Event Notification Report for November 04, 2022

U.S. Nuclear Regulatory Commission
Operations Center

EVENT REPORTS FOR
11/03/2022 - 11/04/2022

EVENT NUMBERS
56184 56187 56188 56198 56200 56202
Agreement State
Event Number: 56184
Rep Org: NJ Rad Prot And Rel Prevention Pgm
Licensee: Phillips 66 Co
Region: 1
City: Linden   State: NJ
County:
License #: 786964
Agreement: Y
Docket:
NRC Notified By: Joe Power
HQ OPS Officer: Bill Gott
Notification Date: 10/27/2022
Notification Time: 14:51 [ET]
Event Date: 10/27/2022
Event Time: 00:00 [EDT]
Last Update Date: 10/27/2022
Emergency Class: Non Emergency
10 CFR Section:
Agreement State
Person (Organization):
Dentel, Glenn (R1DO)
NMSS_EVENTS_NOTIFICATION (EMAIL)
ILTAB, (EMAIL)
Event Text
AGREEMENT STATE REPORT - MISSING TRITIUM EXIT SIGNS
The following information was provided by the New Jersey Bureau of Environmental Radiation via email:
"After an inspection of their specific license on September 13, 2022, the licensee was requested to reconcile an inventory of their generally licensed tritium exit signs. Two signs could not initially be located. After searching the facility, previous receipt records, and contacting the sign manufacturer, the devices were declared missing on October 27, 2022.
"Isotope and activity; manufacturer, model and serial number, leak test results as applicable: H-3, 10 Ci; Isolite Corporation, Model SLX-60, Serial Numbers H60803 and H60804"


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. For additional information go to http://www-pub.iaea.org/MTCD/publications/PDF/Pub1227_web.pdf


Agreement State
Event Number: 56187
Rep Org: Illinois Emergency Mgmt. Agency
Licensee: G.E. Healthcare DBA
Region: 3
City: Arlington Heights   State: IL
County:
License #: IL-01109-01
Agreement: Y
Docket:
NRC Notified By: Gary Forsee
HQ OPS Officer: Thomas Herrity
Notification Date: 10/28/2022
Notification Time: 14:16 [ET]
Event Date: 10/27/2022
Event Time: 00:00 [CDT]
Last Update Date: 10/28/2022
Emergency Class: Non Emergency
10 CFR Section:
Agreement State
Person (Organization):
Feliz-Adorno, Nestor (R3DO)
NMSS_EVENTS_NOTIFICATION (EMAIL)
MacDonald, Mark (ILTAB)
Event Text
AGREEMENT STATE REPORT - RADIOPHARMACEUTICAL PACKAGE LOST IN TRANSIT

The following information was provided by the Illinois Emergency Management Agency (the Agency) via email:

"The Agency was notified after hours on 10/27/22, that a radiopharmaceutical package containing 4.089 mCi of In-111 was reported as lost while in the care of a common carrier. This does not represent a significant public safety hazard and there is no indication of intentional theft or diversion. Details on the package and shipment are provided below. TN [Tennessee Department of Environment and Conservation] program have been notified along with the US NRC Operations Center.

"The package was shipped 10/13/22, from the licensee's facility in Arlington Heights, IL to Isologic Innovative in Burlington, Ontario Canada. The package made it to the [common carrier] hub in Memphis, TN under tracking number [REDACTED]. Thereafter, it could not be accounted for and was declared lost on 10/27/22. The package activity was 4.089 mCi at time of shipment, but has decayed to approximately 0.127 mCi at this time [10/28/22].

"Updates will be provided as they become available."

Illinois Event Number: IL220041

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. For additional information go to http://www-pub.iaea.org/MTCD/publications/PDF/Pub1227_web.pdf


!!!!! THIS EVENT HAS BEEN RETRACTED !!!!!
!!!!! THIS EVENT HAS BEEN RETRACTED !!!!!
Agreement State
Event Number: 56188
Rep Org: California Radiation Control Prgm
Licensee: Southern California Geotechnical
Region: 4
City: Yorba Linda   State: CA
County:
License #: 6506-30
Agreement: Y
Docket:
NRC Notified By: Donald Oesterle
HQ OPS Officer: Ernest West
Notification Date: 10/28/2022
Notification Time: 19:07 [ET]
Event Date: 10/27/2022
Event Time: 00:00 [PDT]
Last Update Date: 10/31/2022
Emergency Class: Non Emergency
10 CFR Section:
Agreement State
Person (Organization):
Roldan-Otero, Lizette (R4DO)
NMSS_EVENTS_NOTIFICATION (EMAIL)
Event Text
HIGH EXPOSURE READ ON TLD

The following information was provided by the the California Radiation Health Branch (RHB) via email:

"On 10/27/2022, the licensee was notified by their dosimetry provider that an employee's whole body thermoluminescent dosimeter (TLD) had a high dose for the reporting period ending in October 2022.

"Readings were as follows: Deep dose - 11,688 mrem, shallow dose - 11,942 mrem, and eye dose 11,964 mrem. The licensee started to investigate by speaking with the employee and informed him that he was not to use the nuclear gauge until the investigation was concluded.

"The alternate radiation safety officer (ARSO) then made a telephone report to RHB South on 10/28/2022."

California Event Number: Not yet assigned.

* * * RETRACTION ON 10/31/2022 AT 1308 EDT FROM ROBERT GREGER TO ERNEST WEST * * *

"[RHB] would like to retract the attached event notification that was submitted Friday, 10/28/2022.

"[RHB's] reason for retracting the notification is that it was reported prematurely since an investigation to [validate] the dose provided by the dosimetry vendor has not been completed, and the 30-day reportability period has only begun. If the investigation determines the dose to the individual exceeded 5 rem whole body, it will be reported accordingly."

Notified R4DO (Agrawal) and NMSS Events Notification via email.


Non-Power Reactor
Event Number: 56198
Facility: Univ Of Texas (TEX2)
RX Type: 1100 Kw Triga Mark Ii
Comments:
Region: 0
City: Austin   State: TX
County: Travis
License #: R-129
Agreement: Y
Docket: 05000602
NRC Notified By: Paul Whaley
HQ OPS Officer: Adam Koziol
Notification Date: 11/02/2022
Notification Time: 08:45 [ET]
Event Date: 10/17/2022
Event Time: 00:00 [CDT]
Last Update Date: 11/02/2022
Emergency Class: Non Emergency
10 CFR Section:
Non-Power Reactor Event
Person (Organization):
Wertz, Geoffrey (PM)
Takacs, Michael (NPR)
Waugh, Andrew (NPR)
Event Text
OPERATION WITH NON COMPLIANT FUEL

The following information was provided by the Nuclear Engineering Teaching Laboratory (NETL) at the University of Texas via email:

"We identified a potential non-compliance with Technical Specifications for the University of Texas research reactor on October 17 while shutdown. Our facility license specifies TRIGA fuel elements with stainless steel cladding, and we operated from January to October [2022] with two aluminum clad fuel elements in the core. On discovery, we suspended operations, removed the aluminum clad elements from the core, and compared the event to each reportable category identified in our Technical Specifications. The closest reporting criteria is:

"An observed inadequacy in the implementation of administrative or procedural controls such that the inadequacy causes or could have caused the existence or development of an unsafe condition with regard to reactor operations.

"However, we were unable to identify the implementation of facility administrative controls or procedures that led to this event. Furthermore, analysis indicates all operations maintained a margin to the safety limit for aluminum fuel, and aluminum clad TRIGA fuel elements are used in other TRIGA reactors. Regardless, we felt strongly that NRC should be informed and notified our program manager and designated inspector before initiating investigation and causal analysis.

"In developing corrective action, NETL staff identified changes in procedures and administrative controls that would have been adequate to prevent insertion of disqualified fuel in NETL reactor core. Since insertion of disqualified fuel has the potential to cause existence or development of an unsafe condition with regard to reactor operations, NETL management is now reporting this as a potentially reportable event under the category described."

NRC Project Manager and NPR Inspector have been notified.


Part 21
Event Number: 56200
Rep Org: Fairbanks Morse Engine
Licensee:
Region: 3
City: Beloit   State: WI
County:
License #:
Agreement: Y
Docket:
NRC Notified By: Martin Kurr
HQ OPS Officer: Karl Diederich
Notification Date: 11/02/2022
Notification Time: 10:01 [ET]
Event Date: 10/27/2022
Event Time: 00:00 [CDT]
Last Update Date: 11/02/2022
Emergency Class: Non Emergency
10 CFR Section:
21.21(d)(3)(i) - Defects And Noncompliance
Person (Organization):
Ruiz, Robert (R3DO)
Miller, Mark (R2DO)
Lilliendahl, Jon (R1DO)
Part 21/50.55 Reactors, - (EMAIL)
Event Text
PART 21 REPORT - FAIRBANKS MORSE ENGINE EMERENCY DIESEL GENERATOR ELECTRONIC SPEED CONTROL MODULE

The following information was provided by Fairbanks Morse (FM) via email:

Facilities affected:
FM Sales Order Item Affected Facility Serial Number
40135890 12996949 Farley 22436624
40132483 12996949 Limerick 22444358
40130845 12996949 Limerick 22444359
40130158 12996949 Hope Creek 22277182

"Basic component which fails to comply or contains a defect: Emergency Diesel Generator Electronic Speed Control Module, Woodward 2301A

"Nature of defect: In some 2301A controls, 1 nF capacitors may have been loaded in place of 150 pF capacitors. This could affect circuitry controlling the units' crystal, speed signal and reset dynamics, and power supply operation.

"Safety hazard which could be created by such defect: This issue can prevent affected 2301A controls from starting up or may lead to unscheduled shutdown of affected controls. It can also prevent the prime mover from obtaining a stable speed response, causing it to hunt or overspeed. In some cases, the RESET potentiometer may run out of range to adjust the unit for stable operation or desired prime mover speed response, resulting in prime mover performance outside of specification limits.

"Fairbanks Morse Engine will notify affected licensees no later than 3 Nov 2022, and repair returned affected units. Additional corrective actions will be documented in the Fairbanks Morse corrective system under PD-1102.

"Any installed affected Speed Control should be removed from service as soon as practical and returned to Fairbanks Morse for repair. If affected controller is installed and licensee experiences unstable speed response, the electronic speed control should be turned off and the emergency diesel generator should be allowed to operate using the mechanical governor system."

POC: Martin Kurr, Quality Assurance Manager (608) 364-8247


Power Reactor
Event Number: 56202
Facility: Waterford
Region: 4     State: LA
Unit: [3] [] []
RX Type: [3] CE
NRC Notified By: Jeff Bradley
HQ OPS Officer: Lauren Bryson
Notification Date: 11/03/2022
Notification Time: 14:05 [ET]
Event Date: 09/06/2022
Event Time: 09:21 [CDT]
Last Update Date: 11/03/2022
Emergency Class: Non Emergency
10 CFR Section:
50.73(a)(1) - Invalid Specif System Actuation
Person (Organization):
Agrawal, Ami (R4DO)
Power Reactor Unit Info
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
60-DAY OPTIONAL TELEPHONIC NOTIFICATION OF INVALID ENGINEERED SAFETY FEATURE ACTUATION SIGNAL

The following information was provided by the licensee via email:

"This 60-day telephonic notification is being made in lieu of a licensee event report submittal as allowed by 10 CFR 50.73(a)(1). This notification is made pursuant to 10 CFR 50.73(a)(2)(iv)(A) to provide information pertaining to an invalid engineered safety feature actuation signal.

"On September 6, 2022, at Waterford 3, while performing a plant protection system (PPS) power supply check, technicians observed an abnormally high voltage output. When the technicians opened the PPS bay cabinet door to adjust the voltage, they then observed low voltage indications. The direct cause of this issue is believed to be vibration induced relay chattering or an intermittent connection issue when opening the rear doors of PPS cabinets. This resulted in half the logic being met for the Engineered Safety Feature Actuation Signal (ESFAS) signals to fully actuate. The ESFAS signal opened the following valves: EFW-228A (EFW to SG 1 Primary Isolation), EFW-229A (EFW to SG 1 Backup Isolation), EFW-228B (EFW to SG 2 Primary Isolation) and EFW-229B (EFW to SG 2 Backup Isolation). This was a partial actuation of ESFAS. Affected plant systems functioned successfully.

"The inadvertent actuation was caused by a spurious signal and was not a valid signal resulting from actual parameter inputs. The 1992 Statements of Consideration define an invalid signal to include spurious signals including jarring of a cabinet door. In accordance with 10 CFR 50.73(a)(1) a telephone notification is being made in lieu of submitting a written licensee event report. The NRC Senior Resident Inspector has been notified. These events did not result in any adverse impact to the health and safety of the public."

Page Last Reviewed/Updated Friday, November 04, 2022