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Event Notification Report for December 20, 2018

U.S. Nuclear Regulatory Commission
Operations Center

Event Reports For
12/19/2018 - 12/20/2018

** EVENT NUMBERS **


53784 53787 53796 53798

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!!!!! THIS EVENT HAS BEEN RETRACTED.THIS EVENT HAS BEEN RETRACTED !!!!!
Power Reactor Event Number: 53784
Facility: BRAIDWOOD
Region: 3     State: IL
Unit: [1] [2] []
RX Type: [1] W-4-LP,[2] W-4-LP
NRC Notified By: SAM KELLER
HQ OPS Officer: THOMAS KENDZIA
Notification Date: 12/08/2018
Notification Time: 06:12 [ET]
Event Date: 12/07/2018
Event Time: 00:00 [CST]
Last Update Date: 12/20/2018
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(3)(v)(A) - POT UNABLE TO SAFE SD
Person (Organization):
PATRICIA PELKE (R3DO)
Unit SCRAM Code RX Crit Initial PWR Initial RX Mode Current PWR Current RX Mode
1 N Y 100 Power Operation 100 Power Operation
2 N Y 100 Power Operation 100 Power Operation

Event Text

INOPERABLE CONTROL ROOM ENVELOPE

"Braidwood Station was performing Control Room Envelope Testing. During testing the Station identified a failed acceptance criteria. The Control Room Envelope is a single train system and could constitute a Loss of Safety Function. If a single train system is inoperable per Technical Specifications (TS), it is Reportable as a Loss of Safety Function per 10 CFR 50.72(b)(3)(v) regardless of the system's continued ability to meet the accident analysis requirements.

"Both Units remain Mode 1, 100% power."

The licensee will be notifying the NRC Resident Inspector.

The acceptance criteria that failed was to maintain the control room pressure above the miscellaneous electrical equipment room pressure.

The station has realigned ventilation to normal, and has entered TS Limited Condition for Operation (LCO) 3.7.10 condition B, which requires the station to restore to operable the control room envelope within 90 days or shutdown the plant.

The station has also initiated contingency actions to verify SCBA (self contained breathing apparatus) are available and control room personnel are qualified to use SCBA.

* * * RETRACTION ON 12/20/18 AT 1714 EST FROM ANTHONY SIEBERT TO JEFFREY WHITED * * *

"On Wednesday, December 19, 2018, Braidwood Station concluded that the ENS notification 53784 could be retracted. It has been determined that the issue was not with the Control Room Envelope structure. Troubleshooting identified that the Unit 1 Upper Cable Spreading Room Area Supply Flow Control (OVC035Y) damper which supplies the Train A control room ventilation equipment room with air flow was not opening enough to supply the required flow. The subject duct work is shared by both A-train and B-train, and the flow through OVC035Y is controlled by a two-position actuator. The damper is less open when A-train is in operation (actuator energized) and more open when B-train is in operation (actuator de-energized). The only adjustments performed were to the actuator energized stroke limits which only affect the A train and thus a single train failure which could affect the safety function of both trains did not exist.

"Further calculations of unfiltered air inleakage into the Control Room Envelope (CRE) under a slightly negative differential pressure condition resulted in a calculated in leakage to the CRE of less than the maximum allowable unfiltered air inleakage for a radiological event of 436 scfm. The unfiltered air inleakage into the CRE assumed in the licensing basis analyses of Design Basis Accident consequences was never exceeded. Thus, TS Surveillance Requirement 3.7.10.4 continued to be met and entry into TS 3.7.10 Condition B was not required.

"The licensee has notified the NRC Resident Inspector."

Notified the R3DO (Stone).

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Agreement State Event Number: 53787
Rep Org: NH DEPT OF HEALTH & HUMAN SERVICES
Licensee: LAKES REGION GENERAL HOSPITAL
Region: 1
City: LACONIA   State: NH
County:
License #: 258R
Agreement: Y
Docket:
NRC Notified By: DAVID SCALISE
HQ OPS Officer: ANDREW WAUGH
Notification Date: 12/11/2018
Notification Time: 16:18 [ET]
Event Date: 12/11/2018
Event Time: 00:00 [EST]
Last Update Date: 12/11/2018
Emergency Class: NON EMERGENCY
10 CFR Section:
AGREEMENT STATE
Person (Organization):
RAY MCKINLEY (R1DO)
NMSS_EVENTS_NOTIFICATION (EMAIL)

Event Text

AGREEMENT STATE REPORT - MEDICAL EVENT

The following was received from the State of New Hampshire via email:

"On December 11, 2018, the NH Radiological Health Section (Agency) was notified by the Radiation Safety Officer at Lakes Region General Hospital of the administration of an incorrect radiopharmaceutical. On this date a patient received an injection of 7.7 milliCuries (mCi) of technicium-99m Sestamibi rather than 7.7 mCi technicium-99m Choletec. The consequence is a dose to an unintended organ.

"The patient, radiologist, and authorized providers were informed. No health effects are anticipated.

"The RSO will conduct a root cause analysis and present a written report of the findings and corrective actions to the Agency within 15 days."

New Hampshire Event Report ID No.: NH 18-005

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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Power Reactor Event Number: 53796
Facility: WATERFORD
Region: 4     State: LA
Unit: [3] [] []
RX Type: [3] CE
NRC Notified By: TRACEY BERRY
HQ OPS Officer: BRIAN P. SMITH
Notification Date: 12/20/2018
Notification Time: 05:32 [ET]
Event Date: 12/19/2018
Event Time: 00:00 [CST]
Last Update Date: 12/20/2018
Emergency Class: NON EMERGENCY
10 CFR Section:
50.72(b)(3)(v)(D) - ACCIDENT MITIGATION
Person (Organization):
RYAN ALEXANDER (R4DO)
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

CONTROL ROOM ENVELOPE INOPERABLE

"On December 19, 2018, at 2322 CST, the shift operating crew declared the control room envelope inoperable in accordance with Technical Specification (TS) 3.7.6.1 due to valve HVC-102 exceeding its maximum allowed closed stroke time of 2.0 seconds during performing of surveillance procedure OP-903-119. Actual closed stroke time was 2.1 seconds. Valve HVC-102 is part of the control room envelope. TS 3.7.6.1 requires that two control room emergency air filtration trains shall be OPERABLE. Operations entered TS 3.7.6.1 action b, which requires that with one or more control room emergency air filtration trains inoperable due to inoperable control room envelope boundary in MODES 1, 2, 3, or 4, then: 1. immediately initiate action to implement mitigating actions; 2. within 24 hours, verify mitigating actions ensure control room envelope occupant exposures to radiological, chemical, and smoke hazards will not exceed limits; and 3. within 90 days, restore the control room envelope boundary to OPERABLE status. Actions b.1 and b.2 were completed by placing the control room ventilation system in isolate mode at 2355. This event is reportable pursuant to 10 CFR 50.72(b)(3)(v)(D), 'event or condition that could have prevented fulfillment of a safety function of structures or systems that are needed to (D) mitigate the consequences of an accident,' due to the control room envelope being inoperable.

"The NRC Resident Inspector has been notified."

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Independent Spent Fuel Storage Installation Event Number: 53798
Rep Org: SAN ONOFRE
Licensee: SOUTHERN CALIFORNIA EDISON COMPANY
Region: 4
City: SAN CLEMENTE   State: CA
County: SAN DIEGO
License #: GL
Agreement: Y
Docket: 72-41
NRC Notified By: TIM CUSICK
HQ OPS Officer: MARK ABRAMOVITZ
Notification Date: 12/20/2018
Notification Time: 13:56 [ET]
Event Date: 12/19/2018
Event Time: 00:00 [PST]
Last Update Date: 12/20/2018
Emergency Class: NON EMERGENCY
10 CFR Section:
72.75(d)(1) - SFTY EQUIP. DISABLED OR FAILS TO FUNCTION
Person (Organization):
RYAN ALEXANDER (R4DO)

Event Text

SPENT FUEL TRANSFER VEHICLE OUTSIDE SEISMIC ANALYSIS LIMITS

"As part of the reviews following the August 3rd 2018 canister downloading event (EN#53605), SCE has identified events where the HI-PORT may have been operated outside the analytical assumptions of the seismic analysis while transporting a loaded canister in the HI-TRAC. SCE has decided to conservatively report this issue.

"The HI-PORT is subject to requirements in the Certificate of Compliance that result in seismic restrictions on center of gravity and proximity to structures that could adversely affect the function of the HI-PORT along the haul route. SCE has concluded that during previous movements of loaded spent fuel canisters during 2018, the HI-PORT likely exceeded these procedural and analytical limits in some cases.

"Additional analysis is underway that may conclude that damage to the HI-PORT would not occur under these conditions. Nevertheless, this situation is being reported in accordance with 10CFR72.75(d)(1) for an important to safety component that was disabled or failed to function. There was no seismic event that resulted in damage to the HI-PORT during the fuel transfer campaign. All 29 spent fuel canisters are currently in safe storage within the ISFSI.

"NRC Region IV will be notified as SONGS does not have a NRC Resident Inspector."


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