITY
Comments: 2 DEMOCRACY CENTER
                   6903 ROCKLEDGE DRIVE
                   BETHESDA, MD 20817
Region: 2
City: PIKETON State: OH
County: PIKE
License #: SNM-2011
Agreement: Y
Docket: 70-7004
NRC Notified By: ERIC SPAETH
HQ OPS Officer: MARK ABRAMOVITZ
Notification Date: 04/14/2009
Notification Time: 13:40 [ET]
Event Date: 04/14/2009
Event Time: [EDT]
Last Update Date: 04/15/2009
Emergency Class: NON EMERGENCY
10 CFR Section:
PART 70 APP A (c) - OFFSITE NOTIFICATION/NEWS REL
Person (Organization):
MALCOLM WIDMANN (R2)
LAWRENCE KOKAJKO (NMSS)

Event Text

DIESEL FUEL OIL SPILL REQUIRING OFFSITE NOTIFICATIONS

"On 04/14/09 at approximately 0918 hours, the Plant Shift Superintendent was notified of an oil spill that occurred on the plant site. A diesel generator sitting near a construction area was leaking fuel. Primary and secondary containment was initiated to contain the spill. At 1130 hours environmental response personnel determined that the quantity of oil spilled exceeded the Reportable Quantity (RQ).

"At 1144 hours, 04/14/2009, the Plant Shift Superintendent notified the National Response Center and the Ohio EPA that a Reportable Quantity (RQ) of oil (diesel fuel) was released to the environment.

"Ohio EPA assigned incident #: 0904-66-1084.
"National Response Center assigned incident #: 902636

"ACD2-RG-044, Appendix N, section 1 requires an NRC event notification when other government agencies are notified."

The amount of fuel oil spilled was 25 to 40 gallons. Licensee will be issuing a press release about this spill.

* * * UPDATE AT 2241 ON 4/14/2009 FROM SPAETH TO ABRAMOVITZ * * *

The licensee is issuing a press release and has revised the estimated spill to 300 gallons.

Notified the R2DO (Widman), NMSS (Kokajko), and PAO (Hayden) via e-mail.

* * * UPDATE ON 4/15/2009 AT 1400 FROM SPAETH TO ABRAMOVITZ * * *

This event occurred at the American Centrifuge Plant (Docket 70-7004, license SNM-2011) and not the gaseous diffusion plant.

Notified the R2DO (Widman) and NMSS (Kokajko) via e-mail.

To top of page
Power Reactor Event Number: 44992
Facility: COOK
Region: 3 State: MI
Unit: [1] [2] [ ]
RX Type: [1] W-4-LP,[2] W-4-LP
NRC Notified By: DEAN BRUCK
HQ OPS Officer: VINCE KLCO
Notification Date: 04/15/2009
Notification Time: 07:31 [ET]
Event Date: 04/15/2009
Event Time: 04:15 [EDT]
Last Update Date: 04/15/2009
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(3)(xiii) - LOSS COMM/ASMT/RESPONSE
Person (Organization):
LAURA KOZAK (R3)

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

Event Text

UNAVAILABILITY OF TSC VENTILATION SYSTEM AND CHARCOAL FILTER DURING SCHEDULED MAINTENANCE

"At 0415 on Wednesday, April 15, 2009, the Cook Nuclear Plant (CNP) Technical Support Center (TSC) ventilation system and charcoal filter was removed from service for scheduled preventive maintenance. The charcoal bed filtration system is also out of service in support of the maintenance on the TSC ventilation system.

"Under certain accident conditions the TSC may become unavailable due to the inability of the filtration system to maintain a habitable atmosphere. Compensatory measures exist to relocate TSC personnel to the unaffected unit's control room if necessary based upon results of procedurally required monitoring of TSC radiological conditions.

"The TSC ventilation system maintenance is scheduled to complete at 1600 on Wednesday, April 15, 2009.

"The licensee has notified the NRC Senior Resident Inspector.

"This notification is being made in accordance with 10 CFR 50.72 (b)(3)(xiii) due to the loss an emergency response facility."

* * * UPDATE FROM DEAN BRUCK TO JOHN KNOKE AT 1352 ON 4/15/09 * * *

"At 1255 on Wednesday, April 15, 2009 the planned maintenance and testing was completed. The TSC ventilation system and charcoal filter have been returned to service restoring full availability to the TSC.

"The licensee has notified the NRC Senior Resident Inspector." Notified R3DO (Laura Kozak)

To top of page
Power Reactor Event Number: 44993
Facility: OYSTER CREEK
Region: 1 State: NJ
Unit: [1] [ ] [ ]
RX Type: [1] GE-2
NRC Notified By: GEORGE VOISHNIS
HQ OPS Officer: JOHN KNOKE
Notification Date: 04/15/2009
Notification Time: 20:19 [ET]
Event Date: 04/15/2009
Event Time: 16:44 [EDT]
Last Update Date: 04/15/2009
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(2)(xi) - OFFSITE NOTIFICATION
Person (Organization):
ART BURRITT (R1)

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

OFFSITE NOTIFICATION DUE TO POTENTIAL RELEASE OF TRITIUM

"Oyster Creek notified the New Jersey Department of Environmental Protection of a potential release due to the discovery of detectable levels of Tritium in a cable vault that was found while replacing the cable to an [Emergency Service Water] ESW pump. No release is known to be occurring and no release is known to have occurred. The source of the Tritium water is not currently known. A prompt investigation is in progress."

The licensee has notified the NRC Resident Inspector.

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