Event Notification Report for October 02, 2023

EN Revision Imported Date: 10/2/2023

EN Revision Text: AGREEMENT STATE REPORT - FIRE AT FACILITY CONTAINING RADIOACTIVE GAUGES

The following report was received via telephone and email by the Illinois Emergency Management Agency [the Agency]:

"At approximately 1900 [CDT] on 9/10/23, a fire/explosion was reported at the Archer Daniels Midland facility located at 4666 East Farie Parkway in Decatur, IL. Information available at this time indicates a flammable hexane environment may have contributed to the incident. The Agency contacted the facility at approximately 2100 [CDT] on 9/10/23 to determine the status of the 23 radioactive gauges located within the building. The gauges contain a quantity of radioactive material that if impacted by the fire could present non-life threatening but elevated exposure rates to first responders. At 0945 [CDT] on 9/11/23, the Agency made contact with the Radiation Safety Officer at the facility. He stated the gauges are in an adjacent part of the facility (shared wall) which remains to be determined if impacted. It was noted that the area containing the gauges has an elevated hexane concentration. The Agency is actively coordinating with the facility's radiation safety staff and the Macon County Emergency Management Agency to provide information to first responders and coordinate a site visit to determine the status of the devices. If additional information regarding integrity of the devices is not available by midday, the Agency will coordinate a site visit. Reportedly, site access is still limited and information is still forthcoming to emergency managers.

"The 23 Texas Nuclear Model 5205 gauges range in activity from 50 to 100 mCi of Cs-137. Information available indicates 4 gauges contain 100 mCi of Cs-137 and 19 gauges contain 50 mCi of Cs-137. 8 additional gauges containing up to 500 mCi of Cs-137 are located in other onsite buildings, but are not anticipated to have been impacted. It is unclear if the Texas Nuclear Model 5205 gauges or their containers have been impacted by the fire/explosion at this time. On scene assessment is not immediately possible and may not be within the 24-hour reporting timeframe. The matter is being reported at this time and will be retracted if the gauges are found to be undamaged."

Illinois Incident Number: IL230024

* * * UPDATE ON 9/12/2023 AT 1501 EDT FROM IEMA TO LAWRENCE CRISCIONE * * *

The following is a summary of an update received via email from the Illinois Emergency Management Agency:

The licensee's hazmat response staff was able to enter the building late yesterday (9/11/23) and indicated none of the 23 radioactive gauges appear impacted by the fire. The Illinois Emergency Management Agency (IEMA) nuclear safety staff still plan to perform confirmatory surveys and wipes once the building can be safely accessed. IEMA staff are working with the licensee and county Emergency Management Agency officials to coordinate that site visit. Based on the information available, IEMA staff do not have any radiation exposure or accountability concerns at this time. This incident will be kept open until Agency staff have conducted a site visit and confirmed the integrity of the 23 devices.

Notified the Region 3 duty officer and NMSS events.

* * * RETRACTION ON 09/29/23 AT 1357 EDT FROM GARY FORSEE TO SAMUEL COLVARD * * *

Agency staff conducted a reactionary inspection with Macon County Emergency Management Agency officials on 9/28/23. The gauges were assessed and determined to not have been damaged by fire or percussion. Therefore, this event is requested to be retracted.

Notified R3DO (Orlikowski), NMSS Events (email).

AGREEMENT STATE REPORT - MISSING I-125 SEED

The following was reported by the Florida Bureau of Radiation Control (BRC) via email:

"At 1537 EDT on 9/22/23, BRC received a call from Cleveland Clinic stating an I-125 source was lost after removal from a patient. The patient was suspected to have breast cancer, and two I-125 sources were implanted in the breast tissue. The patient returned home 9/18/23 with the implanted seeds, and returned to the clinic 9/20/23 to receive a Tc-99m injection prior to tissue removal. The licensee states they confirmed both seeds were no longer in the patient after surgery, however, when the samples were taken by pathology, only one seed was located in the removed tissue. Cleveland Clinic has completed surveys of the operating room and pathology."

Florida incident number: FL23-149

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 - STUCK SHUTTER

The following information was provided by the Texas Department of State Health Services (the Department) via email:

"On September 24, 2023, the Department was notified by the licensee that during a maintenance inspection, the shutter on a Ronan Engineering nuclear gauge failed to close. The gauge contains a 500 millicurie Cs-137 source. Open is the normal operating position for the gauge. The licensee stated that due to the location of the gauge it is not an exposure risk to any individual. The licensee is posting a sign at the access port to the vessel the gauge is attached to stating `NO ENTRY.' Additional information will be provided as it is received in accordance with SA-300."

Texas Incident Number: I-10054

AGREEMENT STATE REPORT - STUCK SHUTTER

The following information was provided by the Georgia Radioactive Materials Program via email:

"During a routine shutter check, it was discovered that a shutter was not working on an in service source device. This device is an Ohmart/Vega containing sealed source of 400 mCi cesium-137, serial number 65574, Model SHF2-45 K2 Chip Bin. The radiation safety officer (RSO) reported that the shutter had failed in the open position. The source was then barricaded from the area with appropriate signage. On August 21, 2023, a qualified technician from VEGA visited the site and repaired this shutter. The technician removed the old rotor and installed a new rotor on the source holder."

Georgia incident number: 70

PART 21 INTERIM REPORT - DEVIATION ASSOCIATED WITH AN SMB-1 GEARED LIMIT SWITCH ASSEMBLY

The following information was provided by Flowserve via phone and email:

"The purpose of this letter is to provide written notification of an evaluation of a deviation in a basic component in accordance with 10 CFR21.21(a)(2). This interim report pertains to actuator geared limit switch assemblies contained in SMB-1 actuators supplied to Bopp & Reuther Valves for use in safety related applications at Bruce Nuclear Generating Station.

"Flowserve - Limitorque was contacted by Bruce Power who reported a malfunction of an actuator geared limit switch (GLS) assembly which occurred while attempting to set the valve travel position limits prior to placing the actuator into service. Site inspections of the GLS assembly revealed damage to the GLS drive pinion which engages with the actuator drive train. Site photos and dimensional measurements of the drive pinion requested by Flowserve indicate that the GLS was assembled with an incorrect drive pinion resulting in the malfunction. Use of an incorrect subcomponent in the assembly constitutes the deviation to the design being evaluated. The actuator GLS assembly is a safety related component. A malfunction of the GLS in service has the potential to affect the safety function of the actuator.

"The assembly containing the deviation is a 4-train geared limit switch (GLS) assembly part number 10168 supplied in SMB-1 actuators manufactured on Flowserve order 175377.001 Three actuators (serial numbers L1226986, L1226987, & L1226988) were shipped to Bopp & Reuther Valves on 2/4/2020.

"Flowserve's evaluation of this issue is ongoing and will not be completed within 60 days. The evaluation is expected to be completed by 11/17/2023 pending return of the affected components to Flowserve for inspection. Questions concerning this notification can be directed to Chris Shaffer, Quality Manager."

The following additional information was obtained from the licensee in accordance with Headquarters Operations Officers Report Guidance:

This issue was identified at a Canadian reactor plant owned by Bruce Power. The Quality Manager at Flowserve is not currently aware of any affected US reactor plants.

MANUAL REACTOR TRIP

The following information was provided by the licensee via email:

"At 2014 [PDT] on 09/30/2023, with [Diablo Canyon] Unit 1 in Mode 1 at 11 percent reactor power in preparation for a pre-planned manual reactor trip into a scheduled refueling outage, the reactor was manually tripped due to a failed secondary system dump valve. Auxiliary feedwater was manually started in accordance with plant procedures.

"This event is being reported in accordance with the reporting criteria of 10 CFR 50.72(b)(2)(iv)(B) and 10 CFR 50.72(b)(3)(iv)(A).

"There was no plant or public safety impact.

"The NRC Senior Resident Inspector has been notified."


The following additional information was obtained from the licensee in accordance with Headquarters Operations Officers Report Guidance:

Diablo Canyon Unit 2 was unaffected.