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Event Notification Report for October 25, 2024

U.S. Nuclear Regulatory Commission
Operations Center

EVENT REPORTS FOR
10/24/2024 - 10/25/2024

EVENT NUMBERS
57388 57390 57391 57400
Agreement State
Event Number: 57388
Rep Org: Texas Dept of State Health Services
Licensee: East Texas Testing Laboratory, Inc.
Region: 4
City: Fort Worth   State: TX
County:
License #: L01423
Agreement: Y
Docket:
NRC Notified By: Art Tucker
HQ OPS Officer: Sam Colvard
Notification Date: 10/17/2024
Notification Time: 12:02 [ET]
Event Date: 10/17/2024
Event Time: 05:45 [CDT]
Last Update Date: 10/17/2024
Emergency Class: Non Emergency
10 CFR Section:
Agreement State
Person (Organization):
Taylor, Nick (R4DO)
NMSS_EVENTS_NOTIFICATION (EMAIL)
ILTAB, (EMAIL) (EMAIL)
CNSNS (Mexico), - (EMAIL) (EMAIL)
Event Text
AGREEMENT STATE REPORT - STOLEN NUCLEAR GAUGE

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

"On October 17, 2024, the Department was notified by the licensee's radiation safety officer (RSO) that a Troxler model 3440 gauge had been stolen from the back of one of the company's pickup trucks. The gauge contains a 40 millicurie americium-241:beryllium source and an 8 millicurie cesium-137 source. The RSO stated the technician went to the truck at 0545 CDT this morning and found that the chains holding the gauge in the truck had been cut and the gauge and transport case were missing. The RSO stated that because the gauge had not been used this day, the cesium source rod should have been locked in the fully shielded position. The City of Fort Worth's police department was notified of the theft. The RSO is traveling to the office where the gauge was normally stored to interview the technician involved in the event.
"Additional information will be provided as it is received in accordance with SA-300."

Texas NMED #: TX240039
Texas Incident #: 10138

* * * UPDATE ON 10/17/2024 AT 1435 EDT FROM ART TUCKER TO NATALIE STARFISH * * *
"The Department has sent a notice of this event to the City of Fort Worth Emergency Management Office."

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


Non-Agreement State
Event Number: 57390
Rep Org: Bakerton Fire Department
Licensee: Hillis-Carnes
Region: 1
City: Harper's Ferry   State: WV
County:
License #: 19-30304-02
Agreement: N
Docket:
NRC Notified By: Josh Smith
HQ OPS Officer: Ernest West
Notification Date: 10/18/2024
Notification Time: 15:02 [ET]
Event Date: 10/18/2024
Event Time: 14:50 [EDT]
Last Update Date: 10/18/2024
Emergency Class: Non Emergency
10 CFR Section:
30.50(b)(2) - Safety Equipment Failure
Person (Organization):
Lally, Christopher (R1DO)
NMSS_EVENTS_NOTIFICATION (EMAIL)
Crouch, Howard (IR)
Fisher, Jennifer (NMSS)
Event Text
DAMAGED TROXLER GAUGE

The following is a summary of information that was provided by the Bakerton Fire Department via phone:

On 10/18/2024 at 1450 EDT, a traffic accident occurred on US Route 340 in Harpers Ferry, West Virginia, near Shipley School Road. The accident involved a model 3430 Troxler moisture/density gauge (nominal activity of 8 mCi of Cs-137 and 40 mCi of Am-241/Be) that was knocked out of its case and was damaged in the accident. The Bakerton Fire Department isolated the area, and initially shut down all lanes of traffic on Route 340. Surveys were later conducted with no signs of contamination or exposure. The gauge is damaged, but the negative survey results indicate no release occurred. The authorities on scene notified the West Virginia Radiological Health Program of the accident. After surveys were conducted, all of the lanes were opened for traffic except for one of the northbound lanes on US Route 340. The company that owns the gauge is Hillis-Carnes based in Frederick, MD. At this time, the license number under which the Troxler gauge is held is unknown.

Notified the National Response Center, the West Virginia Radiation Health Program, DHS SWO, FEMA Ops Center, USDA Ops Center, HHS Ops Center, DOE Ops Center, CISA Central Watch Officer, EPA EOC, FDA EOC (email), FEMA NWC (email), DHS Nuclear SSA (email), DHS NRCC (email), FEMA NRCC SASC (email), FERC (email)

* * * UPDATE ON 10/18/2024 AT 1905 EDT FROM GERALD SMITH TO ERNEST WEST * * *

The following is a summary of information provided by the radiation safety officer (RSO) for Hillis-Carnes:

The RSO passed that Homeland Security responded to the site as well. Homeland Security ensured there was no contamination by spreading anti-contamination material and performing surveys. The RSO also passed that the source rod was ejected from the gauge which was not relayed to the NRC headquarters operations officer previously. The RSO did not know how much exposure personnel may have received from the source rod, but the source rod is intact. Additionally, the RSO clarified that there was no actual vehicle collision. The RSO passed that the Troxler gauge was inside its case in the bed of the truck and the case was chained to the truck by the case's handle. The RSO claims that a load of concrete in the bed of the truck shifted which forced open the tailgate and broke off the handle of the case, freeing the case and allowing it to go into the road, where it was run over by a tractor trailer. The RSO has possession of the gauge, including both the Cs-137 source rod and the Am-241/Be source, and intends to bring the gauge to Northeast Technical Services for evaluation and/or disposal. The RSO passed that Hillis-Carnes' NRC license is 19-30304-02 and their Maryland Agreement State license is MD-21-041-01.

Notified R1DO (Lally), IR MOC (Crouch), NMSS (Williams), and NMSS Events Notification (email)


Agreement State
Event Number: 57391
Rep Org: New York State Dept. of Health
Licensee: NRD, LLC.
Region: 1
City: Grand Island   State: NY
County:
License #: NY C1391
Agreement: Y
Docket:
NRC Notified By: Nathaniel Kishbaugh
HQ OPS Officer: Ernest West
Notification Date: 10/18/2024
Notification Time: 21:03 [ET]
Event Date: 10/18/2024
Event Time: 12:00 [EDT]
Last Update Date: 10/18/2024
Emergency Class: Non Emergency
10 CFR Section:
Agreement State
Person (Organization):
Lally, Christopher (R1DO)
NMSS_EVENTS_NOTIFICATION (EMAIL)
Kevin Williams (NMSS)
Event Text
AGREEMENT STATE REPORT - CONTAMINATION EVENT WITH POSSIBLE OVEREXPOSURE

The following information was provided by the New York State Department of Health (NYSDOH) via phone:

On October 18, 2024, at 1800 EDT, NYSDOH was notified of a contamination event at NRD, LLC., in Grand Island, NY. A radiation worker performing waste packaging was contaminated at approximately 1200 EDT. The worker was decontaminated, but was found to have 2000 counts per minutes (cpm) on a nasal swab. Due to similar events at this location, the worker is suspected of exceeding 50 rem limit to the bone surfaces of their face. The Radiation Emergency Assistance Center Training Site (REAC/TS) was called for assistance. The worker was sent to a local hospital where chelating agents will be administered. The primary radioisotope of concern is Am-241. Po-210 and Ni-63 are a secondary concern. There is no indication of spread of contamination and no members of the public were exposed.

NYSDOH will perform an immediate reactive inspection.

* * * UPDATE ON 10/19/2024 AT 1240 EDT FROM NATHANIEL KISHBAUGH TO ERNEST WEST * * *

The following information was provided by the New York State Department of Health (NYSDOH) via email:

"On Friday, October 18, 2024, at approximately 1730 EDT, the NYSDOH received a call from the radiation safety officer (RSO) of NRD, LLC (license number C1391) providing information that a worker at NRD was packaging waste within a `buffer area' at their facility and was subsequently contaminated with suspected Am-241 waste. This event allegedly occurred at approximately 1200 EDT that same day. The exact [contamination] activities of the worker and the cause of contamination are unknown at this time. Based on information provided by NRD, LLC, it does appear that the extent of contamination was localized to the buffer area and that the affected individual (hereafter [referred to as] `Worker 1') was the only individual working in this area and [the only person who] received any contamination from this event.

"The circumstances in which Worker 1 identified that they had been contaminated is unknown at this time. Once Worker 1 identified that they had been contaminated, a whole-body frisk was performed. Measurements ranged from 23 [disintegrations per minute] (dpm) to 1734 dpm. The individual received removable contamination surveys on several different locations on their body, ranging from 7 dpm/100 square centimeters to 2196.80 dpm/100 square centimeters. Contamination levels on this individual were highest on the individual's left hand and arm (1734 dpm total contamination on the arm and 2196.80 dpm/100 square centimeters removable contamination on the hand). Contamination was highest in the following areas: left arm and hand, both feet, shoulders, right arm, and head.

"Initial nasal swabs were performed and indicated that Worker 1 had 705.29 dpm of Am-241 in one nostril and 1304.23 dpm in the other nostril (combined for 2009.52 dpm). This exceeded the immediate notification threshold required by NRD, LLC's License (C1391) Condition Number 28.B. [333 dpm]. In accordance with [National Council on Radiation Protection and Measurements] Report 161, this amount of Am-241 within the nostrils could constitute an intake exceeding the occupational dose limits prescribed by 10 [New York Codes, Rules and Regulations (NYCRR)] 16.6. It is estimated that this dose may be approximately 151 rem committed dose equivalent (CDE) to the bone surfaces and 9 rem committed effective dose equivalent (CEDE). These dose estimates should not be regarded as the official dose of record as they aim to provide a rough estimate to initiate non-routine bioassays and seek clinical guidance from REAC/TS.

"NRD, LLC, immediately decontaminated Worker 1 and resurveyed until all areas on the worker were indistinguishable from background. NRD, LLC also immediately placed Worker 1 on a 24-hour urinalysis collection. NRD then contacted REAC/TS and was informed that the amount of Am-241 located in the nostrils may suggest that Worker 1 was overexposed and should seek calcium-diethylenetriamine pentaacetate (Ca-DTPA) and zinc-DTPA (Zn-DTPA) treatments as soon as possible. Ca-DTPA and Zn-DTPA are chelating agents used to mitigate the amount of Am-241 uptake in the bone surfaces of Worker 1. Following this information, NRD, LLC contacted NYSDOH for assistance.

"NYSDOH immediately contacted REAC/TS to corroborate the information provided and discuss clinical recommendations. The REAC/TS contact confirmed that one Ca-DTPA (aerosolized via nebulizer) dose was required for immediate administration that evening and up to five Zn-DTPA doses (intravenously administered) may be needed on subsequent days (1 dose per day). Dosage information for both types of DTPA were 1 gram per day. Following this, NYSDOH sourced doses of Ca-DTPA and Zn-DTPA and contacted the local hospital to coordinate the arrival of this patient and provide information for REAC/TS to assist with clinical guidance in administering these chelation medications.

"These doses were rush transported by New York State troopers at approximately 2130 [on October 18, 2024,] and arrived at the medical facility at 0100 on October 19, 2024. The doses were prepared and administered approximately 13.5 hours after the suspected intake occurred.

"The NRC [headquarters operations officer] was called at 2103 on October 18, 2024, to meet the reporting requirement for this event (4 hours post-notification) as this constituted a contamination event meeting the criteria in 10 CFR 30.50(a) and a potential overexposure under 10 CFR 20.2202. This report was filed under [Event Notification] 57391.

"Following this notification, NRD informed the Department that a survey was performed in adjacent areas to where this contamination event was thought to have occurred and contamination has been localized to the area where this individual was doing work. NRD is continuing surveys of areas throughout their facility to confirm that no contamination is present in any other areas. At this moment, NYSDOH Bureau of Environmental Radiation Protection (BERP) is planning a site visit to interview staff and perform independent characterization from the location where this contamination event occurred. Additional information is needed to determine the exact scope of this contamination event and independently validate the information provided by NRD, LLC.

"NYSDOH BERP is actively monitoring this event under Incident Number 1503. Additional information will be provided to [the NRC Nuclear Material Events Database (NMED)] once available."

Notified R1DO (Lally), NMSS (Williams), and NMSS Events Notification (email)


Fuel Cycle Facility
Event Number: 57400
Facility: American Centrifuge Plant
RX Type: Uranium Enrichment Facility
Comments:
Region: 2
City: Piketon   State: OH
County: Pike
License #: SNM-2011
Docket: 70-7004
NRC Notified By: Mike Leonhart
HQ OPS Officer: Natalie Starfish
Notification Date: 10/24/2024
Notification Time: 15:08 [ET]
Event Date: 10/28/2024
Event Time: 07:00 [EDT]
Last Update Date: 10/24/2024
Emergency Class: Non Emergency
10 CFR Section:
70.50(b)(2) - Safety Equipment Failure
Person (Organization):
Suber, Gregory (R2DO)
NMSS_EVENTS_NOTIFICATION (EMAIL)
Event Text
CRITICALITY ACCIDENT AND ALARM SYSTEM OUT OF SERVICE FOR TESTING

The following information was provided by the licensee via phone and email:

"The American Centrifuge Plant (ACP) Criticality Accident and Alarm System (CAAS) is designed to detect a nuclear criticality accident, and provide audible and visual alarms that alert personnel to evacuate the immediate area, as required by 10 CFR 70.24, criticality accident requirements.

"Periodic maintenance and testing, of the CAAS, is scheduled to commence on Monday, October 28, 2024, at approximately 0700 EDT. The maintenance and testing is expected to last approximately 48 hours and affect the X-3001, including the North area. The CAAS will be temporarily taken out of service and declared inoperable, to perform the periodic maintenance and testing in accordance with approved plant procedures.

"In accordance with License Application Section 5.4.4 compensatory measures will be implemented for the ACP. These measures include, but may not be limited to the following:
 Presence of essential personnel during the maintenance and testing activities;
 Evacuation of non-essential personnel from affected areas and the immediate evacuation zone prior to taking CAAS equipment out of service;
 Limiting access to the area by restricting material movements, including fissile material movement, while the CAAS is inoperable;
 Use of personal alarming dosimeters for personnel authorized to access the area during the CAAS outage;
 Compensatory measures will remain in place until CAAS coverage is verified to be operational and the CAAS is declared operable in accordance with approved plant procedures.

"American Centrifuge Operating, LLC (ACO) will notify the NRC when CAAS coverage is returned to normal operation.

"The licensee has notified the NRC Project Manager and Region II Senior Inspector.

"ACP condition notification number: 12198

"The Department of Energy has been notified."